ArticleInternational breastfeeding journal2025
Maternity leave and breastfeeding during COVID: a cross-sectional study.
Article in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
backgroundMaternity leave is an important driver of a woman’s ability to breastfeed, but this association may have changed during the COVID pandemic, which introduced new employment dynamics and breastfeeding challenges for mothers in the workforce. Our objectives were to examine the associations between maternity leave length and type of maternity leave (paid vs. unpaid) with breastfeeding initiation and breastfeeding duration during the pandemic, and to compare our findings with pre-pandemic data.
methodsOur sample was 3,683 recently postpartum women, currently in the workforce, who had given birth between March-December 2020 in the US. Data were obtained from the Pregnancy Risk Assessment and Monitoring System (PRAMS) survey, a population-based surveillance system developed by the Centers for Disease Control (CDC) in the US. We examined associations between taking longer maternity leave compared with shorter (≥ 3 vs. < 3 months), and breastfeeding initiation or continuation (at 1, 2, and 3 months after delivery). We also examined heterogeneity in the associations between maternity leave and breastfeeding by a range of characteristics.
resultsDuring COVID, having a longer maternity leave was not associated with breastfeeding initiation or continuation. These results contrast with pre-pandemic findings from the same cohort, in which a longer maternity leave was associated with more breastfeeding. In tests of heterogeneity in our current analysis, women who were younger, not married, less educated, or who did not receive any pay during their leave were less likely to continue breastfeeding if they took a shorter maternity leave than if they took a longer maternity leave.
conclusionsThe COVID pandemic created a natural experiment for exploring associations between employment and breastfeeding among women in the workforce. Our results suggest that the conditions of the pandemic may have minimized average differences in breastfeeding outcomes by maternity leave length because more women were at home. However, our study highlighted that benefits were concentrated among women who were older, more educated, married, and who received paid leave, reinforcing the urgent need to support women who face greater economic and social disadvantages within the US.
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