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Lactation Friendly Child Care

April 2025

CDPHE accessibility statement

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Why Support Lactation?

Breastfed infants are sick less often

Fewer colds and ear infections, less diarrhea
Protects against SUIDS/SIDS

Breast milk is easier for infants to digest

Spit up less and have less smelly diapers compared to formula-fed infants

Financial benefit in CACFP

Claim breast milk fed meals in the CACFP, whether fed with bottle or by parent on site

Breast milk is the normal nutrition and first food for infants. All major medical organizations promote breast milk feeding as the best support for health and development, and recommend doing so for as long as both mom and child are able and want to continue. Child care providers play an important role in supporting lactation.

You may have heard some of the health benefits for infants when they are fed breast milk, such as protecting them against Sudden Infant Death Syndrome or SIDS. Did you also know that breast milk is easier for infants to digest? As a result, they tend to spit up less than infants eating commercial infant formula.

Another important benefit for child care providers is financial. Those participating in the Child and Adult Care Food Program (CACFP), can claim reimbursement for meals where an infant is fed expressed breast milk or when the parent directly breastfeeds their infant on site.

So, what do you have to do to provide support for families who choose breastfeeding?

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Support Lactation by Following Best Practices:

Commitment
Education and Training
Environment
Communication

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1. Commitment

Clearly written policy supporting lactation for both families and staff
Accurate printed materials
Staff are given appropriate breaks to express milk/nurse
Exclusively breastfed infants are fed only breastmilk during the first 6 months

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Lactation Policy

A comprehensive policy should include:

Supportive environment
Initial contact
Feeding and handling breastmilk
Staff training

Many child care providers recognize the importance of having policies as a tool for educating teachers, staff, and families about how the program operates and what is expected. Without a policy stating expectations for all, families could be subject to the level of lactation support of individual teachers or staff members and staff to the level of support and understanding of their supervisor. Sometimes that support can be subjective or biased.

A lactation support policy, like any policy, ensures that every family and employee knows and understands their rights, their roles and their responsibilities. The policy also ensures every employee and family has access to the benefits of the lactation support provided.

Many of these important policy topics can be added into the parent handbook. Some may fit better in the staff handbook or human resources manual. As long as the topics are covered, they can be located in different places and the program is still meeting the best practice.

Sample policies are available in the Breastfeeding in Child Care Toolkits linked in the resources and references at the end of the module.

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2. Education and Training

For Staff/Teachers

Staff training offered regularly
Important topics to cover:

Benefits to parent and infant
Promoting lactation and supporting parents
Proper storage and handling of breastmilk
Bottle feeding a breastfed infant
Reference materials
Community resources
Policy and practice at child care programs

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2. Education and Training

For Families

Prospective families are told about lactation policy and practice
Enrolled families are regularly offered education

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3. Environment

Clean, designated area for staff, families, and visitors to nurse/express milk
Always enough refrigerator and freezer space for breast milk storage
Elements in the physical space promote lactation (no materials from formula companies)

Create a culture and environment at the program that is openly supportive of breastfeeding. The Breastfeeding environment includes these three elements.

�Space is critical for parents, staff and visitors who are lactating. As an employer, child care providers are required by Colorado and US laws to provide employees a space for expressing milk or feeding their infant while at work. A clean, designated space should always be available, even if the space is shared for other activities. The space also needs to be private so no one can walk in, it needs an electrical outlet to plug in a breast pump, it should have a comfortable seat, and there should be a sink with running water in it or nearby.

Refrigerator and freezer space for storing expressed milk should always be available. If there isn’t adequate refrigerator or freezer space to store breast milk, it can’t be fed to the infant safely.

Posters, children’s books and play materials that show breastfeeding in families that look like theirs or teach about lactation help all children and families normalize breastfeeding for current and future generations. No educational materials, posters or other products from commercial infant formula companies should be posted or shared with families. The education and freebies formula companies share always market their products. Even if they seem like they promote lactation, they are actually promoting their products. This can undermine a family's ability to meet their lactation goals.

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4. Communication

Written feeding plans
Feeding cues
No feeding in last 1 to 1.5 hours before pick up
Properly label, handle, and store breastmilk
Handouts and educational materials
Marketing Lactation Friendly Recognition

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Lactation-Friendly Child Care Recognition

Healthy Child Care Colorado

Complete application
Work with an Advisor
Submit county recognition certificate

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Resources and References�

Supporting Breastfeeding In Child Care: Colorado Shines PDIS www/coloradoshinespdis.com
Lactation-Friendly Child Care toolkits, resources, training and recognition: https://cdphe.colorado.gov/nutrition-services-menu/lactation-friendly-child-care
Lactation Friendly Child Care Recognition: healthychildcareco.org/programs/quality-initiatives/lactation-friendly-child-care/
American Academy of Pediatrics Policy Statement: Breastfeeding and the Use of Human Milk: https://doi.org/10.1542/peds.2022-057988
Continuity of Care in Breastfeeding Support Blueprint: https://www.breastfeedingcontinuityofcare.org
Caring for Our Children National Standards: https://nrckids.org/CFOC
USDA, Food and Nutrition Service. Breastfed Babies Welcome Here. Tools for CACFP providers: https://www.fns.usda.gov/tn/breastfed-babies-welcome-here

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Thank you

Made possible with funding from the Centers for Disease Control and Prevention