Study: Paid leave laws boost breastfeeding…if you’re well off

Mother cuddling with newborn baby.

Creative Commons/David J. Laporte

Less affluent mothers more likely to return to work early, stop breastfeeding

A new study suggests that mothers in states with paid family leave laws breastfeed their newborns at higher rates. But there’s a catch: That increase applies mostly to mothers who have the luxury to take the time off. Even with paid family leave in place, low-income moms stop breastfeeding sooner.

That’s according to research conducted by San Francisco State University Health Equity Institute Assistant Professor of Economics Sepideh Modrek. Modrek found that exclusive breastfeeding of newborns increased in states that implement paid family leave policies. Those increases, though, were not seen as much for working-class mothers. 

“We found a 1.3 percent increase in exclusive breastfeeding at six months,” Modrek said. “But higher income, married, white, older moms benefitted the most in terms of breastfeeding activities.”

The Centers for Disease Control and Prevention recommends that newborns be breastfed exclusively until 6 months, followed by supplementary breastfeeding, as a complement to other food, until 12 months. To determine whether paid family leave might affect this practice, Modrek and researchers from the University of California, San Francisco, made use of data from the National Immunizations Survey, which included answers to questions about breastfeeding practices.

The annual survey was conducted from 2003 to 2015 and tracked the prevalence of exclusive breastfeeding for children aged 3 months to 12 months old. Since the United States does not have a federal paid family leave policy, Modrek focused on the only two states that had implemented such a policy within the survey’s timeframe: California and New Jersey. The team’s goal was to see if there was a difference in the breastfeeding rates and practices after the laws were enacted.

Modrek, who has taught economics at San Francisco State since 2016, said the study generally found higher rates of breastfeeding in California and New Jersey compared to the rest of the country. Exclusive breastfeeding at 3 months increased for mothers with middle-to-high income status, along with a lengthened duration of breast-feeding. However, no increase in breastfeeding rates was seen for mothers who made less than $25,000 a year.

“For less affluent mothers the paid leave might not be enough income to keep them from going back to work,” said Modrek. “If mothers know they have to go back to work within a couple weeks they may not have the time or ability to invest in breastfeeding during the key early weeks to build milk supply and establish nursing.”

California mandates 60 or 70 percent paid leave, dependent on income, with a maximum weekly wage of $1,216. New Jersey requires 66 percent of pay during family leave, with a cap at $633 a week.

“If the goal is to make sure that all women of all classes who may want to breastfeed are able to, then these laws may need to be expanded,” said Modrek, who points out that San Francisco gives mothers the right to full-income replacement for up to six weeks. She notes, however, that the benefits of breastfeeding are outside the scope of the study, and she is not maintaining that all mothers must breastfeed.

Modrek hopes to expand her research and has secured more data from the Centers for Disease Control in order to determine other ways families are impacted by leave policy, including child and maternal health outcomes.

“The idea is to accumulate a set of evidence around parental paid leave laws to [learn if] they enable more bonding in this crucial period,” she said. “We think there might be positives for both the mother and child above and beyond breastfeeding.”

Researchers Rita Hamad and Justin White at the University of California, San Francisco, were co-authors on this study.