Many daycares don’t allow breast milk after 1 year of age
The reality of breastfeeding in America is in stark contrast to the recommendations by major health organizations. New mothers are faced with countless obstacles, roadblocks and dead ends to reach their breastfeeding goals. Moms receive inadequate lactation support, short maternity leave which can hinder milk supply, and some daycares actually prohibit breast milk for children beyond 12 months old, whereas medical organizations such as The American Academy of Pediatrics (AAP) recommend “continued breastfeeding up to 2 years of age or beyond.” There’s a massive disconnect.
Yet this is happening across the country to mothers who spend countless hours pumping breast milk, only to be prohibited from sending it with their child to daycare. That’s why I set out to highlight these important stories from moms who directly faced this outrageous issue. It’s helpful to know about the potential regulations you may face when sending your breastfed child to daycare—and push for change where you can.
“I had to have a stern conversation”
Elise Koch, a pediatric nurse and mom, is making big, milky waves at her child’s daycare. When her baby turned 1 and was ready to transition to a new room, Elise was informed by her daycare that they would no longer give her daughter breast milk.
“I had to have a very stern conversation with the assistant director and teacher in the new room because they said she was not able to have a bottle anymore and that she would have to switch to cow’s milk. I told them that I did not agree with that as she is still considered an infant, and that she will only be receiving breast milk until the age of 2. They told me that they had to check with the director and they would let me know,” Elise says.
It’s a glaring reminder of the uphill battle many moms face.
Elise would not stand for her daycare’s policy, but many moms don’t question this bizarre regulation because they don’t have the expertise or resources to do so.
“Ultimately, they agreed to let me provide breast milk to my daughter as long as she transitioned over to a sippy/straw cup,” Elise says.
In addition to advocating for her daughter, Elise volunteered to give a presentation about the importance of breast milk to the entire daycare staff and director: “I felt the staff at my children’s daycare was severely lacking in basic breastfeeding/bottle-feeding knowledge,” Elise says.
Prior to her presentation, Elise asked for feedback from her breastfeeding support group. The experiences shared are jaw-dropping and highlights a desperate need for breastfeeding education and policy change in daycares. The discussion also revealed that Koch’s situation was not an isolated issue.
“As first-time parents, we didn’t push back”
Martha Avery, mother of a toddler with a baby on the way, shared her experience as a first-time mom.
“My daughter was just under 1 year old and our daycare told me that once she turned 1 and moved over to the next room they could no longer give her my milk and they would switch her to cow’s milk. As a first time parent I didn’t know what else to do, or whether it was a topic that was up for discussion, but the daycare teachers are seasoned and we really liked them, so we didn’t really push back at all,” Martha says.
“I was told my breast milk was ‘dangerous’ to other kids”
A daycare in Washington, DC told Megan Pieper that her breast milk was “dangerous to expose other kids to if it spilled or touched another kiddo’s sippy cup.” Megan creatively solved this problem by saying her children had allergies to cow’s milk and asked a health practitioner to write a note stating that they were getting special milk from an organic source. “That left it ambiguous enough that I was able to get away with sending breast milk until they were 2,” Megan said.
“I felt they rushed my child’s development”
Becky Radiel, a teacher with two young children, also struggled to find a daycare in Gardner, Kansas that was breast-milk friendly.
“Our son was placed in the first toddler room, a room where we could not bring in outside food and he couldn’t have breast milk. So for a mother who was nursing her son before and after daycare, he couldn’t have any during the day. I bawled. I couldn’t bring in a doctor’s note either; the best I could do was not allow cow’s milk and continue nursing at home. It was so hard.”
When Becky had her second child, she found a daycare that claimed to be supportive of breastfeeding moms, but this was far from true.
“When my daughter was finally moved into the ‘infant 2 room’, they told us we needed to move her away from the bottle and give her a sippy cup. She also needed to transition from two naps to one nap. Rushing development much? This is the room where they took her pacifier away from her, forced me to put her breast milk in a sippy cup, required I have a doctor’s note for them to give less food, no cow’s milk, and more breast milk. In an “infant 2 room” the kids are under 1 year old and not walking fully yet. We were able to get both kids out [relatively soon after that], and to this day, my baby girl is still nursing; we are just over the one-year mark,” Becky says.
Training for daycare employees around breast milk is limited
Megan Brewer, a former daycare employee with two years of experience caring for infants and toddlers shared some insight of her training.
“I wasn’t given any knowledge of providing toddlers with breast milk due to the rule that at the age of 1 we were unable to provide bottles or sippy cups with breast milk or formula. When it came to infants, I was taught to warm the milk. I was taught that after one hour it was required that I dump unused milk once it had been warmed due to state [regulations]. All unused milk had to be dumped out, not saved. I know about the different colors of breast milk and not to be alarmed as the body [composition] changes with each baby. That was through experience, not training. Most of what I learned was verbal/trial and error from coworkers with little training from state or facility.”
A 12-month-old baby benefits from breast milk just as much as an 11-month-old baby. To remove breast milk as an option for an eight-hour stretch and switching it with cow’s milk sends a confusing message to moms who are simply trying to do what’s best for their child.
“I am bewildered by the fact that daycare centers and providers will not provide expressed breastmilk after a baby reaches one year of age,”says Summer Friedmann, an International Board Certified Lactation Consultant with 18 years of experience and founder of Done Naturally. “Especially considering the American Academy of Pediatrics and World Health Organization both recommend continued breastfeeding and breastmilk-feeding for a minimum of two years. The fact is, human milk continues to provide nutritional benefits for a child and never loses health impact.”
“Sadly, families I have worked with have expressed so much frustration with this and feel unsupported. Many have been told they have to get a written physician’s note to allow the child to be exempt from being offered cow’s milk, as well as a note from the physician deeming it appropriate to continue to have expressed breast milk beyond one year.”
Understanding CACFP breastfeeding guidelines for childcare centers
Brenda Bandy, an International Board Certified Lactation Consultant and the Executive Director of the Kansas Breastfeeding Coalition shed some light on this issue.
“The issue of providing breast milk for children over a year of age in child care is, unfortunately, a perennial problem. It usually occurs when a child care program misinterprets the Child and Adult Care Food Program (CACFP) requirements. Not all child care providers participate in CACFP, but many do.”
“Breast milk is allowed at any age in the CACFP. You can see on this handout from CACFP that breast milk is not listed as an option for children over 12 months of age. You must look closely to see the statement: ‘Breast milk is allowed at any age in the CACFP.’ Page 41 of the CACFP Infant Feeding Guidelines clearly states, ‘Breast milk may be used to meet the fluid milk component in the meal pattern for children. If a parent wants their child (1 year old or older) to be served breast milk in place of fluid milk, a written request by the parent is not required. Mothers may breastfeed on site or parents can provide pumped breastmilk for their child.’”
The CACFP meal requirements for serving milk to children over one year of age are often a source of misunderstanding, which has led many daycares to refuse mothers the right to provide their child with breast milk, Bandy notes.
Ask questions about daycare centers’ breast milk policies
Because Elise took a stand and provided much needed education and clarification, other parents at her daycare will not have to fight the same battle or feel unsupported in their breastfeeding goals. If prioritizing breast milk is one of your must-haves, it’s important to explore the options available in your own area before committing to a daycare.
5 questions to ask childcare providers about breast milk policies
Do you accept and store expressed breast milk brought from home? If so, what are your procedures for properly handling and serving it?
Do you have refrigerators/freezers specifically dedicated to storing expressed breast milk separately from other foods/drinks?
What training do your staff receive on properly handling, thawing, and serving expressed breast milk?
What are your policies on providing expressed breast milk to children over 12 months old?
For toddlers over 12 months, will staff help transition them to drinking expressed breast milk from a cup/sippy cup if needed?
Even if you don’t know if you’ll be breastfeeding until your child is 1 or after, it’s still important to inquire about their breast milk policies. Advocate for your child and for yourself by asking these questions.
“These poor families are falsely led to believe they can’t send their expressed milk. They are given incorrect information that sends them to the physician. As a lactation consultant and mother, this is completely backwards and mind boggling,” Friedmann says. “This has got to change. Children should be able to have expressed breast milk sent with them to their daycare because their parents deem it appropriate. Period.”
