Abstract
Purpose
Breastfeeding and responsive feeding are important practices that support the health of infants and women. In the United States, breastfeeding continuation rates remain lower than recommended, and working women face additional challenges with breastfeeding continuation. Providers in a family child care setting are uniquely positioned to support and provide important resources to families in their breastfeeding and infant feeding practices.
Methods
The Go NAP SACC program was designed to improve the nutrition and physical activity environments and practices in child care settings serving infants and young children. This evaluation focuses on Breastfeeding and Infant Feeding in Nebraska Family Child Care Homes (FCCH).
Assessment
Paired-sample t-tests were used to examine differences in pre-post evaluation scores. A repeated measure ANCOVA was used to examine differences between rural–urban settings. Nebraska FCCH met recommendations at pre-test, and exceeded recommendations at post-test (p < .05). Rural and urban FCCH performed equally well in 18 of 22 items, indicating little difference in the ability to provide supportive environments and adhere to best practices in both settings. Improvement in family engagement items were significant at the p < .001 level. Family engagement in FCCH is an important area for intervention that was well-received by provider participants.
Conclusion
This evaluation shows that the Go NAP SACC program improves breastfeeding and infant feeding environments and practices in rural and urban FCCH. Interventions should continue to focus on basic and practical education and professional development for FCCH providers, with emphasis on intentional family engagement and support.
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Acknowledgements
The authors would like to thank the child care providers, trainers, and partner agencies for their participation and support of Go NAP SACC. Additionally, we would like to thank Nebraska Step Up to Quality for their supportive efforts. This project was supported by the Cooperative Agreement Number NU58DP004819, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. This work was also supported by a Nebraska Department of Health and Human Services Child Care and Development Fund, USDA Nebraska Team Nutrition, and a Title V Maternal and Child Health Block Grant. Finally, we would like to acknowledge members of the Steering Committee who provided feedback for the final manuscript.
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Kohel, K., Hatton-Bowers, H., Williams, N. et al. Improving Breastfeeding Environments and Feeding Practices in Family Child Care Homes with the Go NAP SACC Program. Matern Child Health J 25, 510–520 (2021). https://doi.org/10.1007/s10995-020-03075-2
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DOI: https://doi.org/10.1007/s10995-020-03075-2