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if they do not serve food and/or parents bring in food. In regards to adults eating the same food as children at mealtime, it is possible that because the food program does not pay for staff meals, providers may not see this question as relevant to them. The large percentage of programs indicating that nutrition needs of children with special needs are taken into account may not be serving children with special needs and this item would be not applicable to their site.
Large percentages of participants (50% or more) reported that the following items did not apply to their site:
 Breastfeeding mothers are provided access to a private area for breastfeeding or pumping with appropriate seating.
 Staff are trained in proper handling and storage of breast milk.
 Parents are aware that they could leave breast milk at the child care site for their child.
This result may be reflective of the sample of programs who responded to this survey. About 33% of programs responding to the survey serve children 0-2 years old, which is in line with the 34.4% to 39.1% of programs who indicated they are “Doing” the activities stated above. It is possible that providers who do not currently serve children younger than 2 years perceive these items as irrelevant to them. Nevertheless, given the importance of breastfeeding to the child’s development, this may be an area for further intervention.
Findings from this survey are not unique to this sample. A recent study in Philadelphia conducted a survey of child care centers and found that although a very high percentage of centers (95%) would not feed an infant anything other than breast milk, only 40% of centers surveyed provided training for their staff on how to prepare or store human milk. xxix In addition, a needs assessment of child care providers’ knowledge, attitudes and behaviors on infant feeding practices, specifically breastfeeding indicated that infant room teachers and directors reported low knowledge on ways to store breast milk and
Items which showed a significant increase in the percent of providers “Doing” the activity from baseline to follow-up were:
 Parents receive written nutrition policies upon enrollment.
 Parents are given information about what their children are eating.
 Parents are given information about what their children are offered (menus).
 Children decide which foods they will eat from the foods offered.
 Children serve themselves from serving dishes at mealtime.
Improving Health in Child Care Settings: 2016 20

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