Improving Breastfeeding Environments and Feeding Practices in Family Child Care Homes with the Go NAP SACC Program

Kara Kohel, Holly Hatton-Bowers, Natalie Williams, Dipti Dev, Donnia Behrends, Emily Hulse, Zainab Rida, Holly Dingman, Danae Dinkel, Liz Gebhart

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: Breastfeeding and responsive feeding are important practices that support the health of infants and women. In the United States, breastfeeding continuation rates remain lower than recommended, and working women face additional challenges with breastfeeding continuation. Providers in a family child care setting are uniquely positioned to support and provide important resources to families in their breastfeeding and infant feeding practices. Methods: The Go NAP SACC program was designed to improve the nutrition and physical activity environments and practices in child care settings serving infants and young children. This evaluation focuses on Breastfeeding and Infant Feeding in Nebraska Family Child Care Homes (FCCH). Assessment: Paired-sample t-tests were used to examine differences in pre-post evaluation scores. A repeated measure ANCOVA was used to examine differences between rural–urban settings. Nebraska FCCH met recommendations at pre-test, and exceeded recommendations at post-test (p < .05). Rural and urban FCCH performed equally well in 18 of 22 items, indicating little difference in the ability to provide supportive environments and adhere to best practices in both settings. Improvement in family engagement items were significant at the p < .001 level. Family engagement in FCCH is an important area for intervention that was well-received by provider participants. Conclusion: This evaluation shows that the Go NAP SACC program improves breastfeeding and infant feeding environments and practices in rural and urban FCCH. Interventions should continue to focus on basic and practical education and professional development for FCCH providers, with emphasis on intentional family engagement and support.

Original languageEnglish (US)
Pages (from-to)510-520
Number of pages11
JournalMaternal and Child Health Journal
Issue number4
StatePublished - Apr 2021


  • Breastfeeding
  • Child care
  • Family child care home
  • Family engagement
  • Infant
  • Nutrition
  • Responsive feeding

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Epidemiology
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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