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Blythe S, Peters K, Elcombe E, Burns E, Gribble K. Australian Foster Carers' Views and Concerns Regarding Maternal Drug Use and the Safety of Breastmilk. CHILDREN-BASEL 2021; 8:children8040284. [PMID: 33916975 PMCID: PMC8067616 DOI: 10.3390/children8040284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 12/27/2022]
Abstract
Parental substance misuse and mental health issues are major factors associated with infant placement into out-of-home care. Such placements may result in disruption and/or cessation of breastfeeding. Provision of breastmilk to infants in out-of-home care (OOHC) is desirable in terms of infant health and development, and also in supporting maternal caregiving. However, little is known about how breastfeeding is supported for infants in out-of-home care. This study used an online survey to explore the facilitation of breastfeeding in the context of OOHC and foster carers' management of expressed breastmilk (EBM). Foster carers were generally open to the idea of maternal breastfeeding and infants in their care receiving EBM from their mothers. However, the majority of respondents expressed concern regarding the safety of EBM for infant consumption due to the possibility of harmful substances in the milk. Concerns regarding the safety of handling EBM were also prevalent. These concerns caused foster carers to discard EBM. Findings suggest foster carers' may lack knowledge related to maternal substance use and breastmilk. Better integration between health care and social service systems, where the voices of mothers, foster carers and child protection workers are heard, is necessary to develop solutions enabling infants living in OOHC access to their mother's breastmilk.
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Affiliation(s)
- Stacy Blythe
- School of Nursing and Midwifery, Western Sydney University, Penrith 2763, Australia; (K.P.); (E.E.); (E.B.); (K.G.)
- Translational Research and Social Innovation (TReSI) Group, Ingham Institute of Applied Medical Research, Liverpool 2170, Australia
- Correspondence:
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith 2763, Australia; (K.P.); (E.E.); (E.B.); (K.G.)
| | - Emma Elcombe
- School of Nursing and Midwifery, Western Sydney University, Penrith 2763, Australia; (K.P.); (E.E.); (E.B.); (K.G.)
- Translational Research and Social Innovation (TReSI) Group, Ingham Institute of Applied Medical Research, Liverpool 2170, Australia
| | - Elaine Burns
- School of Nursing and Midwifery, Western Sydney University, Penrith 2763, Australia; (K.P.); (E.E.); (E.B.); (K.G.)
| | - Karleen Gribble
- School of Nursing and Midwifery, Western Sydney University, Penrith 2763, Australia; (K.P.); (E.E.); (E.B.); (K.G.)
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Bauer KW, Chriqui JF, Andreyeva T, Kenney EL, Stage VC, Dev D, Lessard L, Cotwright CJ, Tovar A. A Safety Net Unraveling: Feeding Young Children During COVID-19. Am J Public Health 2021; 111:116-120. [PMID: 33211589 PMCID: PMC7750580 DOI: 10.2105/ajph.2020.305980] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The emergence of COVID-19 in the United States led most states to close or severely limit the capacity of their early child-care and education (ECE) programs. This loss affected millions of young children, including many of the 4.6 million low-income children who are provided free meals and snacks by their ECE programs through support from the federal Child and Adult Care Food Program (CACFP).Although Congress swiftly authorized waivers that would allow CACFP-participating ECE programs to continue distributing food to children, early evidence suggests that most ECE programs did not have the capacity to do so, leaving a fragmented system of federal, state, and local food programs to fill the gaps created by this loss.Critical steps are needed to repair our nation's fragile ECE system, including greater investment in CACFP, to ensure the nutrition, health, and development of young children during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Katherine W Bauer
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Jamie F Chriqui
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Tatiana Andreyeva
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Erica L Kenney
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Virginia C Stage
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Dipti Dev
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Laura Lessard
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Caree J Cotwright
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
| | - Alison Tovar
- Katherine W. Bauer is with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Jamie F. Chriqui is with the Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Tatiana Andreyeva is with the Department of Agricultural and Resource Economics, Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford. Erica L. Kenney is with the Departments of Nutrition and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Virginia C. Stage is with the Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC. Dipti Dev is with the Department of Child, Youth and Family Studies, College of Education and Human Sciences, University of Nebraska, Lincoln. Laura Lessard is with the Department of Behavioral Health & Nutrition, University of Delaware, Newark. Caree J. Cotwright is with the Department of Foods and Nutrition, University of Georgia, Athens. Alison Tovar is with the Department of Nutrition and Food Sciences, University of Rhode Island, Kingston
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Lee DL, Traseira R, Navarro S, Frost N, Benjamin-Neelon SE, Cradock AL, Hecht K, Ritchie LD. Alignment of State Regulations With Breastfeeding and Beverage Best Practices for Childcare Centers and Family Childcare Homes, United States. Public Health Rep 2020; 136:79-87. [PMID: 33166484 PMCID: PMC7856380 DOI: 10.1177/0033354920964156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Childcare is an important setting for nutrition; nearly half of young children in the United States participate in licensed childcare, where they consume up to two-thirds of their daily dietary intake. We compared state regulations for childcare with best practices to support breastfeeding and healthy beverage provision. METHODS We reviewed regulations for childcare centers (centers) and family childcare homes (homes) in effect May-July 2016 and rated all 50 states for inclusion (1 = not included, 2 = partially included, 3 = fully included) of 12 breastfeeding and beverage best practices. We calculated average ratings for 6 practices specific to infants aged 0-11 months, 6 practices specific to children aged 1-6 years, and all 12 practices, by state and across all states. We assessed significant differences between centers and homes for each best practice by using McNemar-Bowker tests for symmetry, and we assessed differences across states by using paired student t tests. RESULTS States included best practices in regulations for centers more often than for homes. Average ratings (standard deviations) in regulations across all states were significantly higher in centers than in homes for infant best practices (2.1 [0.5] vs 1.8 [0.5], P < .001), child best practices (2.1 [0.6] vs 1.8 [0.6], P = .002), and all 12 best practices combined (2.1 [0.5] vs 1.8 [0.6], P < .001). CONCLUSIONS Although best practices were more consistently included in regulations for centers than for homes, many state childcare regulations did not include best practices to support breastfeeding and the provision of healthy beverages. Findings can be used to inform efforts to improve regulations and to reduce differences between centers and homes.
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Affiliation(s)
- Danielle L. Lee
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Oakland, CA, USA
| | - Raquel Traseira
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Oakland, CA, USA
- University College London Medical School, London, England
- Children’s Hospital Oakland Research Institute, Oakland, CA, USA
| | - Sophia Navarro
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Oakland, CA, USA
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Natasha Frost
- Public Health Law Center, Mitchell Hamline School of Law, St Paul, MN, USA
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ken Hecht
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Oakland, CA, USA
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Oakland, CA, USA
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