4.2 Breastfeeding & Bottle Feeding

Breastfeeding

The World Health Organization and UNICEF recommend that infants are exclusively breastfed for the first 6 months of their lives (WHO, 2023). Solids may be introduced at 6 months of age but it is recommended that children continue to breastfeed until the age of 2 or beyond (WHO, 2023). Early years settings play an important role in providing support for continued breastfeeding once a child is enrolled into an infant program. Educators may want to be equipped with breastfeeding resources in the event a parent is struggling with breastfeeding and would benefit from additional information.

Policies are put in place to ensure children can continue to consume breast milk while in licensed child care. Families may choose to bring breast milk in storage containers or bottles to be stored and served safely while their child is in care. Early years settings can be supportive by ensuring they have proper safe food handling techniques in place to put a family at ease, knowing their child can safely continue to drink breast milk while away from their caregivers.

Some caregivers may be able to drop into an infant program to breastfeed when their child is in care. A warm, calm, and welcoming space with comfortable adult sized furniture is necessary for a caregiver to breastfeed their child. There may be a space inside a classroom or a quiet space outside of the classroom where a caregiver and infant can go to engage in breastfeeding. It is important to let new families know this is an option for them when they are enrolling their child in care.

Bottle Feeding

Many bottle fed infants attend early years programs. Communication between educators and family members is important to ensure the correct information is exchanged. A child may be breastfeeding at home but needs to drink from a bottle while at child care because their caregiver cannot attend during the day due to other commitments such as work or school.

Many families will provide their ready made bottles for their infants upon drop off to an early years setting. The bottles may contain prepared formula, breastmilk, cow’s milk, or an alternative such as soya formula. It is important to label the bottles immediately with the child’s first and last name to ensure the correct bottle goes to the correct child. This measure will reduce the potential for error and help to prevent a child from drinking something they may not be able to drink due to allergies or dietary restrictions.

Feeding plans will be developed for children under the age of one. Educators also collaborate with families and dietary planners to ensure the nutritional needs are met for infants over the age of one. Some families may want their infant to use a sippy cup when possible. Many infants are bottle fed before nap. Educators provide a nurturing environment for infants when bottle feeding. This includes holding children while they drink from their bottle. A child should never be put down for a nap with their bottle. Some children may want to hold their bottles independently while sitting in a high chair or at a small child sized table. Infants must not walk around while drinking from their bottles to avoid choking, injuries, and tooth decay.

Milk and Milk Alternatives

Families may be exclusively breastfeeding their child but there are times when this is not possible for a wide variety of reasons. These barriers could include a reduced milk supply, lack of support for breastfeeding, a caregiver taking medication that is not suitable for consumption by an infant, strong marketing of infant formula, lack of support when returning to work, and many other reasons. Educators must be open to listening and supporting all choices made by families.

Infants in early years settings may be exclusively breastfeeding or may be drinking formula for their main source of nutrients. Some children may have an allergy to milk protein so soya or rice based formulas may be used instead. Educators and families must collaborate to ensure this main source of nutrition is consistent between home and the early years setting.

Some families may want cow’s milk introduced around the age of one but this should not be introduced in the early years setting first. Families should introduce new foods or milk at home prior to their introduction in an early years setting to ensure there are no allergic reactions. Licensed child care programs are encouraged to provide whole milk for children ages two and under. Programs may switch to 2% milk once the child is an older toddler or preschooler.

Infant Milk Storage

Most infant programs in licensed child care settings will have a refrigerator to store prepared bottles or containers until the children are ready to consume the milk. Refrigerators in the kitchen or classroom must contain a fridge safe thermometer to ensure the fridges are kept at a safe cooling temperature to avoid any food borne illnesses. A public health inspector will check for fridge thermometers when they conduct inspections. They will also be checking for a daily log of fridge temperatures. These logs must be recorded for each fridge, each day, to ensure the proper cooling temperatures are maintained. Typically, the dietary planner will record the daily temperatures of refrigerators and freezers in the kitchen area.

Infant Milk Preparation

Some families may choose to provide a sealed container of liquid or powder formula if their child is drinking formula. Educators will discuss preparations of the formula with families to ensure feeding practices are consistent with home. Educators need to be aware of how to mix the formulas in a safe manner to ensure there is no cross contamination or food borne illnesses when serving formula to children.

It is recommended that milk be heated in a bottle warmer, rather than a microwave, to avoid hot spots that may be present in microwaved milk. The temperature of the milk should always be tested before serving it to a child. Educators follow nurturing bottle feeding routines after preparing the formula to ensure the child’s nutritional, social, and emotional needs are being met.

Introducing Solids

A written plan developed between families and early years settings provides educators and dietary planners with instructions regarding feeding practices for children under the age of one. These written plans outline the type of milk the child is consuming, how it is consumed, the schedule for consumption, and supportive methods for nurturing this important aspect of nutrition for infants. The plan also includes information regarding any solid foods that have been introduced at home. This may include any likes or dislikes, any potential allergies, and textures that are familiar for the child. This information helps educators understand how to serve solid food for the child to prevent choking, allergic reactions, and to nurture a preference for a wide variety of foods. Any restrictions will be visibly posted in the classroom to ensure infants are not consuming something they have not tried at home or something they are unable to consume.

Many early years settings will request a written plan for children over the age of one as part of the registration process. This supports the educators and dietary planners in understanding which foods have yet to be introduced and which textures the child can manage. There may be a transition period when a child is eating some menu food and some food provided by the family. Ongoing communication between the educators, dietary planner, and the family is essential to ensure the nutritional needs of the child are being met. Families have different values around the introduction of solid foods so educators must be open to new ideas and be able to support families if they have questions regarding the introduction of solid foods for their children. Educators provide support by offering information and resources from public health to assist families in making informed decisions.