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Subject:
From:
Laura Spitzfaden <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 20 Jul 2017 12:44:29 -0400
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It is not true that she needs a doctor's note. I wrote about this subject a few years ago and it was posted in Lactation Matters. 

http://feedthebabyllc.com/usda-child-nutrition-program-breastfed-toddlers-and-day-care/

The only time a Dr.'s note is needed is if the milk substitution is something other than cow's milk or breastmilk even if the baby is over 1 year.

The following from link from USDA.gov states:

Use of Breastmilk for Babies Over 12 Months of
Age 
Some parents may request that the caregiver continue feeding
their babies breastmilk after 12 months of age.  Continue to
serve babies their mother’s milk as long as the mother is able
and wishes to provide it.  Mothers who wish to continue provid-
ing breastmilk for their babies older than 12 months of age can
do so without having to submit a medical statement.  Breastmilk
is a substitute for cow’s milk in the meal pattern for children.  

https://www.fns.usda.gov/sites/default/files/feedinginfants-ch3.pdf

My frustration lies with the parent who wishes to pump wean and not give substitute milk to their older toddler who is nursing plenty when they are together. Either the daycare provider must take a hit to their compensation with the food program or the baby must be served either cow's milk which threatens the breastfeeding relationship or the parent must continue to pump when it is no longer necessary.

Laura Spitzfaden, LLLL, APL, IBCLC

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