N O R T H C A R O L I N A

CChildren grow like weeds! What afitting description of how quicklychildren grow and develop. During

these early years, children learn and absorban enormous amount of information aboutthemselves and their world. They establishhabits that can have a life long impact ontheir health and well-being. Child careproviders have the opportunity to promotechildren’s health and well being by offeringhealth education in child care. Parents canjoin in the fun by reinforcing the healthhabits at home.

Many health topics can be explored. Theyinclude personal hygiene, nutrition, safetyand first aid, and social/emotional health.Children can take better care of their bodieswhen they know how they work. As theylearn about germs and how they spread,children begin to understand why they washtheir hands before and after so many dailyroutines. Reviewing the safety rules aboutriding and running, reminds a child to putdown a stick before running across anoutdoor play area. Supporting social andemotional health and education promotesself confidence and a healthy self concept.

Simple strategies can be used to teachchildren about health and safety. Onestrategy is to integrate lessons into dailyroutines. While an older infant is being fed,the caregiver can talk about the food andhow it affects the child. “You like peaches.They make you smile. They give you energytoo. Eat them up!” The child learns a littleabout herself and about nutrition. Beforegoing outside to play, the provider can talkabout sun safety as he or she slatherssunscreen on toddlers’ arms. “On goes thelotion to protect our skin from the hot sun.”

Teachable moments occur spontaneouslyduring the course of the day. As a caregiverwashes and bandages a cut knee, he or shecan talk about blood, about how the skinheals, or about playground safety. When anew child cries because he misses his mother,the caregiver can give words to the child’s

feelings and help him cope with his sadness.“You feel sad when your mother leaves in themorning. Are you ready yet to read to yourfavorite teddy bear?”

Setting up the environment to reflect andsupport the health topic, exposes children tothe information in a variety of ways.Learning centers, toys and props, and visualdisplays can be set up so that children areable to explore the topic on their own and attheir own pace. If the subject is bones, aflexible plastic skeleton can be added to alearning center. Picture books about bonescan be included in the book corner. Childrencan measure their bones or count the boneson a skeleton’s leg. A stuffed animal or dollcan have a broken leg and need a cast.

Child care providers can have a profoundeffect upon the health of the young childrenin their care. They keep the environmenthealthy and safe and provide nutritiousfoods. By thoughtfully planning andimplementing health and safety education,they help children develop habits that willsupport their health and well beingthroughout their lives.

References:Copple C. and Bedekamp S. Basics of Developmentally

Appropriate Practice. Washington, DC: NationalAssociation for the Education of Young Children,

2006Smith C., Hendricks C., and Bennett B. Growing

Growing Strong; A whole Health Curriculm for YoungChildren. St. Paul: Redleaf Press, 1997

The NC Child Care Health and SafetyResource Center is a project of theDepartment of Maternal and ChildHealth, School of Public Health, TheUniversity of North Carolina at ChapelHill. Funding for the Resource Centeroriginates with the Maternal and Child Health Title V Block Grant ofUSDHHS’s Health Resources andServices Administration/Maternal andChild Health Bureau, awarded to theUniversity under a contract from theDivision of Public Health, NCDHHS.

The development, translating, printing,web posting and mailing of the Health andSafety Bulletin are supported by fundingfrom the Child Care and DevelopmentFund Block Grant of the Child CareBureau, Administration on Children and Families, USDHHS, through acontract between the Division of ChildDevelopment, NCDHHS, and theDepartment of Maternal and ChildHealth, School of Public Health, The University of North Carolina at Chapel Hill.

11 Hip, Hip Hooray! – I’mHealthy Today!

22--33 Planning Health and SaftyActivities

44 Children and Loss

55 Families and Health Habits

66 Routine Care: Anything But Basic

77 The Way I Feel

88 Ask the Resource Center

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CHILD CARE HEALTH AND SAFETY BULLETIN

NORTH CAROLINA CHILD CARE HEALTH AND SAFET Y RESOURCE CENTER

Hip Hip Hooray –I’m Healthy Today!

Health and safety covers a wide variety of topics. Caringfor Our Children’s National Standard 2.061 recommendsincluding the following list of topics as part of the dailyplanned program of activities.

• Body awareness

• Families (including cultural heritage)

• Personal/social skills

• Expression of feelings

• Self-esteem

• Nutrition

• Personal hygiene

• Safety

• First aid

• Physical health

• Hand washing

• Awareness of special needs

• Importance of rest and sleep

• Fitness

• Oral health

• Health risks of second hand smoke

• Taking medications

• Dialing 911 for emergencies

When child care providers plan howto incorporate health and safetyactivities into the day, they beginwith the goals. What do they wantthe children to learn from the activity? A provider maywant the children to understand that calcium buildsstrong bones and that milk is high in calcium. Thesesimple messages can be reinforced through a variety ofactivities that are appropriate for the developmental agesof the children. Activities can stretch children’s minds andstay within their ability to participate and understand.

22 • HEALTH AND SAFETY BULLETIN • AUGUST/SEPTEMBER 2006

Health and Safety for All Ages

InfantsKeep health and safety programsfor infants simple. A positiveattitude towards daily healthroutines is a good beginning to ahealthy life style. Daily routinesfill much of the day for infants.Caregivers can take advantage ofeach routine and create apleasant environment formealtimes, diapering, nappingand playing. Holding an infantduring bottle feeding makesmeals relaxing. Talking about thefood being served to an older infant makes mealtimes apleasure. An infant becomes familiar with nutrition words asthe provider names the foods being offered, and talks aboutthe different tastes.

Babies are naturally curious about their bodies. Providerscan take advantage of this interest by naming for the baby’sfeet, toes, hands, and fingers during diaper changes. Theycan play games like, “This little piggy went to market” or“Pat-a-cake“. They can help an infant ride a pretend bicycleby pumping their legs up and down. These body awarenessgames are fun for both babies and caregivers. Providerssupport learning to crawl when they provide plenty oftummy time while infants play indoors and outdoors. This

relaxed playful approach to health and safety education iseasy to weave into the infant’s daily routines.

ToddlersToddlers are gaining control over their bodies anddiscovering who they are. They are experiencing the worldthrough their senses and learning by trial and error. Healthand safety goals for toddlers should focus on supportingtheir body awareness, the senses and their beginning selfcare skills. As with infants, routines are ideal times forproviders and toddlers to do one-on-one health activities.They can learn to help get themselves dressed and washtheir hands after a diaper change. They can feed themselvesor help with their feeding. They can get out their toys andhelp put them away. Toddlers will need to practice theseskills over and over again. Providers can make the learningand practicing fun and rewarding.

Toddlers are discovering what they like. Providers can givetoddlers the words for their behaviors, feelings andpreferences. “You really loved apple slices. Smell thepeaches. Yum! Let’s see if you will like peach slices too.Peaches give you energy and you love to run!” “You lookmad. You don’t want me to turn off the water. It is time toturn off the water. Your hands are all clean. Dry them off.”After handwashing, the provider can smell the child’s hands,“Your hands are so clean….they smell just like roses!”

Toddlers are natural explorers. They will need boundaries toallow them. Age appropriate materials and equipment

Planning Health

References:American Academy of Pediatrics and the National Resource Center for

Health and Safety in Child Care. Caring for Our Children, National Health andSafety Performance Standards: Guidelines for Out-Of-Home Child Care Programs. 2002

Copple C. and Bredekamp S. Basics of Developmentally Appropriate Practice, AnIntroduction for Teachers of Children 3-6. Washington DC:NAEYC; 2006

Cryer D., Harms T., Bourland B. Active Learning Series. Parsippany: DaleSeymour Publications; 1987

AUGUST/SEPTEMBER 2006 • HEALTH AND SAFETY BULLETIN • 33

Some children, like adults, learn best by doing, some byhearing, some by seeing. All benefit from learning that isreinforced by all those approaches. When children hearabout milk and calcium and then a milk carton is placedin housekeeping children can use their knowledge. Theycan serve milk to their dolls so their bones will be strong.When milk is served at lunch, providers can talk aboutwhere milk comes from, what it tastes like, what it doesfor the body, where children who are allergic to milk gettheir calcium. These activities become a part of the dayand providers often find opportunities to remind childrenwhat they learned throughout the year. At the end ofparticularly active day a provider might say, “Our bonesworked hard today! Good thing we got our calciumtoday!”

Whenever there is a goal there must be a way to see ifthe goal was met. The provider should know if thechildren have understood the lesson. Observation mayprovide that information. When listening to the children

a provider might hear a child say to a friend, "Drink youmilk. You want your bones to be strong." This lets themknow that the child understood the message. Anotherway to find out is to casually ask each child questions,such as, “What makes your bones strong?” or “Whatfoods have the most calcium?” Questions for childrenshould be asked informally, as a natural part of the day.Young children do not need to be tested. They shouldfeel confident about their learning and have the timethey need to process skills and knowledge. If children donot know the answers to questions, provide the answers.Returning to the simple messages throughout the yeargives young children opportunities to learn more or feelreally proud that they have already learned theinformation.

should providechallenges withouthazards. Toddlersneed constantsupervision so theycan be redirectedwith actions andwords to moreappropriate play ifnecessary. They arejust beginning to

learn that some things are not safe to do. A trusted adult isoften the champion of their safety. “Hot. Don’t touch!Let’s cool off the slide with water. Then we can slide.”Weaving lessons into the daily routine makes healtheducation a relaxed, natural learning experience fortoddlers.

PreschoolersPreschoolers are perfecting their self care skills. Providerscan create an environment and schedule that allowschildren to care for their needs as much as they are able.Morning snack can be accessible at a small table for aspecific time period. The children can learn to wash theirhands, serve their food, eat, clean up their dishes and washtheir hands before returning to play. They learn torecognize when they are hungry and how to satisfy thathunger. They learn that washing their hands before eatingprevents the germs that make people sick from spreading.

They are learning to be responsible for their own bodiesand their environment.

Preschoolers are developing intellectual, social andbehavioral skills. They are ready for planned structuredactivities that support their interests. The goal of healtheducation for preschoolers is to provide activities thatstimulate their interest. Follow the children’s lead if theywant to learn more about a topic. If a provider wants thechildren to understand pedestrian safety, his or her goalsmay be to have the children learn to look both waysbefore crossing the street and how to recognize when it issafe to cross at a traffic light. In the process children maybecome interested in maps, roads, vehicles or traffic rules.Be prepared to provide materials to support their interests.Vehicles, people and traffic signs in the block area allowchildren to build roads and set up traffic patterns for theplay people and vehicles to follow. Consider a walkingfield trip to the library. The children can practice lookingboth ways and crossing at a traffic light. Traffic signs onbike paths let the children practice obeying the signs.Safety rules helpyoung childrenlearn to guidetheir behavior.

and Safety Activities

Children and Loss

Though adults try to protectchildren from trauma, there aretimes when nothing can be done tostop a traumatic event fromhappening. Nothing can stop therain and high winds of a hurricane.Sometimes nothing more can bedone to stop a parent, sibling or petfrom dying. These kinds of eventscan leave children feeling sad andconfused. Children begin to processtheir experience of a difficult eventwhen they learn the words thatidentify and express their feelings.The following activities can helpchildren process their loss.

• Offer dramatic play indoors andoutdoors to help children workthrough their feelings andconcerns. As they recreate thedistressing event, they gaincontrol over their grief, anxietyand fear.

• Provide plenty of water and sandplay. They are soothing forchildren recovering from trauma.

• Have children bring in pictures ofloved ones. They can share storiesand talk about what they likedabout the person or pet.

• Plant seeds with the children andwatch them grow. Together, lookfor similarities between plants andpeople. Children learn that birth,growth and death are part of life.

• Read children’s books, such as TheFall of Freddie the Leaf, by LeoBascaglia. They are gentle ways tohelp children understand thatdeath is a natural part of life.

References:Age Related Reactions to a Traumatic Eventhttp://www.nctsn.org/nctsn_assets/pdfs/age_related_reactions.pdf

Smith C, Hendricks C, and Bennett B. Growing,Growing Strong; a Whole Health Curriculum for YoungChildren, 1997

Farish M. When Disaster Strikes. NAEYCWashington DC

44 • HEALTH AND SAFETY BULLETIN • AUGUST/SEPTEMBER 2006

AAuugguusstt iissChildren’s Eye Health and Safety Month

August 1-7 World Breastfeeding Week

SSeepptteemmbbeerr iissBaby Safety Month

National 5-A-Day MonthNational Food Safety Education Month

Head Lice Prevention MonthNational Sickle Cell Month

National Literacy MonthSeptember 23 R.E.A.D in America Day

September 30 Family Health and Fitness Day USASeptember 1-7 Child Injury Prevention Week

Bulletin BoardAugust is National Immunization Awareness Month:

The Annual Child Care Immunization Report is due December 1,2006. Time to get all childhood immunizations up to date.

September 24-30 is National Adult Immunization Awareness Week:

Go to www.immunizenc.org/Adults.htm for information on adult immunizations.

Don’t miss the NCaeyc Annual Study Conference, September 14-16Koury Center, Greensboro, NC

Emergency Lockdown in Child CareIn May 2006 a child care facility in Durham County was put onlockdown. This was done to keep the children and adults safe duringa police standoff next door. A lockdown is an emergency measurethat is ordered by someone in authority, like a law enforcementofficer. It prevents children, adults as well as information from leavingthe facility. It also keeps anyone from entering the building until it issafe. Plan for and practice a lockdown. It will prepare a child carefacility to respond calmly and effectively when a lockdown isrequired. Emergency Preparedness and Response for Child Care* training is now availableto all regulated child care programs across North Carolina. It covershow to respond when a lockdown is required. A list of EmergencyPreparedness and Response for Child Care trainers can be found on the NCDivision of Child Development’s web site: www.ncchildcare.org .* The Emergency Preparedness and Response for Child Care Training was developed by the University ofNorth Carolina at Chapel Hill School of Public Health, Department of Maternal and ChildHealth and funded by the North Carolina Division of Child Development.

Young children are learning to care for themselves.Families and caregivers support the development ofhealth habits. Personal hygiene, eating, toileting,exercising and resting happenevery day. When children arewell-fed, have had plenty oftime for active play, and arewell-rested, they feel strong andhealthy. The goal of healtheducation is to focus on a child’ssense of well-being. Well-beingalso means feeling safephysically and emotionally.

Children’s health habits becomemore consistent when the dailyroutines at home are similar tothose practiced at the child care facility. Cultureinfluences many of the choices made by families andcaregivers. The child care facility may include a widevariety of traditions andfoods from the culturesrepresented in theclassroom. Families andcaregivers can educateeach other about howthey handle routine care.Then they can begin tomake their routinessimilar, so that thechildren get the samehealth messages in bothplaces.

Families are oftenencouraged bycaregivers to participatein health education.They might receivehandouts on routinehealth procedures, or acaregiver might let familiesknow what the children are studying. For example,pedestrian safety might be the topic. Families who arefamiliar with the health education goals will find thereare teachable moments at home, too. A teachablemoment is a time when a child, or an adult, is likelyto be ready to learn something. As the family walks tothe park or grocery story they can talk about crossingthe street safely. They can wait patiently for the redlight to turn green before they cross the street. Athome they can use the same procedures the child care

facility uses for handwashing.During meal preparation familiescan wash hands before handling

food. They can taste thesweetness of an apple and the sourtaste of a lemon and discovertogether what they like or dislike.

Caregivers often appreciate families’contributions to their program.Families can share a meal that hasimportant meaning in their culture.They can loan the program utensilsor pans they use for foodpreparation. A mother who is adoctor can talk about howhandwashing protects people from

germs. A grandfather can help plant a garden. A fathercan join the planning team and contribute valuable

ideas for health education.

The habits and attitudeschildren form in these earlyyears can last a life time.

Eating healthy foods,practicing good personal

hygiene, getting regular exercise,being safely secured in a car, following safety rules,and getting plenty of rest are positive habits toestablish. Providing a clean and safe environment andpracticing healthy habits reinforce the importance ofleading a healthy life style.

References:

Aronson S., MD FAAP, Editor. Healthy Young Children: A Manual forPrograms, 2002 edition. Washington DC: NAEYC, 2002.

11 88 00 00 33 66 77 22 22 22 9AUGUST/SEPTEMBER 2006 • HEALTH AND SAFETY BULLETIN • 55

Families and Health Habits

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Families - Be Healthy Together!

• Wash hands before eating, after outside play,after toileting and when they are dirty

• Brush teeth in the morning and before bed

• Eat 5-9 fruits and vegetables every day – countthem

• Walk together for 20 minutes every day

• Talk about feelings, events and ideas

• Celebrate new skills, knowledge, relationships

• Go to bed early

• Wake up and welcome the new day

FAMILY

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The Consultants’ Corner has expanded! It will nowinclude articles from Infant Toddler Specialists andBehavior Specialists as well as the Child Care HealthConsultants. These consultants and specialists offertechnical assistance, resources, training andconsultation to child care facilities in their areas ofexpertise. Amy Fulcher, an Infant Toddler Specialistfrom Region 15, begins this series of articles with wisewords about Routine Care.

Routine Care:Anything butBasic!When caring for infantsand toddlers it can seemas if the entire day istaken up with routinecare activities. Whendo babies have time tolearn or caregivers havetime to teach? Diaperchanges, bottlefeedings, and being putdown for naps are basicroutines that can take upto 80% of a caregiver’s

time. With so much time devoted to routine care,these basic caregiving responsibilities should beanything but basic!Instead of looking at routine care as tasks to becompleted, caregivers should look at these activities asspecial opportunities for one-on-one interactions.Changing a diaper provides a wonderful opportunityfor face-to-face contact with a child. Why not makethis as interactive as possible? Smile, talk and sing softlywhile changing a diaper. Eye contact and talking, evensimply telling the child what you are doing as you doit, can make this a learning opportunity.While participating in routine care, children can learn:• Security and self esteem• Pleasure and tactile stimulation• A sense of time and space and rhythms• Independence and competence• Cognitive and language skillsCaregivers are effective when they respond to eachchild’s developmental level when providing routinecare. Young infants are learning basic trust and shouldhave care that is consistent, gentle, and timely. Moremobile infants are learning to be increasinglyindependent - a skill that is sometimes misinterpreted as

being oppositional. Toddlers often move betweenindependence and dependence, sometimes happilycomplying with routine care, other times requestingassistance when completing skills they have previouslymastered.Positive interactions during routine care can also affecta child care program’s star rated license. Providingeffective health and safety measures during routine careis only part of the scoring of the Infant ToddlerEnvironment Rating Scale-Revised. Items“Greeting/departing”, “Meals/snacks”, “Nap”,“Diapering/toileting”, and “Health practices” all containindicators that reference a caregiver’s interactionsduring routine care.There are many things a caregiver can do to increaselearning during routine care activities:Meals and snacks• Sit with children and make meals a social time.• Make eye contact and talk to infants during bottle

feedings.• Help children name the foods they are eating and the

utensils they are using.• Encourage older toddlers to develop self-help skills

by serving their own food and pouring their ownmilk.

Diapering• Provide pleasant interactions during diaper changes.• Talk with infants about what you are doing as you

change their diaper.• Encourage children to develop self-help skills by

allowing them to help put their clothes back on, washtheir own hands, etc.

Handwashing• Use fun songs, such as Row, Row, Row Your Boat, to

encourage children to wash their hands for theappropriate length of time.

• Talk to children about why they are washing theirhands and the health benefits it provides.

• Encourage self-help by allowing children to get theirown soap and paper towels.

By providing warm and interactive routine care, acaregiver helps to build a close personal relationshipwith each child. This results in meeting the physical,emotional, and developmental needs of the child, andincreases the professional satisfaction of the caregiver.

Reference:

California Department of Education, WestEd.Infant/Toddler Caregiving: A Guide to Routines (Second

Edition). California: CDE Press; 2002.

Harms, T., Cryer, D., and Clifford, R. Infant ToddlerEnvironment Rating Scale-Revised Edition. New York:

Teachers College Press; 2006.

66 • HEALTH AND SAFETY BULLETIN • AUGUST/SEPTEMBER 2006

CCoonnssuullttaannttss’’CCoorrnneerr

Amy FulcherInfant Toddler SpecialistRegion 15

Children’s Books about FeelingsA to Z – Do You Ever Feel Like Me?by Bonnie Hausman 1999 ( )

Funny Faceby Nicola Smee 2006 ( )

How Are You Feeling? by Saxton Freymann 2004 ( )

I’m Feeling ……Teaching Your Baby to Sign by Lora Heller 2006 ( )

Today I Feel Silly and Other Moods That Make My Dayby Jamie Lee Curtis 2006 ( )

Correction: The illustrator of The Incredible Peepersof Penelope Budd, Amy Wummer, was listed as theauthor of the book in the June/July 2006 issue. Theauthor is Marie Karns.

Reference:Clearinghouse on Early Education and Parenting. Emotions

Count: Scaffolding Children’s Representations of Themselves and TheirFeelings to Develop Emotional Intelligence. Retrieved Jun 12, 2006

from http://ceep.crc.uiuc.edu/pubs/katzsym/shuster.html

= Infant-Toddler = Preschool-School Age

How Many DifferentWays Can You Feel?

Angry

Bashful

Cranky

Frightened

Happy

Nervous

Sad

Silly

Surprised

When planning a curriculum of health education, include activities that helpyoung children identify and express their feelings.

☺ Talk! Talk! Talk about feelings!

☺ Give voice to what a smiling infant might be feeling. “Oh, you are smiling.You look very happy. Did you like it when I tickled you under your chin?”

☺ Encourage the use of “feeling” words. Use the words angry, sad, and happyrather than a phrase such as, "You feel like hitting someone."

☺While reading a story aloud, pause in the middle and have childrenimagine how different characters might be feeling and why. Read Alexanderand the Terrible, Horrible, No Good, Very Bad Day by Judith Viorst. Ask questionslike, “How do you think Alex was feeling when he got lima beans fordinner?” “How can you tell that was what he was feeling?” A responsemight be that “I could tell Alex was feeling grumpy because his face wasscrunched up and frowning.”

☺ Create a yummy snack! Children can make Pizza Faces. Spread tomato sauceon an English muffin. Children can make faces on their pizza muffins byarranging halved olives, green and red pepper strips and pepperoni. A redpepper strip turned up becomes a grin for a happy face ….turn it down for asad frowning face. Sprinkle on a little cheese and pop into a 350° oven.*Make sure the pizza cools before children eat.

☺ Play a game of Simon Says …Feelings. “Simon says, ‘Look as angry as agrizzly bear’.” “Simon says, ‘Look as frightened as a tiny mouse in front of abig cat’.” “Simon says, ‘Look as silly as a cartwheeling clown’.”

☺ Place mirrors where children can look at their faces. Ask them to describetheir own facial expressions. Encourage descriptive words …. “My teeth showwhen I smile. I am happy.” “My eyes look very big when I am surprised.”

☺ Move the mirrors into the art center. Ask children to look carefully at theirfaces and then draw what they observe. Offer sheets of white paper,colored pencils and markers. Encourage children to think about the linesthat appear on their faces when they are expressing different emotions.

☺ Collect these drawings for a My Feelings book. Have children dictate storiesabout what might make them feel like the expression in their drawings.Share the book at circle time. Then make it available in the book corner.Reading children’s books that explore the themes of sadness, fear, angerand joy provides the opportunity for young children to begin to expresstheir own feelings. These feelings might include: sadness at the loss of apet, fears about being in the dark, anger at a toy being snatched, or joyabout a coming celebration. Extend the activity by having children use puppets toact out the different emotions expressed in their book.

AUGUST/SEPTEMBER 2006 • HEALTH AND SAFETY BULLETIN • 77

TThhee WWaayy II FFeeeell "Feelings come and

feelings go. I never know what they'll be.

Silly or angry, happy or sad- They're all a

part of me!"The Way I Feel by Janan Cain 2000

Nonprofit Org

US Postage

PAIDChapel Hill, NCPermit No. 177

88 • HEALTH AND SAFETY BULLETIN • AUGUST/SEPTEMBER 2006

NC Child Care Health & Safety Resource Center1100 Wake Forest Road, Suite 100Raleigh, NC 27604

POSTMASTER: Please deliver as soon as possible – time dated material enclosed

HEALTH BULLETINEDITOR: VOL. 8 ISSUE 3Jacqueline Quirk

CONTRIBUTORS:Lucretia Dickson, Amy Fulcher, JeannieReardon, Jonathan Kotch.

DOWNLOAD:You may download a copy of thispublication from our website at:www.healthychildcarenc.org

REPRINTING:Articles may be reprinted withoutpermission if credit is given to thebulletin and the material is notreproduced for commercial purposes.This publication is produced by theNorth Carolina Child Care Health andSafety Resource Center and distributedto licensed child care facilities, CCR&Ragencies, DCD child care licensingconsultants, and child care healthconsultants throughout North Carolina.

10,000 copies of this document were printed at a cost of $.46 per copy

We’d like to hear from you…

Call us at 1-800-367-2229to share your comments

and request articles or information.

Q: I have an infant enrolling next month. The mother wants to continue breastfeeding after herbaby starts the program. What can I do to support this mother?

A: “Three cheers” for supporting breastfeeding! According to the American Academy ofPediatrics (AAP) breast milk provides the perfect nutrition for growing infants anddeveloping brains. It is the only food a baby needs for the first 6 months of life. Breast milkreduces the risk of common infections, diarrhea, allergies, and childhood obesity. It alsoreduces the risk of childhood cancers, juvenile-onset diabetes, and Sudden Infant Death Syndrome.

You can support this mother by making your child care environment breastfeeding friendly.It will let the mother know she is welcome to breastfeed in your facility and that you will

offer practical solutions to make it easy for her. Hang a poster orpicture of a mother and infant breastfeeding to show your

facility’s support for breastfeeding. Make pamphlets andbrochures about breastfeeding available for parents and

caregivers. Arrange a comfortable, private and cleanplace for the mother to breastfeed her infant or pumpbreast milk while she is at your facility. She will needto have a sink close by so she can wash her handsand the breast pump.

Establish a written policy on breastfeeding. Includewhy your facility supports breastfeeding. Outline the

steps caregivers and parents must understand andfollow to safely handle breast milk. Encourage daily

communication between the caregivers and the parentsto build trust. Sanitation of Child Care Centers Rule .2804

(d) addresses safe handling of breast milk. Breastfeedingresources are available on the NC Nutrition Services Branch

website: www.nutritionnc.com/breastfeeding/breastfeeding-home.htm . A child care healthconsultant can help you make your facility breastfeeding friendly.

Let the parents know they can help make their infant’s transition to child care a little easier.A couple of weeks before the infant is enrolled, they can begin to offer one or two bottlesof breast milk a day to their infant. They can also bring the infant in for a few hours at atime for the first few days. Then suggest they gradually increase the number of hours untilthe infant is staying for the full enrollment hours. The mother and the infant will becomecomfortable with the routines followed in your facility.

Reference:

North Carolina Division of Public Health, How to Support Breastfeeding in a Child Care Center

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