Breastfeeding is good for the health of both mother and baby. It creates moms who are more responsive to their infant's needs, and may even confer cognitive benefits to the developing child. So why do American women breastfeed at a rate lower than any other industrialized nation?
Fear of being stigmatized is certainly one reason, but the primary drawback is probably economic. It's hard to breastfeed regularly while holding down a full-time job—and for many women, giving up the latter is not a realistic option.
New research offers some good news: Progressive governmental policies that support new parents can make a difference. It finds babies were more likely to be exclusively breastfed at six months in states that have paid family leave policies, which guarantee new parents a portion of their salary for the first six weeks of a child's life.
Such laws "allow mothers to modestly encourage extended breastfeeding during infancy, a critical developmental window for child health," writes a research team led by Rita Hamad of the University of California–San Francisco.
This good news comes with a caveat: This benefit was largely confined to higher-income women. A guarantee of a partial salary may not be enough to allow women in low-paying jobs to stay home with their infants.
The study, published in the American Journal of Public Health, utilizes a diverse sample of more than 306,000 American children born between 2003 and 2013. The data includes several measures of breastfeeding behavior, including whether the child was exclusively breastfed at three and six months, and whether the mother was still breastfeeding part of the time at the one-year mark.
Most health organizations recommend solely breastfeeding for six months, and mixing breast milk with other forms of nutrition over the following six months. As the researchers note, "breastfeeding duration is thought to influence infants' risk of infection and other outcomes later in childhood."
The researchers compared rates in the two states that enacted parental leave policies during this period—California and New Jersey—with those in other states. (Rhode Island and New York followed in 2014 and 2018, respectively.)
The researchers found only one indicator—exclusive breastfeeding at six months—was positively affected by the laws. While that might seem to be a modest result, they point out the data set they used included all women—not just those who worked outside the home, and were thus potentially affected by these policies. Restricting the results to that subset of the population would presumably reveal greater benefits.
Why would six weeks of leave lead to more breastfeeding at six months? The researchers speculate that time to focus on parenting may increase mother-child bonding, as well as giving new moms "increased time to gain the skills and social support to maintain breastfeeding after returning to work."
The disappointing news: Demographic analysis revealed these polices "favor more advantaged women," the researchers add. "Because the California and New Jersey policies provide only partially paid leave (55 and 67 percent respectively, up to a specified weekly limit), the benefits may not be sufficient to support low-income workers who can ill-afford any loss of wages."
So, in an apparent case of unintended consequences, these laws may exacerbate health disparities between the rich and poor. But they also mean more babies are enjoying the benefits of breastfeeding longer into their young lives.