title: Breastfeeding support in child care: an international comparison of findings from Australia and the United States.
abstract: BACKGROUND
  Many women in industrialized countries return to work while their children are infants. This is often associated with decreased breastfeeding duration or exclusivity. In order to better understand the breastfeeding support activities in childcare settings, studies were undertaken in settings with very different levels of infant mortality, breastfeeding, and breastfeeding support: Adelaide, Australia, and Wake County, North Carolina. The researchers collaborated to explore, contrast, and compare their baseline data.
  
  
  METHODS
  Available data on breastfeeding rates and infant mortality rates were explored for the two settings. In addition, the two childcare datasets were explored for common questions, and descriptive and χ(2) analyses were carried out.
  
  
  RESULTS
  Similarities were found between the response from childcare settings providers in Australia and the United States. Rates of having at least one breastfeeding infant (70.6% vs. 66.3%), a place to breastfeed (90.7% vs. 95%), and a refrigerator for storage (100% vs. 100%) were similar for Adelaide and Wake County, respectively. Qualitative data from Adelaide also mirrored Wake County data in that providers in neither setting were actively promoting breastfeeding. However, the Adelaide data reflected significantly higher rates of encouragement (95.3% vs. 21.7%), written policy (77.8% vs. 20.8%), resource/materials distribution (76.6% vs. 1% and 93.8% vs. 17%), and training (44.4% vs. 13.9%).
  
  
  CONCLUSIONS
  Childcare practices may reflect the environment of support, or lack thereof, for breastfeeding in the society as a whole. The similarities and differences seen in these settings may reflect both official guidance as well as the breastfeeding environment. There is much work to be done in the United States to come up to the same level of support for breastfeeding in child care and in other programs as is seen in Australia.
authors.affiliation: Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 27599-7445, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Cameron
authors.forename: Sara
authors.initials: S
authors.lastname: Javanparast
authors.forename: Miriam
authors.initials: M
authors.lastname: Labbok
authors.forename: Rachel
authors.initials: R
authors.lastname: Scheckter
authors.forename: Ellen
authors.initials: E
authors.lastname: McIntyre
mesh_terms: D001315:Australia / Q000453:epidemiology; D001942:Breast Feeding / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data*; D007229:Infant Welfare / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D011181:Postnatal Care / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D014481:United States / Q000453:epidemiology