Child Care Licensing
Supporting breastfeeding mothers and infants

Mothers may wish to continue breastfeeding while their babies are in your care. They may choose to adjust their work schedules so they can come and nurse the baby. They may collect and store breast milk for you to use while they are away, or they may have you feed the baby formula during the day, but continue nursing at home. The following information about breastfeeding babies can help you and your staff be better informed and support nursing mothers and their babies.

Supporting nursing moms
Breastfeeding is an important way for mothers to bond with their babies. It also offers important advantages for babies. Breastfed babies usually are sick less often, spit up less, have less constipation, and have less odor in their stools.

Create a quiet, comfortable space for nursing mothers in your child care program. Some mothers may come to nurse their babies at mealtime. They also may wish to nurse their babies before they go home. Some breastfeeding mothers may feel comfortable nursing the baby while visiting with you and the other children. Others may prefer a quiet corner or another room. Work to maximize the mother’s commitment to providing the best for her baby. A restroom is not an appropriate place for a mother to nurse.

Other ways you and your staff may create a friendly breastfeeding environment:
Display posters and pictures that support breastfeeding including “Breastfeeding is welcome here” messages.
When giving tours of your program, point out supports for breastfeeding, such as a comfortable area for nursing and refrigerator space for storing milk.
Provide information about local and state resources.
Provide training to your staff in handling breast milk.

Preparing and storing breast milk
Breast milk does not look like cow’s milk or formula. In spite of its thin appearance and bluish color, breast milk is rich and nutritious. Thawed milk often has small pieces of fat floating in it that makes it look curdled. Warming and gently swirling (instead of shaking) the breast milk will help fat dissolve.

Containers of breast milk need to be labeled with the date it was expressed along with the child’s first and last names.

When preparing to feed an infant, wash your hands before handling the breast milk. Although breast milk is a body fluid, it is not necessary to wear gloves when feeding or handling it.

Frozen breast milk may be thawed in the refrigerator or by placing it in a bowl of warm water. Do not use a microwave oven to thaw or warm the milk because microwave ovens do not heat liquids evenly and excessive heat may destroy key nutrients. Gently shake or swirl the container of breast milk and test the temperature before feeding.

Feeding breastfed babies
Follow the written feeding instructions provided by the infant’s parent or health care professional. Breast milk is digested more quickly than formula, so breastfed babies may get hungry more often. Breastfed babies may eat smaller amounts at each feeding than babies who are fed formula. An older baby that is developmentally ready to feed herself may drink from a sippy cup with a narrow plastic spout on the lid.

Watch for hunger cues, and feed the infant in a way that mimics breastfeeding. Hold the infant in an upright position, supporting the head and neck with the hand. Use a slow flow nipple and keep the nipple full of milk. Gently brush the nipple on the infant’s lips and allow him to draw the nipple in. Feed slowly and stop feeding when the baby releases the nipple or shows other signs of fullness.

Frequent, loose daily stools are normal for breastfed babies in the first two months. Stools may look like cottage cheese and mustard. Watch for six to eight wet diapers during the day. This indicates that the baby is getting enough food.

Additional resources on breastfeeding
Texas Department of State Health Services, www.dshs.state.tx.us/wichd/bf/bf1.shtm. The health department has information on local resources, downloadable posters, and a training module you can use with your staff.
Texas A&M AgriLife Extension, Supporting breastfeeding in the child care setting (training). http://extensiononline.tamu.edu/courses/child_care.php.
U.S. Centers for Disease Control, www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm.
U.S. Centers for Disease Control in cooperation with Nemours. Let’s move child care. www.healthykidshealthyfuture.org/home/nutrition/infantfeeding.html.