Deciding among child care options is a particularly tough decision for many mothers, especially for a first child. In some instances, the child's parents arrange work schedules so that one or the other is available to stay home with the baby. Others are able to ask a grandparent or other trusted family member to provide care. When neither is possible, you will want to select a child-care provider who is supportive of your efforts to breastfeed.
Another consideration is the convenience of the location of the child-care provider to your workplace. Although in-home child care has its advantages, some mothers find a care provider close enough to their worksites that they can drop in during work breaks or at lunchtime to breastfeed. Some mothers are able to have their care provider bring the infant to them at work. When the commute time between the place where child care is provided and the workplace is minimized, you and your baby spend less time apart and you are able to make time for more direct breastfeeding (so fewer pumping sessions may be needed).
The following are some questions you may want to ask candidates when choosing a care provider for your breastfed child:
Are they familiar with proper breast milk storage, thawing, and warming of breast milk?
Do they have refrigerators or freezers where your breast milk can be stored for later use?
What is the method for feeding young babies? Is a baby held closely for bottle feedings? Young babies cannot be expected to hold a bottle, and propping bottles is not safe or appropriate. Propping is associated with choking and increasing the risk of ear infections. Also, the social interaction during feedings or mealtime can be as important as obtaining food.
If you plan for your baby to be fed by an alternative feeding method, such as cup-feeding, finger-feeding, or syringe-feeding, inquire about the care provider's ability and willingness to continue this practice when your child is in this type of care.
Here are recommendations from the American Academy of Pediatrics (AAP) on how to reduce the risk for sudden infant death syndrome (SIDS) and sleep-related deaths from birth to age 1:
Place your infant on his or her back for sleep or naps. This can decrease the risk for SIDS, aspiration, and choking. Never place your baby on his or her side or stomach for sleep or naps. If your baby is awake, allow your child time on his or her tummy as long as you are supervising, to decrease the chances that your child will develop a flat head.
Always talk with your baby's doctor before raising the head of their crib if he or she has been diagnosed with gastroesophageal reflux.
Offer your baby a pacifier for sleeping or naps, if he or she isn't breastfed. If breastfeeding, delay introducing a pacifier until breastfeeding has been firmly established.
Use a firm mattress (covered by a tightly fitted sheet) to prevent gaps between the mattress and the sides of a crib, a play yard, or a bassinet. This can decrease the risk for entrapment, suffocation, and SIDS.
Share your room instead of your bed with your baby. Putting your baby in bed with you raises the risk for strangulation, suffocation, entrapment, and SIDS. Bed sharing is not recommended for twins or other higher multiples.
Avoid using infant seats, car seats, strollers, infant carriers, and infant swings for routine sleep and daily naps. These can cause the baby to be in a position that creates a risk of suffocation or airway obstruction. Babies who fall asleep in these should be moved to a safe, flat bed surface as soon as possible.
Avoid overbundling, overdressing, or covering an infant's face or head. This will prevent him or her from getting overheated, reducing the risk for SIDS.
Avoid using loose bedding or soft objects — bumper pads, pillows, comforters, blankets — in an infant's crib or bassinet to help prevent suffocation, strangulation, entrapment, or SIDS.
Avoid using home cardiorespiratory monitors and commercial devices — wedges, positioners, and special mattresses — to help decrease the risk for SIDS and sleep-related infant deaths. These devices have never been shown to prevent SIDS. In rare cases, they have resulted in an infant's death.
Always place cribs, bassinets, and play yards in hazard-free areas — those with no dangling cords or wires — to reduce the risk for strangulation.