Breastfeeding can be a very rewarding and nurturing experience. While there are many nutritional benefits, it also establishes a physical and emotional bond between mother and baby.
Breastmilk contains all the nutrients needed, in the right quantities and in a form that babies can easily absorb. It also provides antibodies and bacteria that help protect against infections and allergies. Some evidence suggests that breastfeeding may reduce the risk of obesity too.
Nurseries have an important role to play in encouraging and supporting mothers to continue breastfeeding. Depending on a baby's age, they may be given expressed breastmilk, formula or cow's milk.
Jude Scott, head of operations at the National Day Nurseries Association (NDNA), says the norm is to express, and mothers bring in bottles with breast-shaped teats.
Breastmilk must be labelled at nursery, stored in a fridge and used within 24 hours. It can be kept at room temperature for up to eight hours and can be frozen for three months. As it separates quickly into fat and whey, bottles of refrigerated expressed milk must be shaken before use.
Ms Scott points out that separation anxiety is greater in breast-fed babies. 'From birth, breastfed babies will be used to skin-to-skin contact and the smells and sounds of their mother,' she says. 'It takes time to accept expressed milk from a stranger. One person should consistently be the main feeder and they must persevere.
'Nurseries may find it helpful to ask parents to bring in something the baby will find comforting during feeds. Anything soothing should be welcome, such as a blanket or piece of cloth that has the mother's smell.'
For a breastfed baby being bottle-fed at nursery, there is not only the stress of being away from home and separated from its mother, but the additional difficulties of not being used to the bottle. To ease the process, mothers should introduce a bottle at home first and perhaps let one feed per day be given by a friend or relative. Alternatively, a free-flowing cup can be introduced, especially for babies over six months.
For the breastfed baby who is given formula at nursery, practitioners should be aware that because formula milk tastes different to breastmilk this could also cause distress. Patience will be required while they get used to it. For babies who have started weaning, some expressed or formula milk could be added to purees or other solids if it is not accepted from a bottle or cup.
Anecdotal evidence suggests that breastfeeding is not frequently talked about with children at nursery. However, the NDNA recognises that it is becoming more openly discussed and, through the use of books, imaginative play, home-corners and talking with children at lunch-time, the subject need not be intrusive. Sometimes discussions can be triggered if a child has a new sibling at home who is breastfed. This scenario could lead to changes in behaviour caused by sibling rivalry. Constant communication with parents is important, so practitioners can be aware of what is going on with the family.
Nurseries can encourage and sup- port mothers to continue breastfeeding in a variety of ways, including putting up annual displays to support National Breastfeeding Awareness Week in May. A breastfeeding policy could be produced and accompanied by a supporting statement displayed at the nursery entrance. Information about the rights of working and breastfeeding mothers should be given to all new parents joining the nursery, as many may be unaware of the legislation that exists.
Nurseries may have established partnerships with local health professions.
Some work with health visitors and midwives to support breastfeeding by inviting them in to run evening classes or workshops for staff and/or parents.
Ms Scott recognises breastfeeding can be stressful and may be a struggle, and that parents may want advice but feel too intimidated to ask. 'There will be more take-up if classes are offered,' she says. 'It's as simple as just phoning the local health visitor or doctor's surgery and asking them to come in to the nursery.' Any support a nursery can provide will help, and building good relationships with parents is key to sustained breastfeeding for those mothers who wish to do so.'
References
* Department of Health: Infant Feeding Recommendation (2003) www.dh.gov.uk.
Further information
* For information about National Breastfeeding Awareness Week visit www.breastfeeding.nhs.uk
* For information about developing a breastfeeding policy and breastfeeding mothers' rights at work visit The National Childbirth Trust www.nct.org.
uk/breastfeeding
* Breastfeeding Network www.breast feedingnetwork.org0870 900 8787
* La Leche League 0845 456 1855 (Mon and Thurs)
* Association of Breastfeeding Mothers 0870 401 7711 www. abm.me.uk
