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This non-substantive amendment aligns with the recommendations from Caring for Our Children and maintains OSSE’s intent as set forth in the proposed rulemaking to ensure that facilities are using safe approaches to feeding infants while in their care.

One commenter recommended the language in § 156.2(m) is amended to prohibit microwaving breast milk, unless parents have been notified in writing. OSSE will not accept the commenter’s recommended language. Microwaving breastmilk is prohibited because uneven hot spots in the milk may cause burns in the infant and excessive heat may destroy beneficial components of the milk. Subsection 156.2(m) provides that parents must be notified in writing if a facility plans to microwave liquids and foods, other than breastmilk.

Swimming and Water Play Section 157 provides the requirements for swimming and water play. As noted in Caring for Our Children, drowning is the second leading cause of unintentional injury-related death for children ages one to fourteen. Children can drown in as little as two inches of water. A prior study of drowning deaths of children younger than five years of age attributed the highest percentage of drowning reports to an adult losing contact or knowledge of the whereabouts of the child. OSSE set forth the requirements in § 157 because timely administration of resuscitation efforts by a trained staff member trained is critical. The circumstances surrounding drowning and water- related injuries of young children suggest that staffing requirements and environmental modifications may reduce the risk of this type of injury. Further, studies have shown that prompt rescue and the presence of a trained resuscitator at the site can save about 30% of the victims without significant neurological consequences.

OSSE received three comments on § 157. Two stakeholders sought clarification of the requirements in § 157.7 and § 157.8 regarding the ratios, training and certification for water play and whether such training and water play was required for water table play. OSSE has considered these comments and recognizes that phrase “water activities” is not clear as the phrase includes anything from playing at water tables to swimming. OSSE intended to distinguish requirements for proper supervision during various water activities in the proposed rulemaking; however, further clarification in the final rulemaking is necessary based on the comments received.

To clarify the requirements for swimming or playing in water, OSSE strikes § 157.7 and renumbers the following subsections accordingly. In § 157.8, which requires adults certified as lifeguard or water safety instructor, OSSE strikes the phrase “all children’s water activities” and inserts “children are swimming or playing in water, including baby pools, wading pools, and full-depth pools” in its place. Finally, in § 157.10(a), which is now § 157.9(a), OSSE strikes “Children are supervised in accordance with supervision provisions of Subsection 157.7” and inserts “(a) At least one (1) adult for every six (6) children shall be certified in pediatric First Aid and CPR and in attendance. Adult-to-child ratios as set forth in Section 121 shall be maintained” in its place. These non-substantive amendments clarify the varying requirements for swimming and water table play while maintaining OSSE’s intent to distinguish requirements for proper supervision during various water activities.