To explore mothers’ and early childhood (EC) educators’ experiences of breastfeeding/breast milk provision and breastfeeding support in child care centers (CCCs) in the United States (U.S.).

We conducted one-time, semi-structured phone interviews with mothers and EC educators to examine perceptions of support, accommodations, and barriers to breastfeeding in CCCs. We administered a background survey to assess participant characteristics and quantify perceived degree of breastfeeding support in the workplace (mothers) and CCCs (mothers and EC educators).

U.S.-based CCCs

50 working mothers using CCCs for their infants and 22 EC educators

Interview themes and background surveys reflected neutral feelings toward breastfeeding support received (mothers) and provided (EC educators) in CCCs. Maternal expectations for breastfeeding support in CCCs were generally low; workplace and social support for breastfeeding were perceived as the most important factors impacting breastfeeding. EC educators’ capacity to offer breastfeeding support was constrained by CCC infant feeding regulations, inadequate breastfeeding training, and time limitations. Tensions arose when mothers attempted to manage low milk supply at the CCC level by requesting EC educators to individualize feeding or milk storage practices for their infant.

Breastfeeding efforts of working mothers are undermined in multiple settings, including the workplace and CCCs. Improving breastfeeding outcomes for this population requires structural/policy changes that: 1) maximize opportunities for continued, direct breastfeeding and maternal/infant proximity and 2) enforce evidence-based CCC feeding protocols and standards and EC educator lactation training.