OBJECTIVE-The purpose of this study was to compare state and regional variation in infant feeding regulations for child care facilities and to compare these regulations to national standards.METHODS-We reviewed regulations for child care for all US states and Washington, DC, and examined patterns according to type of facility and geographic region. We compared state regulations with national standards for feeding infants in child care. The standards included were: (1) infants are fed according to a feeding plan from a parent or physician; (2) breastfeeding is supported by the child care facility; (3) no solid food is given before 6 months of age; (4) infants are fed on demand; (5) infants are fed by a consistent caregiver; (6) infants are held while feeding; (7) infants cannot carry or sleep with a bottle; (8) caregivers cannot feed >1 infant at a time; (9) no cow's milk is given to children <12 months of age; (10) whole cow's milk is required for children 12 to 24 months of age; and (11) no solid food is fed in a bottle.
RESULTS-The mean number of regulations for states was 2.8 (SD: 1.6) for centers and 2.0 (SD: 1.3) for family child care homes. No state had regulations for all 11 standards for centers; only Delaware had regulations for 10 of the 11 standards. For family child care homes, Ohio had regulations for 5 of the 11 standards, the most of any state. States in the South had the greatest mean number of regulations for centers (3.3) and family child care homes (2.2), and the West had the fewest (2.3 and 1.9, respectively).CONCLUSIONS-Many states lacked infant feeding regulations. Encouraging states to meet best-practice national standards helps ensure that all child care facilities engage in appropriate and healthful infant feeding practices.Address correspondence to Sara E. Benjamin, PhD, MPH, RD, Harvard Medical School and Harvard Pilgrim Health Care, Department of Ambulatory Care and Prevention, Obesity Prevention Program, Boston, MA 02215. sara_benjamin@harvardpilgrim.org. FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
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Author ManuscriptPediatrics. Author manuscript; available in PMC 2011 March 8. In recent decades, greater numbers of parents have turned to organized child care to help care for their infants. In the United States, nearly two thirds of infants are cared for routinely by someone other than a parent. About half of these infants attend child care centers, whereas the other half spend time in a variety of home-based settings including licensed family child care homes or the home of a family member, friend, or neighbor. 1 Recent studies revealed that nonparental home-based child care may negatively affect children's health. Kim and Peterson 2 examined child care during the first 9 months of life and found that infants who were cared for by a relative were less likely to have been breastfed and more likely to be given solid foods too early compared with infants cared for by a parent. The aut...