Family Matters

Want to Boost Breast-Feeding Rates? More Maternity Leave is Key

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If the United States wants to significantly increase its breast-feeding rates, extending women’s maternity leave would be a good place to start, according to new research published today in the journal Pediatrics.

Public health researchers from the University of South Carolina found that women whose maternity leave lasted longer than six weeks were more likely to initiate breast-feeding, continue for more than six months and rely mostly on exclusive breast-feeding beyond three months, compared with women who returned to work between one and six weeks after giving birth.

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Not surprisingly, women whose maternity leave lasted at least 13 weeks were particularly likely to shun formula in favor of breast milk for more than three months after delivery.

“Based on our findings, if women delay their return to work, then the prevalence of breast-feeding in the U.S. may increase,” says Saundra Glover, associate dean for health disparities and social justice in the School of Public Health at the University of South Carolina.

For breast-feeding rates to improve, contend experts and advocates, there has to be a significant amount of societal support in terms of longer, paid leaves. Many women can’t afford to not earn an income, leading them to  head back to the workplace soon after they give birth. A greater proportion of poorer women return to work within six weeks, which likely contributes to their lower breast-feeding initiation rates.

Researchers interviewed 6,150 women at nine months postpartum, looking at length of total maternity leave, length of paid leave and point at which women returned to work to assess how time off after giving birth impacts breast-feeding.

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The study controlled for factors including ethnicity, race (blacks have lower rates of breast-feeding compared to whites) and age (women aged 35 or older are more likely to initiate breast-feeding and more likely to stay home from work at least six weeks) to conclude that:

  • Women who returned to work at 13 weeks or later were 99% more likely to predominantly breast-feed (meaning they might also supplement with water) more than three months, compared to those who returned within six weeks. They were also 21% more likely to breast-feed — with or without supplemental formula — beyond three months.
  • Women who had not yet returned to work by the nine-month interview were 13% more likely to initiate breast-feeding compared with those who returned to work within the first six weeks. They also were 70% more likely to predominantly breast-feed beyond three months.

On average, mothers stay out of work an average of 12.4 weeks, which coincides neatly with the 12 weeks that the federal Family Medical Leave Act (FMLA) protects a woman’s job from being ceded to another employee.

“If the FMLA could be extended, and were some remuneration attached to leave as recommended in the Surgeon General’s Call to Action to Support Breastfeeding, women would be more likely to stay home,” says Chinelo Ogbuanu, a senior maternal and child health epidemiologist at the Georgia Department of Community Health who conducted the research as a doctoral student at the University of South Carolina.

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The U.S. doesn’t have much company when it comes to unpaid maternity leave. It’s one of just a handful of countries that don’t mandate any compensation during time off after giving birth, along with nations including Swaziland and Papua New Guinea.

Would paid leave — and more time off — have helped you breast-feed longer?