Background:Ten years ago, the U.S. Surgeon General’s Call to Action to Support Breastfeeding made recommendations for childcare settings, including: (1) accommodating and supporting breastfeeding families; and (2) adopting national guidelines on breastfeeding support in childcare settings.Research Aims:To (1) describe the existing breastfeeding friendly childcare designation programs in the United States; and (2) describe how states are accommodating breastfeeding families in childcare settings.Method:The study design was cross-sectional, prospective thematic description of existing publicly available documents. A search of state breastfeeding coalitions was conducted to assess the number of states with breastfeeding friendly childcare designation programs. A definitive yes-or-no answer regarding whether each state had a program was obtained from all 50 states. For states with programs, designation materials were analyzed using thematic analysis and the framework method to compare designation components.Results:Fifteen states had evidence of breastfeeding friendly childcare designation programs and similarities exist across designation program components. Four standards were common to all 15 programs: written policy on breastfeeding, suitable space within the center where mothers can breastfeed or express their milk, educational materials, and resources on breastfeeding available to parents. Most states required self-assessment to achieve designation status.Conclusion:Research is needed to enable evidence-based programs and decision-making regarding components and processes. Federal funding should support these programs’ mission, including funding research to assess how and in what circumstances these programs are improving breastfeeding-related outcomes and supporting breastfeeding families.

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我们母乳喂养友好型儿童保育计划的现状：2011 年外科医生呼吁采取行动支持母乳喂养十年后

背景：十年前，美国外科医生呼吁采取行动支持母乳喂养对托儿机构提出了建议，包括：(1) 容纳和支持母乳喂养的家庭；(2) 通过关于儿童保育机构母乳喂养支持的国家指南。研究目的：(1) 描述美国现有的母乳喂养友好型儿童保育指定项目；(2) 描述各州如何在儿童保育环境中容纳母乳喂养家庭。方法：研究设计是对现有公开文件的横断面、前瞻性主题描述。对州母乳喂养联盟进行了搜索，以评估有母乳喂养友好儿童保育指定计划的州的数量。从所有 50 个州获得了关于每个州是否有计划的明确是或否答案。对于有计划的州，使用主题分析和框架方法对指定材料进行了分析，以比较指定组件。结果：15 个州有证据表明母乳喂养友好型儿童保育指定计划，并且指定计划组件之间存在相似之处。所有 15 个项目共有四个标准：关于母乳喂养的书面政策、中心内母亲可以母乳喂养或挤奶的适当空间、教育材料和可供父母使用的母乳喂养资源。大多数州都需要进行自我评估才能获得指定状态。结论：需要进行研究以实现有关组件和过程的基于证据的计划和决策。联邦资金应支持这些计划的使命，