Maternity or parental leave and breastfeeding duration: Results from the ELFE cohort.
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SUBMITTER: de Lauzon-Guillain B
PROVIDER: S-EPMC6859974 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objectives. To examine associations of workplace leave length with breastfeeding initiation and continuation at 1, 2, and 3 months. Methods. We analyzed 2016 to 2018 data for 10 sites in the United States from the Pregnancy Risk Assessment Monitoring System, a site-specific, population-based surveillance system that samples women with a recent live birth 2 to 6 months after birth. Using multivariable logistic regression, we examined associations of leave length (< 3 vs ≥ 3 months) with breastfeeding outcomes. Results. Among 12 301 postpartum women who planned to or had returned to the job they had during pregnancy, 42.1% reported taking unpaid leave, 37.5% reported paid leave, 18.2% reported both unpaid and paid leave, and 2.2% reported no leave. Approximately two thirds (66.2%) of women reported taking less than 3 months of leave. Although 91.2% of women initiated breastfeeding, 81.2%, 72.1%, and 65.3% of women continued breastfeeding at 1, 2, and 3 months, respectively. Shorter leave length (< 3 months), whether paid or unpaid, was associated with lower prevalence of breastfeeding at 2 and 3 months compared with 3 or more months of leave. Conclusions. Women with less than 3 months of leave reported shorter breastfeeding duration than did women with 3 or more months of leave. (Am J Public Health. 2021;111(11):2036-2045. https://doi.org/10.2105/AJPH.2021.306484).
| S-EPMC8630484 | biostudies-literature
Project description:BACKGROUND:Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90?days; additionally, a further 300?days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding. AIM:To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12?months after birth. An additional aim was to describe infants' and parents' characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding. METHODS:This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012-2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding. RESULTS:Infants were exclusively breastfed for, on average, 2.5?months (range 0-12?months) and partially breastfed, on average, 7?months (range 0-12?months). Most of the parental leave was taken by the mother (mean?=?10.9?months) during the infant's first 12?months, while the partner took 3?months, on average. The parental leave (used and planned) during the infant's first 24?months were, on average, 21?months. In the multivariate linear regression analysis, mothers' and partners' high level of education (p?<?0.001, p?=?0.044, respectively), mothers' higher age (p?=?0.049), non-instrumental vaginal birth (p?=?0.004) and longer parental leave for the first 24?months (p?<?0.001) were associated with longer duration of partial breastfeeding. CONCLUSION:The duration of partial breastfeeding was associated with higher parental educational level, higher age, non-instrumental vaginal birth and longer parental leave.
| S-EPMC7155253 | biostudies-literature
Project description:In low- and middle-income countries, the protective effect of breastfeeding against infections is well established, but in high-income countries, the effect could be weakened by higher hygienic conditions. We aimed to examine the association between breastfeeding and infections in the first 2 years of life, in a high-income country with relatively short breastfeeding duration. Among 10,349 young children from the nationwide Etude Longitudinale Française depuis l'Enfance (ELFE) birth cohort, breastfeeding and parent-reported hospitalizations, bronchiolitis and otitis events, and antibiotic use were prospectively collected up to 2 years. Never-breastfed infants were used as reference group. Any breastfeeding for <3 months was associated with higher risks of hospitalizations from gastrointestinal infections or fever. Predominant breastfeeding for <1 month was associated with higher risk of a single hospital admission while predominant breastfeeding for ≥3 months was associated with a lower risk of long duration (≥4 nights) of hospitalization. Ever breastfeeding was associated with lower risk of antibiotic use. This study confirmed the well-known associations between breastfeeding and hospitalizations but also highlighted a strong inverse association between breastfeeding and antibiotic use. Although we cannot infer causality from this observational study, this finding is worth highlighting in a context of rising concern regarding antibiotic resistance.
| S-EPMC6682893 | biostudies-literature
Project description:Objectives:Many women do not reach their own breastfeeding goals regarding duration of breastfeeding. Different factors influence breastfeeding, and to learn more about breastfeeding within a multidimensional and longitudinal perspective, further research is needed. Therefore, the aim of the present study was to investigate diverse factors correlated with first-time mothers' enjoyment of breastfeeding and breastfeeding duration, between childbirth and two years after birth. Methods:In a prospective longitudinal cohort study, 324 newly become mothers were followed. The Spearman correlation test was used to investigate factors correlated with the degree to which mothers enjoy breastfeeding and the duration of breastfeeding. The Mann-Whitney test was conducted for comparisons of demographic characteristics between mothers who did or did not breastfeed. Results:Among the mothers, 99.2% initiated breastfeeding after birth. Frequencies of breastfeeding were 54.8% at six months, 9.1% at one year, and 1.0% at two years. The degree to which the mother enjoyed breastfeeding was correlated positively with (1) the duration of breastfeeding, (2) more positive feelings for and relation to the child, (3) the partner's perceived relation to the child, (4) a higher sense of coherence, and (5) stronger perceived parental couple's relationship. Longer breastfeeding duration was correlated positively with (1) a higher degree of enjoyment of breastfeeding, (2) more positive relation to the child, and (3) stronger perceived parental couple's relationship. Additionally, breastfeeding during the first two hours after birth, more positive feelings for and relation to the child, and a higher degree of enjoyment of breastfeeding were more frequently reported among breastfeeding mothers, in comparison with not breastfeeding mothers. Conclusion:Mothers' subjective experience from breastfeeding, sense of coherence, and couple relationship with partner and relationship with the child are valuable factors in regard to breastfeeding.
| S-EPMC7321520 | biostudies-literature
Project description:Most professional and international organizations recommend folic acid supplementation for women planning pregnancy. Various studies have shown high levels of non-compliance with this recommendation. This study aimed to identify sociodemographic characteristics related to this compliance. The analyses were based on 16,809 women from the French nationwide ELFE cohort (Etude Longitudinale Française depuis l'Enfance). Folic acid supplementation was assessed at delivery, and sociodemographic characteristics were collected at two months postpartum. The association between sociodemographic characteristics and compliance with recommendations on folic acid supplementation (no supplementation, periconceptional supplementation, and supplementation only after the periconceptional period) was examined using multivariate multinomial logistic regression. Only 26% of French women received folic acid supplementation during the periconceptional period, 10% of women received supplementation after the periconceptional period, and 64% received no supplementation. Young maternal age, low education level, low family income, multiparity, single parenthood, maternal unemployment, maternal overweight, and smoking during pregnancy were related to lower likelihood of folic acid supplementation during the periconceptional period compared to no supplementation. These associations were not explained by unplanned pregnancy. Immigrant and underweight women were more likely to receive folic acid supplementation after the periconceptional period. Our study confirms great social disparities in France regarding the compliance with the recommendations on folic acid supplementation.
| S-EPMC6566921 | biostudies-literature
Project description:ObjectivesTo understand differences in the relationship between parental leave duration and postpartum care across sociodemographic and income groups.MethodsWe used data from six states participating in the Center for Disease Control and Prevention's yearly PRAMS study from 2016 to 2019 with a total sample of 12,442 people. Bivariable analyses assessed demographics among those who took more or less parental leave and estimated the prevalence of not accessing postpartum care by demographics, stratified by leave length. We used propensity score weighting to estimate the predicted risk and risk ratios of not accessing postpartum care with < 7 as compared to > = 7 weeks of leave, stratified by income.ResultsThere were significant differences in the prevalence of not accessing care stratified by leave duration, and disparities in utilization by race, ethnicity, and income. A shorter leave duration was associated with a higher risk of not accessing care (RR: 1.98 [CI 1.25-3.20] in higher income group, RR: 1.45 [CI 1.08, 1.99] in lower). The absolute risk of not accessing care was highest in the lower income group regardless of leave duration, though patterns of increased utilization with longer leave duration were consistent in both groups.Conclusions for practiceWhile shorter leave durations increased the risk of not attending postpartum care, those with lower incomes had the highest absolute risk of not attending care. Policies to support paid leave and extended leave duration are necessary, along with additional supports to increase postpartum care utilization, particularly among low-income families.
| S-EPMC11358175 | biostudies-literature
Project description:BackgroundMaternity leave reduces neonatal and infant mortality rates in high-income countries. However, the impact of maternity leave on infant health has not been rigorously evaluated in low- and middle-income countries (LMICs). In this study, we utilized a difference-in-differences approach to evaluate whether paid maternity leave policies affect infant mortality in LMICs.Methods and findingsWe used birth history data collected via the Demographic and Health Surveys to assemble a panel of approximately 300,000 live births in 20 countries from 2000 to 2008; these observational data were merged with longitudinal information on the duration of paid maternity leave provided by each country. We estimated the effect of an increase in maternity leave in the prior year on the probability of infant (<1 y), neonatal (<28 d), and post-neonatal (between 28 d and 1 y after birth) mortality. Fixed effects for country and year were included to control for, respectively, unobserved time-invariant confounders that varied across countries and temporal trends in mortality that were shared across countries. Average rates of infant, neonatal, and post-neonatal mortality over the study period were 55.2, 30.7, and 23.0 per 1,000 live births, respectively. Each additional month of paid maternity was associated with 7.9 fewer infant deaths per 1,000 live births (95% CI 3.7, 12.0), reflecting a 13% relative reduction. Reductions in infant mortality associated with increases in the duration of paid maternity leave were concentrated in the post-neonatal period. Estimates were robust to adjustment for individual, household, and country-level characteristics, although there may be residual confounding by unmeasured time-varying confounders, such as coincident policy changes.ConclusionsMore generous paid maternity leave policies represent a potential instrument for facilitating early-life interventions and reducing infant mortality in LMICs and warrant further discussion in the post-2015 sustainable development agenda. From a policy planning perspective, further work is needed to elucidate the mechanisms that explain the benefits of paid maternity leave for infant mortality.
| S-EPMC4811564 | biostudies-literature
Project description:Background and purposeA uniform policy on parental leave in radiology training programs is lacking. Although previous publications have addressed the status of parental leave policy among radiology residency programs, the state of parental leave in radiology fellowships has not been addressed to date. Our aim was to determine the state of parental leave policies in American neuroradiology fellowship programs.Materials and methodsAn Internet survey was sent to the directors of neuroradiology fellowship programs listed on the Accreditation Council for Graduate Medical Education Web site (n = 87) in January 2020. The questionnaire assessed the policies of the fellowship programs and Program Directors' attitudes toward maternal and paternal leave. Four reminders were sent during the 3 weeks before closing data collection.ResultsThe response rate was 76% (66/87). Ninety-four percent (62/66) of program directors claimed to have a maternal leave policy, of which 51/62 (82%) were written and 53/62 (85%) were paid. Additionally, 77% (51/66) had a policy for paternal leave, of which 80% (41/51) were written and 76% (39/51) were paid. The average length of paid leave was 6.7 ± 3.25 weeks for new mothers and 2.9 ± 2 weeks for new fathers. Unpaid leave was mostly based on the Family and Medical Leave Act. Fellows were responsible for making up call duties during the parental leave in 47% of the programs. Radiation exposure was restricted in 89% of the programs during pregnancy. Policies addressed breast feeding and untraditional parenthood in just 41% of the responding programs. Most program directors supported the development of a unified national policy on maternal (83%) and paternal (79%) leave.ConclusionsMost neuroradiology fellowship programs have explicit maternal and paternal leave policies that grant paid leave to trainees. Some also offer unpaid leave, mostly through Family and Medical Leave Act guidelines. A uniform policy derived from the Accreditation Council for Graduate Medical Education and/or American Board of Radiology would be useful and overwhelmingly accepted.
| S-EPMC7658894 | biostudies-literature
Project description:The WHO European Region has the lowest exclusive breastfeeding (EBF) rates at 6 months in the world. In Austria, 55.5% of infants are EBF at the age of one week, although breastfeeding initiation is 97.5%. The study was conducted in 2019/2020 and considered 1214 mothers of legal age, who received four online questionnaires during their child’s first year of life. The influence of different variables on total/exclusive breastfeeding duration were analysed by using a Cox model (Extension of the Cox Proportional Hazards Model) with time-dependent covariates. Multivariate analyses showed a significant influence of maternal BMI, lifestyle factors, such as smoking, and breastfeeding support on total breastfeeding duration. Remarkable differences in the median duration of any breastfeeding were found for breastfeeding support, where mothers breastfed twice as long. Support came primarily from hospital staff, the midwife and the partner. A higher monthly household net income, delivery in a baby-friendly certified hospital (BFH) and breastfeeding support were associated with a longer EBF duration. Obese mothers started feeding infant formula earlier and had a higher risk of early weaning. The results offer valuable insights into the importance of breastfeeding-friendly structures such as BFHs, a focus on breastfeeding aftercare and support of the mother to promote and protect breastfeeding.
| S-EPMC9102851 | biostudies-literature
Project description:ImportanceBenchmarking attitudes surrounding parental leave among posttraining North American ophthalmologists may reveal possible areas for intervention.ObjectiveTo evaluate perceptions of current parental leave policy and culture among posttraining North American ophthalmologists.Design, setting, and participantsThis nonvalidated survey used a 19-item online questionnaire. A convenience sample of 186 self-identified North American-based ophthalmologists who had completed training was obtained using listservs, residency program coordinators, and social media. Data collection occurred from May to July 2022.Main outcomes and measuresDescriptive analysis demonstrated response frequencies. Pearson χ2 comparison of means was performed for categorical variables. Two-tailed t tests were performed for continuous variables.ResultsAmong the 186 surveys completed, 105 respondents (56.5%) identified as female, 76 (40.9%) worked in academia, 133 (71.5%) were 1 to 20 years out of training, and 156 (83.9%) had children. Attitudes toward stop-the-clock policies, or delays in tenure/promotion/partnership review when taking leave, were mixed. Of 171 respondents, 78 (45.6%) thought that stop-the-clock policies should be optional, 39 (22.8%) thought that they should be required, and 31 (18.1%) thought that they should be removed. Of 76 academicians responding, 56 (73.7%) and 49 (64.5%) were unaware if their institution had a stop-the-clock policy for tenure review or promotion review, respectively. Male and female respondents differed in feeling comfortable with taking leave (36 of 66 [54.5%] vs 67 of 90 [74.4%], respectively; P = .04), as well as in their ratings of stress about peer perception on a scale of 0 to 10 (3.70 vs 4.81, respectively; P = .05). Private practitioners and academicians differed in confirmation of leave options for both parents (52 of 101 [51.5%] vs 49 of 69 [71.0%], respectively; P = .02) and ratings of financial stress (7.10 vs 5.43, respectively; P = .004) and research considerations (1.60 vs 3.85, respectively; P < .001).Conclusions and relevanceResults of this survey study support the hypothesis that demographic factors affect attitudes toward parental leave among posttraining ophthalmologists; policies could be better publicized. Feelings regarding policies and leave were mixed. These findings should be viewed as hypothesis generating because the survey was not validated and the associations provided could be due to confounding factors.
| S-EPMC9856738 | biostudies-literature