Promoting breast feeding in creches

Need for breast feeding in creches: Creches need mothers to breastfeed their children to provide the best possible nutrition and health benefits for the baby. As the child would remain around 6 hours in the creche, breast feeding of the child is necessary especially for children between 7 months to 2 years. The benefits of breast feeding a child in a creche can be attributed to the following:

Breast milk is an important source of energy and nutrients in children aged 6-23 months.
Breast milk provides essential nutrients, especially during the first year of life, and continues to contribute significantly to a child’s nutritional needs even after complementary feeding is introduced.
It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months.
Breast milk contains antibodies that help protect infants and young children from infections.
Breast feeding is crucial for optimal growth and development and continues to be important for meeting the evolving nutritional needs of a child.
Breast feeding strengthens the bond between mother and child, which is important for the child’s emotional and social development.
Breast milk is a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished.
Regularly breast-fed children perform better on intelligence tests.
Women who breastfeed regularly have a reduced risk of breast and ovarian cancer.

Creating a welcoming and supportive environment in the creche for breast feeding

A dedicated, clean, quiet, and private area needs to be created in the creche where mothers can comfortably breastfeed their babies.
To display welcoming messages and posters that celebrate breastfeeding in creches.
To acknowledge and praise mothers who are coming regularly to breast feed their babies in the creche.
Provide access to soap and water for hand washing.
Ensure good ventilation in the breast-feeding area.

*Frequency of breast feeding from 6months to 2 years *

There should be continuation of frequent, on-demand breast feeding until 2 years of age or beyond.
In creches children will be introduced to complimentary feeding and the frequency of breast feeding will go down.
It is therefore crucial to actively encourage breast feeding to maintain breast milk intake and its benefits for children especially between 7 months to 2 years.

Optimizing breast feeding of children in creches

The creche supervisor can discuss and demonstrate the need and relevance of breast feeding in creches along with any misconceptions or biases regarding breast feeding during the creche committee meetings.
ASHA/Sahiya/Mitani/ Female Health Worker can be requested to demonstrate the appropriate positioning and attachment of the child during breast feeding in creche committee meetings.
Discussing with mothers of children, especially between 7 months to 2 years, who are malnourished and those who have recovered from illness, not to go very far to work so that they can come frequently to breast feed their child.
Mothers can be requested to do breast feeding just before handing over the child in the morning. We can also request the mothers for breast feeding the child in the creche while taking the child back in the evening.
Organizing breast feeding week celebrations in coordination with ASHA and AWW.

*Promoting frequent breast feeding during and post illness: *Breast feeding during illness of the child is important because it helps in boosting the baby’s immune system, helping them to fight against infections. It also contains antibodies and other protective factors not found in complimentary foods.

During illness

Children who have started complimentary feeding are most likely to reduce or stop eating during illness. The child is likely to demand more breast feeding.
As the child will be at home during illness, we should promote that the mother should breast feed more often during the illness.
As the child may lose appetite, we should communicate that the mother can give small diverse meals in a day while continuing breast feeding.

Post illness

Breast feeding is to be continued after illness and there should be an increase in complimentary feeding. We should encourage frequent breast feeding in creches while also giving attention to increasing the complimentary feeding of the child.

*Breast feeding of malnourished children in creches: *

Frequent breast feeding along with appropriate complimentary feeding is crucial for the recovery of malnourished children between 7 months to 2 years. Breast milk provides essential nutrients and antibodies that support growth and immune functions, particularly during this period when energy and nutrient needs are higher than before.
Breast milk is more easily digested and absorbed by the infant than other foods, making it ideal for promoting healthy growth and development.
We should encourage frequent breast feeding by the mother while the child is in the creche and provide additional food which will help the malnourished child gain weight and recover faster.

Breast feeding in creches during illness of mothers

In common illnesses like cold or flu, it is safe to continue breast feeding the baby in the creche. However, we should promote proper hygiene precautions like handwashing by the mother.
Continuation of breast feeding will help the mother in maintaining milk supply and will also provide the baby with protection against illness that the mother is experiencing.
We should promote immediate access to health facilities by the mother for a health checkup for her recovery.

Promoting hygiene practices during breast feeding in creches

At the creche level the creche caregiver should ensure the personal hygiene of mothers before and after breast feeding.
Mothers should wash hands before and after breastfeeding with soap and water- This is crucial to prevent the transfer of germs from the mother’s hand to the baby’s mouth.
We can also ensure alcohol-based sanitizers containing at least 60% alcohol for ready use.
Creche care givers can educate the mothers to clean their breasts before coming to the creche for breast feeding so that dirt and germs can be removed that may be present on the skin. Also, they can use water to clean the nipples using water. Soap should be avoided for cleaning nipples as it can remove natural oils and can cause dryness or irritation. A small amount of breast milk can be applied to the nipples for keeping the nipples moisturized and healthy.
Mothers should be asked to take bath regularly so that the breasts can remain clean and dry.

Emphasizing breast feeding of children during initiation of complimentary feeding in creches

After completing the exclusive breast-feeding period when a child comes to the creche the complimentary food should be introduced in small amounts initially and breast feeding should be the major focus.
The creche caregivers should discuss with the mothers to come to the creche to assist in complementary feeding and giving breast feeding to their children during the initial stages till the baby stabilizes.
Once the baby stabilizes in taking complementary feeding mothers can come for breast feeding of the children in creches.
There can be some flexibility in scheduling the complementary feeding of the child in creches to accommodate the needs and preferences of breast feeding by mothers in the creches. This is because once a complementary feeding has been done, the baby may not show immediate interest in having breast milk.