Supporting Breastfeeding in Early Childhood Education and Care Settings in Italy: A Relational and Cultural Analysis of Maternal and Educator Perspectives

在意大利的幼儿教育和保育机构中支持母乳喂养:基于母亲和教育者视角的关系和文化分析

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Abstract

Background/Objectives: Breastfeeding is widely acknowledged for its benefits to child development and maternal well-being. Yet breastfeeding practices often decline during early childhood transitions, particularly when children enter early childhood education and care (ECEC) services. Research has largely concentrated on healthcare contexts, leaving the educational domain comparatively underexplored in its potential to sustain or hinder breastfeeding continuation. This cross-sectional study examines associations between maternal beliefs regarding the value of breastfeeding and personal, relational, and contextual factors related to breastfeeding continuation within ECEC settings. It also incorporates educators' perspectives and situates breastfeeding practices within the broader framework of parental ethnotheories. Methods: The study formed part of a pilot parental engagement initiative involving 17 childcare centers in Northern Italy, designed to promote dialogue and supportive practices around breastfeeding within ECEC services. This context is acknowledged when interpreting findings related to organizational climate and educator perspectives. Participants included 490 mothers of children enrolled in ECEC services and 118 educators. Mothers completed questionnaires assessing breastfeeding beliefs and experiences, co-sleeping practices, perceived social support, and parental ethnotheories (independence versus interdependence). Educators reported on their experiences in supporting breastfeeding within the childcare context. Analyses included descriptive statistics, analyses of variance, chi-square tests, and binary logistic regression to examine factors associated with breastfeeding continuation. Results: Mothers strongly endorsed the developmental benefits of breastfeeding and expressed greater alignment with caregiving practices emphasizing interdependence and physical proximity. Continued breastfeeding within childcare settings correlated with interdependence-oriented ethnotheories, younger child age, and higher engagement in co-sleeping practices. Educators reported generally positive views of breastfeeding in childcare, highlighting its contribution to children's emotional security and maternal calm, alongside its negligible impact on educational organization. Conclusions: ECEC services play a crucial role in sustaining breastfeeding beyond the domestic sphere. Relational practices and organizational climates that welcome breastfeeding can foster continuity of care, strengthen parental engagement, and promote child well-being.

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