Roig-Romero Regina M, Livingston Taylor A, Schafer Ellen J, Reyes Martinez Estefanny, Wachira Maret, Marhefka Stephanie
University of South Florida College of Public Health, Tampa, FL, USA.
School of Global Integrative Studies, University of Nebraska-Lincoln, Lincoln, NE, USA.
J Hum Lact. 2022 Aug;38(3):477-486. doi: 10.1177/08903344221097321. Epub 2022 May 19.
Ten years ago, the U.S. Surgeon General's made recommendations for childcare settings, including: (1) accommodating and supporting breastfeeding families; and (2) adopting national guidelines on breastfeeding support in childcare settings.
To (1) describe the existing breastfeeding friendly childcare designation programs in the United States; and (2) describe how states are accommodating breastfeeding families in childcare settings.
The study design was cross-sectional, prospective thematic description of existing publicly available documents. A search of state breastfeeding coalitions was conducted to assess the number of states with breastfeeding friendly childcare designation programs. A definitive yes-or-no answer regarding whether each state had a program was obtained from all 50 states. For states with programs, designation materials were analyzed using thematic analysis and the framework method to compare designation components.
Fifteen states had evidence of breastfeeding friendly childcare designation programs and similarities exist across designation program components. Four standards were common to all 15 programs: written policy on breastfeeding, suitable space within the center where mothers can breastfeed or express their milk, educational materials, and resources on breastfeeding available to parents. Most states required self-assessment to achieve designation status.
Research is needed to enable evidence-based programs and decision-making regarding components and processes. Federal funding should support these programs' mission, including funding research to assess how and in what circumstances these programs are improving breastfeeding-related outcomes and supporting breastfeeding families.
十年前，美国卫生局局长就儿童保育机构提出了一些建议，包括：（1）为母乳喂养家庭提供便利和支持；（2）采用儿童保育机构母乳喂养支持的国家指导方针。
（1）描述美国现有的支持母乳喂养的儿童保育机构认定项目；（2）描述各州在儿童保育机构中如何为母乳喂养家庭提供便利。
本研究设计为对现有公开可用文件进行横断面、前瞻性主题描述。对各州母乳喂养联盟进行搜索，以评估拥有支持母乳喂养的儿童保育机构认定项目的州的数量。从所有50个州获得关于每个州是否有该项目的明确的是或否的答案。对于有项目的州，使用主题分析和框架方法分析认定材料，以比较认定内容。
15个州有支持母乳喂养的儿童保育机构认定项目的证据，且认定项目内容存在相似之处。所有15个项目都有四个共同标准：关于母乳喂养的书面政策、中心内母亲可以进行母乳喂养或挤奶的合适空间、教育材料以及向家长提供的母乳喂养资源。大多数州要求进行自我评估以获得认定资格。
需要开展研究，以制定基于证据的项目，并就项目内容和流程进行决策。联邦资金应支持这些项目的使命，包括资助研究以评估这些项目如何以及在何种情况下改善与母乳喂养相关的结果并支持母乳喂养家庭。
