Perception and handling of breastmilk by childcare staff: A qualitative study of childcare facilities in Japan

BACKGROUND: Breastfeeding in infancy has immunological and nutritional benefits. The actual status of breastfeeding in childcare facilities is unclear. However, it is expected to vary in every facility and region. This study aimed to explore what the staff of childcare facilities perceive of breastfeeding and how they feel about handling breast milk. METHODS: The study was conducted from May 2012 to September 2015. A list of childcare facilities in three cities in Japan was compiled. A questionnaire was sent to the facilities by mail asking whether or not they provided breastfeeding care and whether or not they would participate in the study. Semi‐structured interviews were conducted with the staff members of childcare facilities that consented to the study. The transcribed text was analyzed by thematic analysis. RESULTS: Of the 211 facilities sent, 55 responded, and 21 of these facilities were implementing breastfeeding. Interviews were conducted at four facilities for those who agreed to be interviewed. The researchers extracted three categories of breastfeeding factors at childcare facilities: the value that caregivers see in breastfeeding, difficulties associated with breastfeeding in childcare facilities, and devices and elements for breastfeeding by childcare facilities. Although facility staff acknowledged the nutritional and psychosocial benefits of breast milk, they also felt the administrative difficulties and mental burden of handling expressed breast milk. CONCLUSION: This study revealed that for the childcare facility staff, breastfeeding was positioned as a means of communication and reassurance to the mother, and the immunological and nutritional benefits of breast milk.