'Why do we need a policy?' Administrators' perceptions on breast-feeding-friendly childcare

Area of Science:

• Public Health
• Nutrition Science
• Implementation Science

Background:

• Mothers' return to work and childcare support impact breastfeeding duration in the USA.
• Most US infants receive non-parental care, highlighting the role of childcare settings.
• The Florida Breastfeeding Friendly Childcare Initiative aims to support breastfeeding mothers.

Purpose of the Study:

• To explore Florida childcare administrators' awareness of the Breastfeeding Friendly Childcare Initiative.
• To understand administrators' perceptions regarding the implementation of the initiative.
• To identify barriers and facilitators to adopting breastfeeding-friendly practices in childcare.

Main Methods:

• Semi-structured interviews with 28 childcare administrators in Tampa Bay, FL.
• Utilized the Consolidated Framework for Implementation Research (CFIR).
• Applied thematic analysis to interview data.

Main Results:

• Administrators viewed the initiative as simple and beneficial to implement.
• Low perceived need for the initiative, with formula feeding being normative.
• Varied perceptions of financial costs and priority; some facilitating factors existed, but no formal policies were in place.

Conclusions:

• A cultural shift, supported by state and national policies, is needed to increase the perceived need for breastfeeding-friendly childcare.
• National, evidence-based policies, regulations, and technical assistance are essential to bolster state-level initiatives.
• Enhancing breastfeeding-friendly childcare access requires systemic support and policy changes.