Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
Prev Med. 2017 Dec;105:232-236. doi: 10.1016/j.ypmed.2017.09.026. Epub 2017 Sep 28.
Most women in the US are not meeting the recommendation of exclusively breastfeeding their infants for the first 6months of life. The child care environment can be especially influential in a mother's ability to continue breastfeeding after returning to employment. For this study, we reviewed child care regulations related to breastfeeding for centers and homes in all 50 states and the District of Colombia in late 2016, and compared them to 5 national standards. We coded regulations as either not meeting, partially meeting, or fully meeting each standard. We assessed correlations between number of regulations consistent with standards and 1) geographic census region and 2) last year of update. This study provides an update to a previous review conducted in 2012. No state met all 5 of the included standards, and only 2 states for centers and 1 state for homes at least partially met 4 of the 5 standards. More states had regulations consistent with standards encouraging general support for breastfeeding and requiring a designated place for mothers to breastfeed onsite. Number of regulations consistent with standards was associated with geographic census region, but not last year of update. States in the South had a greater number of regulations consistent with standards and states in the West had the fewest number of regulations consistent with standards. Overall support for breastfeeding at the state child care regulation level continues to be insufficient. States should improve child care regulations to include greater support for breastfeeding in child care facilities.
大多数美国女性未能达到建议的在婴儿生命的头 6 个月内完全母乳喂养的要求。儿童保育环境对母亲在重返工作岗位后继续母乳喂养的能力具有特别大的影响。在这项研究中，我们在 2016 年底审查了全美 50 个州和哥伦比亚特区与中心和家庭相关的母乳喂养儿童保育法规，并将其与 5 项国家标准进行了比较。我们将法规编码为不符合、部分符合或完全符合每个标准。我们评估了与标准一致的法规数量与以下两者之间的相关性：1）地理普查区域，2）最近一次更新年份。这项研究对 2012 年进行的先前审查进行了更新。没有一个州完全符合包括的 5 项标准，只有 2 个州的中心和 1 个州的家庭至少部分符合 5 项标准中的 4 项。更多的州有与鼓励普遍支持母乳喂养并要求在现场为母亲提供母乳喂养场所的标准一致的法规。与标准一致的法规数量与地理普查区域相关，但与最近一次更新年份无关。南部各州有更多与标准一致的法规，而西部各州与标准一致的法规数量最少。州级儿童保育法规对母乳喂养的总体支持仍然不足。各州应改进儿童保育法规，在儿童保育设施中增加对母乳喂养的更大支持。
