Study: Paid Family Leave Boosted Breast Feeding

New research provides support for policy increasingly popular within GOP

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California's paid family leave law led to new moms breastfeeding more, a study released Monday finds, reflecting a benefit that could be spread nationwide by current proposals for federal PFL.

The paper, by three professors from Columbia and one from the University of Virginia, examines the effects of California's first-in-the nation introduction of paid leave for new parents in 2004. Under the law, parents are entitled to up to six weeks of leave following the birth or adoption of a child, compensated at a fixed percentage of their pre-leave income.

The results are notable. Based on their analysis, the new study's authors conclude that California's PFL law increased breastfeeding by nearly 18 days on average, and raised the probability of breastfeeding for at least six months by five percentage points. These effects were strongest among "historically disadvantaged groups of women."

Family leave policies are widespread in the rest of the developed world, and studies have linked these laws to higher frequency of breastfeeding. But just 14 percent of U.S. workers have access to PFL, meaning that new mothers—especially poorer ones—often opt to return to work quickly rather than forgo much-needed wages.

This matters because breastfeeding has been connected to benefits for both mother and child. Observational research has linked breastfeeding to lower incidences of obesity and type II diabetes, and higher IQ; more robust randomized studies have tied it to lower incidences of gastrointestinal tract infections and atopic eczema. More significant benefits accrue to mothers in terms of a 20 to 30 percent reduction in risk of cancer and type II diabetes.

On the basis of these benefits, the American Academy of Pediatrics recommends exclusively breastfeeding infants through the first six months. But, according to the Centers for Disease Control, many women do not breastfeed this long, with the switch to formula particularly common among low socio-economic-status mothers, including black moms and the parents of children eligible for WIC benefits. Although women stop for a host of reasons, many in particular cite "unsupportive work policies and lack of parental leave" as a key justification for doing so.

As such, the new study asks how a program like California's PFL policy can encourage breastfeeding. To study this topic, the authors used data from the nationally representative National Immunization Survey, which asks mothers about their breastfeeding habits among a suite of other topics.

Using these data, the authors compared the breastfeeding habits of women both in California and in other states, before and after the introduction of California's PFL law. (Their comparison states were weighted to produce pre-treatment parallelism to California, what is called a "synthetic control" method.)

They found that duration and length of breastfeeding rose after 2004 both in California and outside of it, but that California saw a bigger bump. Interestingly, the authors note, PFL did not seem to lead to more mothers breastfeeding who otherwise did not; in other words, it worked by mostly encouraging women to breastfeed for longer overall.

This, they speculate, is because PFL makes it easier for women to return to work later than they would have otherwise, leading to more time spent breastfeeding a newborn. This also explains why low-status women were more likely to breastfeed longer after PFL: in general, it is high-status, high-earning women who have access to private paid leave plans, while low-status women must return to work quickly absent government support.

Both conclusions—that PFL encourages breastfeeding, and that its effect is particularly apparent among poor mothers—should hearten advocates of federal paid family leave. This is a group that increasingly includes Congressional Republicans; multiple GOP bills to implement PFL have been floated in recent months. These proposals would allow new parents to draw on their social security entitlements early to replace wages, repaying the withdrawals by delaying retirement slightly.

"Families, of course, are the bedrock of our society," Sen. Mike Lee (R., Utah) said in rolling out his and Sen. Joni Ernst's (R., Iowa) PFL proposal. "The family is the fundamental unit of society, upon which the success of society is contingent."