More mothers are returning to work shortly after their children are born. Many of these mothers may have just begun to breast-feed their baby. It is sad to see a new mother stop breast feeding before she or her baby is ready. But, because the hardest child care placements are for infants, parents may feel pressured into making the choice to abandon breast feeding. You can promote and help parents to advocate breast feeding.

For baby:

Breast feeding gives nutrients which match perfectly with what a baby needs. Breast milk is easily digested. It also offers protection from disease, because immunities are passed from the mother to the baby, and "bad" bacteria do not multiply while "good" bacteria do. One valuable consequence is a reduced risk of spreading illness to other children in your care.

Breast feeding can be an important factor in an infant bonding with its mother. Breast feeding has been linked with a lower incidence of SIDS (Sudden Infant Death Syndrome), ear infections, diarrhea, and allergies. Lastly, breast feeding promotes healthy jaw and tooth alignment.

For mother:

Breast feeding offers a convenient, low cost feeding option. There are also indications that it may help prevent breast cancer.

Breast feeding also appears to facilitate the return of the uterus to its pre-pregnancy condition. In addition, breast feeding can help with weight loss, because many calories are burned during the process.

For child care providers:

Encouraging breast feeding can result in healthier children in your care. Also, the use of breast milk can make for a more content baby.

In terms of the business of child care, if you encourage breast feeding that fact can be used as a good marketing tool. You may be able to increase your client base by advertising that you do support breast-feeding moms.

For mothers:

With breast feeding, a mother will no longer be able to feed her baby by demand, because her baby must is on its own schedule. In-person breast feeding also calls for the mother to be present. However, it may not be possible for her to visit her baby throughout the day.

A regular program of breast feeding calls for extra work in cooperating with the child care provider On the home front, a breast-feeding mother may often face a lack of support from family members. And when time is at a premium, breast feeding takes longer than bottle feeding.

For child care providers:

If you support breast feeding moms, you will need to be flexible and recognize that nursing babies do interrupt your routine, including properly storing and caring for the breast milk. Another disadvantage involved the Child and Adult Care Food Program. There is no financial incentive from the program when breast milk is served alone. Lastly, breast feeding calls for a closer relationship to be formed with the nursing mother.

Disadvantages Are Challenges to Overcome

But be sure not to let the disadvantages of breast feeding overshadow the opportunities. As a child care provider, if you have openings for infants and receive a new one into your home, here is how to help:

A close relationship must form between parents and the provider. Good, constant communication is a must. Consider using a checklist of good questions and suggestions when you and a mother consider breast feeding as a part of your day care. You can prevent problems by asking in advance:

• "Do you want to express milk and bring it frozen for me to store?"

• "Do you want me to use supplemental formula?"

• "If you are coming into my home to breast feed, will you be within 15 minutes of the allotted schedule?"

• "I will provide a quiet place for you to nurse. Please use the (back, front, or side) door and let yourself in."

Being extra supportive to moms with nursing infants means that baby will get the best nutrition in the first year.

Fresh milk should always be stored in plastic containers since some of the white cells (called leukocytes) may adhere to glass. This is especially important for a premature or sick baby. Since leukocytes are destroyed by freezing or heating, either glass or plastic containers can be used if the milk will be frozen or heat-treated.

If using plastic bottle bags such as Playtex or Gerber, always double-bag to protect from any punctures or splitting. It may also help to stand the bags upright in another storage container. (Ameda/Egnell makes freezer bags with a layer of plastic and a layer of nylon to prevent contamination of milk from punctures.)

Freeze milk in small quantities (1 to 2 oz.) to minimize waste and for easier thawing. Cool all freshly expressed milk in the refrigerator before adding to a container of frozen milk.

Label containers with the date and time pumped. Add the baby's name if taking milk to a day care center, hospital, or other facility away from home.

How does a parent decide how much breast milk should be left with you for their child? To help calculate how much milk to leave for feedings in the mother's absence, the following formula may be helpful:

• A baby will usually consume approximately 2 1/2 ounces of milk per pound of body weight in a 24-hour period.

• For example, a 12 pound baby will need a total of about 30 oz. of milk in a 24-hour period, which equals about 3 to 3 3/4 oz. per feeding for 8 to 10 feedings.

Do...

• Thaw frozen milk in its container under cool running water, gradually adding warmer water until the milk is thawed. Milk need not be at body temperature to feed the baby. Room temperature is adequate.

• Gently shake the container of thawed milk before feeding to the baby in order to mix the layers which have separated.

Do Not...

• Defrost breast milk under hot running water or in boiling water.

• Defrost milk in the microwave. Uneven heating patterns may alter the composition of the milk and can create "hot spots" that may burn the baby's mouth.

Freshly Expressed Milk (in sealed container)

Freezer:

2 weeks in freezer compartment located inside refrigerator

3 to 4 months in separate door refrigerator/freezer

6 months or longer in deep freezer (0 degrees F or less)

Refrigerator:

5 days (mature milk)

Room Temperature:

12 to 24 hours (colostrum)

6 to 10 hours (mature milk)

Frozen Milk (thaw in refrigerator or under running water)

Freezer:

Do not refreeze

Refrigerator:

24 hours

Room Temperature:

1 hour

"One baby just refuses to take a bottle of breast milk while he is in my care."

Experiment with different nipples. Try holding the baby in a different position while you feed him. Be patient! It may take extra time for this baby to adjust to the bottle-feeding.

"One mother is not providing adequate breast milk for the time her baby is with me."

Discuss this with the mother, and explain the baby's needs during the day. Encourage her to express more milk. And you can discuss supplemental formulas with her.

"A mother is having difficulty with the mechanics of breast feeding."

Put her in touch with someone who is experienced and supportive. Make sure she has access to pamphlets and literature on breast feeding. Supply the phone number of a LaLeche League in the area. Offer your continued support.

"The baby appears hungry just prior to mom's anticipated arrival."

Postpone feeding, if at all possible. Offer a pacifier. Walk with the baby. Offer a small amount of sterile water.

"Mom comes during the day to nurse the baby. This is disruptive to the our care routine."

Prepare a quiet space of mom and baby to be alone. Allow siblings to visit mom and the baby in this "Nursing Nook." Work with the mother to establish a routine for her coming and going.

"Mom has limited time to come into my day care home for her nursing break. Stress and time pressures make the nursing difficult."

Again, provide a quiet, private place. Encourage the mother to relax. Provide a comfortable chair, soft music, and perhaps even some fruit juice. Discuss with the mother whether or not it might be less stressful to substitute a bottle-feeding.

"One mother's work schedule varies from day to day. This messes up my planning."

Communication is the key! Help this mother set up a good schedule for her breastfeeding. Encourage her to work within that schedule. Have the mom write down her expected pick-up time for the baby at the time she drops off the child at your home.

From the April, 1994, issue of The Teddy Bear.