Breastfeeding increased by 2 weeks when mothers stayed at home

Research finding offers support for National paid family leave policy.

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The Academy of Pediatrics recommends six months of exclusive breastfeeding, as the practice is well known to improve health for both infant and parent. The United States ranks worse than similar countries regarding breastfeeding initiation and duration. A new study by the UC San Francisco estimated changes in national breastfeeding trends immediately before and after COVID-19‒related workplace closures in early 2020.

Scientists used the 2017-2020 national survey and birth certificate data for 118,139 postpartum people to examine whether an infant was breastfed and, if so, for how long. They compared the initiation and duration of breastfeeding for babies born before and after shelter-in-place policies.

Compared to before the pandemic, American mothers breastfed their babies for two weeks longer when COVID-19 shelter-in-place orders were in effect.

Implementing shelter-in-place policies in early 2020, when 90% of people in the United States were urged to remain at home, represents a unique natural experiment to assess the pent-up demand for breastfeeding among U.S. women that the lack of a national paid leave policy may stymie.

First author Rita Hamad, MD, Ph.D., UCSF associate professor in Family and Community Medicine, and the director of UCSF’s Social Policies for Health Equity Research Program, said, “Stay-at-home policies enabled parents to continue breastfeeding at home instead of returning to the workplace. This suggests a pent-up demand for breastfeeding which may be stymied by the lack of a national paid family leave policy in the U.S.”

White women and those with higher incomes saw the most increases in breastfeeding duration under shelter-in-place, likely because these groups had employment that could be done more easily at home.

Breastfeeding improvements in this group were less significant because Hispanic parents were more likely to have “essential,” low-paying professions during the epidemic, according to the study.

While breastfeeding rates did not change throughout the pandemic, women nursed their children for an additional 12.6 to 14.8 weeks, or 18% longer. White women experienced a 19% rise in duration, whereas Hispanic women experienced a 10.3% decrease. Women with higher incomes increased by 18.5% compared to 16.8% for lower-income women. Before returning to pre-pandemic levels, the prolonged durations remained through at least August 2020.

Scientists noted, “The fact that breastfeeding initiation overall didn’t change in the early pandemic months may suggest that barriers to starting breastfeeding differ from those for continuing. However, Black and low-income subgroups did show a dip in initiation during the pandemic, which may reflect less access to breastfeeding support during shelter-in-place for these groups.”

Hamad said, “Our study suggests that breastfeeding duration in the U.S. would be higher and more comparable to peer countries if working parents were paid while staying home to care for their newborns, particularly parents of color and those with lower income jobs who can’t afford to take unpaid time off work.”

Journal Reference:

  1. Rita Hamad, Daniel F. Collin et al. The Pent-Up Demand for Breastfeeding Among U.S. Women: Trends After COVID-19 Shelter-in-Place. American Journal of Public Health. DOI: 10.2105/AJPH.2023.307313
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