That did not sit well with Carla, a public health nutritionist for the Child and Adult Care Food Program (CACFP) within the New York State Department of Health. She was determined to find a way to support breastfeeding mothers whose children attended child care centers. So Carla and a colleague brainstormed possibilities. They had no money to offer, and no staff. What they could do was offer the child care centers that encouraged breastfeeding a special designation—a title that would signify their support for nursing mothers. It was 2005, and New York became the first state to offer a breastfeeding-friendly child care designation for centers.
Five years later, the program was broadened to include family day care home providers. Today, 20 percent—or 360 of New York’s 1,800 licensed child care centers—are designated breastfeeding-friendly. So are 17 percent of licensed family day care homes (1,547 out of a total of 9,100).
To earn the designation, centers and homes must fill out a self-assessment form. The form for centers and the one for family day care homes each contain six standards related to breastfeeding (e.g., ‘Our center trains all staff so they are able to support breastfeeding families,’ or ‘My day care home is a place where breastfeeding families are welcome’). A day care home must meet all six of its standards to earn the designation. A center must meet all six of its standards, plus send a copy of its breastfeeding policy to the CACFP office, before it is approved. In return, designated centers/homes can be listed as breastfeeding friendly on the CACFP website. They can also use the designation in their own marketing efforts.
Carla is now the statewide coordinator for the breastfeeding friendly designation. There is still no official budget, but the CACFP office allows Carla to spend 50 percent of her time on the program. There are also four other CACFP dietitians across the state who participate in a workgroup with the goal of expanding the designation program to additional child care centers and family day care homes.
When asked, Carla identifies two top moments from her work over the last 12 years. One is when she learned that one designated child care center offers reduced tuition to breastfeeding families. The other is the news about another center that offers free lunches to mothers who come in to breastfeed. “That’s really getting it,” she says. “How much more supportive can you be than feeding someone who’s coming in to feed her child?”
Carla sees plenty still to be done. She would like her position as statewide coordinator to become full-time. She thinks the online trainings about the certification program need to be more robust so they can reach more providers. She’d like the state licensing agency to indicate on its website whether a child care program is breastfeeding friendly or not. And she wants to find a way to connect providers who are designated. According to Carla, “What I’ve not accomplished and wanted to, is develop a forum for centers to use to communicate with one another.”