Your Guide to Child Health and Nutrition

EDITIONNUTRITION

Supporting Breastfeeding Mothers in Child Care

I Want to Grow Up Healthy and Active Recipes Creative Gardening Activity Food FunnyINSIDE:

Friday, May 10th is Child Care Provider Appreciation Day! It is a great time to give special recognition and thanks for the tireless efforts of all those who care for children.

The American Academy of Pediatrics recommends that women breastfeed their babies exclusively for about six months, and for one year or longer with complementary foods.

Despite current breastfeeding rec-ommendations only 25.5 percent of infants in the United States are breastfed for 12 months.

The Affordable Care Act requires most employers to provide unpaid time for a mother to express milk and a private and clean space to do so.

Sources: www.providerappreciationday.org, American Academy of Pediatrics

Quotable Quotes

“ Fish is the only food that is considered spoiled once it smells like what it is.”

— P.J. O’Rourke

There is now no doubt that breast milk provides unsurpassed nutrition and disease protection for a develop-ing infant. Studies have shown that breastfed infants are healthier, less likely to develop chronic condi-tions such as obesity and diabetes and possibly do better in school. However, one third of mothers return to work within 3 months after giving birth and two-thirds return within 6 months. Childcare

providers can support breastfeeding by having a comfortable place for mothers to breastfeed their infant when dropping off, picking up and/or at the lunch hour. Providers and mothers feel comfortable when proper storage and handling of breast milk is understood and there is good communication about baby’s feeding schedule. In addition, using good feeding techniques will minimize “nipple confusion”, help baby adjust back and forth from breast to bottle and reduce the risks for promotion of over consumption associated with bottle-feeding. Over consumption may be one of the mechanisms that leads to increased risk of obesity seen in formula fed infants.

The following guidelines for bottle-feeding infants are suggested whether feeding breast milk or formula:

• Babiesshouldbebottle-fedwhentheir cues indicate hunger, rather than on a schedule.

• Holdtheinfantinaslightlyupright position. Avoid letting the baby drink lying down which is

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Nutrition Edition, Issue 24 www.CCFPRoundtable.org

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associated with dental caries and increased frequency of ear infections.

• Chooseaslowflowbottlenippleandoffer3to5ouncesfor infants less than 6 months.

• Mimictheusualbreastfeedingexperiencebyfeedingslowly over 10 to 20 minutes so that the infant has time to feel his tummy is full before it is overfilled.

• Gentlyallowtheinfanttodrawthenippleintohisorhermouth rather than pushing the nipple into the infant’s mouth, so that the baby controls when the feeding begins. Stroke the baby’s lips from the top to bottom with the nipple to illicit a rooting response of a wide open mouth, and then allow the baby to “accept” the nipple.

• Allowfrequentpausestomimicbreastfeedingandreducenipple “confusion.”

• Donoturgethebabytofinishthebottlebyforcingthenipple into the mouth, massaging the jaw or throat or rattling the nipple around in the infant’s mouth.

• Ifthebabyisroutinelyleavingextrabreastmilk,askthemother to store breast milk in smaller quantities. The amount of formula prepared can also be adjusted to fit the infants’ intake, 1 to 4 ounces.

• Iftheinfantdoesnotfinishthebottle,discardtheremainder. If the infant finishes and is still hungry, offer more.

Benefits of feeding in this manner:• Promotesconsumptionofappropriatevolume• Minimizescolic-likesymptomsfromdistendedstomach

and over feeding• Supportsthebreastfeedingrelationshipleadingtolonger

duration of breastfeeding

Handling and storing breast milkBreastmilkcanbestoredinglass,plasticcontainersorstorage bags made for breast milk. Containers with breast milk need to be tightly sealed and labeled with the child’s name and the date. Use refrigerated bottles of fresh breast milkwithin48hours.Breastmilkcanbestoredfrozen.Keep milk well frozen in the back of the freezer if you don’t plan to use within two days. Rotate frozen milk, using older milkfirst.Breastmilkcanbestoredina0°Ffreezerfor3to

6months.Breastmilkmayseparateintolayers.Swirlgentlybefore feeding, do not shake.

Defrosting milkBabiesmaydrinkmilkcool,atroomtemperatureorwarmed. Do not thaw breast milk at room temperature. Thaw milk overnight in the refrigerator or hold the container under warm running water to quickly thaw. You may place a sealed container in a bowl of warm water for 20 minutes. The “warm” water used to thaw breast milk should notexceed98.6°F.Excessiveheatdestroysinfectionfightingproperties of milk. Thawed milk is safe in the refrigerator for 24 hours. Do not refreeze. Never microwave breast milk or formula. This can lead to severe burns.

Nipples that may minimize “Nipple Confusion”Nipple confusion is when babies have trouble breastfeeding after using artificial nipples, because these two methods of feeding require different mouth and tongue motions and swallowing skills. Nipple confusion may also result fromtheinfant’slearnedpreferenceforafasterflowofmilk. The following recommendations are from Diana West,InternationalBoardCertifiedLactationConsultant(IBCLC),RegisteredLactationConsultant(RLC):

No artificial nipple is like a human breast, however, ultrasound studies suggest that perfectly round nipples, with a broad base, best facilitate tongue and jaw motion most similar to suckling at the breast. For newborns use a slowflownipple.Silicone,ratherthanlatex,ispreferredtoreduce risk of allergy.

CommunicationGoodcommunicationbetweenmothersandchildcareproviders will help working moms continue to breastfeed longer. Each day, the parent should let the provider know the time of the last feeding before drop-off. Also, let the provider know if mom will be coming at lunch time or arriving early to pick-up. If the infant is hungry, and mom will be arriving soon, give a small amount to hold him/her over until mom arrives to breastfeed.

For further information on breastfeeding visit www.kellymom.com

— Nancy Busby Hill, MS, RD, IBCLC

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Supporting Breastfeeding Mothers in Child Care— Continued from front page

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Activity Corner

Food Funny

Q: What kind of cup can’t hold water?

A: A cupcake!

Creative Gardening

There’s no denying that most kids love playing in the dirt. Plant fast germi-nating seeds such as corn, radishes, watermelon, lettuce or sugar snap peas. Plant in moist soil in yogurt cups or egg cartons, and place in a warm sunny place inside.

Pizza patchCreate a circular plot and divide it into triangular sections. In each section place seedlings of a different pizza ingredient such as tomatoes, garlic, onions, oregano, basil or bell peppers.

Garden tee-pee Place tall poles in the ground and angle them toward the center tying them to form a tee-pee. Tie a few tiers of string around the poles horizontally, leaving an open “door”. Plant pole beans on the outside rim of the tee-pee; train them to grow up the poles and string. Keep the “door” clear for little bodies to crawl in and out.

Sunflower housesTallsunflowersgrowninasquareforma “house’ in which children can play.

Spinach and Strawberry Salad

Spinach, rinsed and torn into pieces ........ 2 bunchesStrawberries, rinsed and sliced ................. 4 cupsVegetable oil ................................................. ½ cupWhite vinegar .............................................. ¼ cupSugar ............................................................. ½ cupPaprika .......................................................... ¼ tspSesame seeds ................................................ 2 TbspPoppy seeds .................................................. 1 Tbsp1. In a large bowl, toss together spinach and strawberries.2. In a medium bowl, whisk together the oil, vinegar, sugar, paprika,

sesame seeds and poppy seeds. Pour over the spinach and strawberries and toss to coat.

Yield: 16 servingsMeetsrequirementforfruit/vegetable — allrecipes.com

Cinco de Mayo Chicken Casserole

Chicken breast, boneless, skinless ............ 12 ouncesTaco seasoning ............................................. 1 tspRed bell pepper, seeded and chopped ...... 1Salsa, prepared ............................................ 1½ cupsCream cheese ............................................... 2 ouncesBlack beans, drained and rinsed ............... 1 (15 ounce) canTomato, chopped ......................................... 1Tortillas, whole wheat ................................ 2Cheese, shredded ........................................ ½ cup1. Preheatovento375°F.Cutchickenintobitesizepieces.Mistalarge

nonstick skillet with cooking spray and warm over medium heat. Add chicken and taco seasoning and cook stirring until lightly browned.

2. Add bell pepper and continue cooking for 2 minutes. Stir in salsa and cook 2 minutes. Stir in cream cheese and continue cooking until well blended, about 2 minutes. Stir in beans and tomato.

3. Spoon1/3ofthechickenmixtureintoan8inchbakingdish.Coverwithonetortilla,thentopwith½cheeseand1/3ofthechickenmixture.Topwithremainingtortillaandchickenmixture.

4. Cover and bake until heated through, about 20 minutes. Uncover andsprinklewithremainingcheese.Bakeuncovereduntilcheesehasmelted,about5minuteslonger.

Yield: 6 servingsMeetsrequirementforfruit/vegetableandprotein/meatalternate —www.allyou.com

and is produced by:Contra Costa Child Care Council

Child Health & Nutrition ProgramPhone: (925) 676-6117 Fax: (925) 676-5829

E-Mail: nutrition@cocokids.orgWebsite: www.CoCoKids.org

Program Director ................................... Paula JamesCo-Editor .......................................... Donna Green, rdCo-Editor ...................................... Catherine Stafford

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