A Pediatrician's View Of Paid Parental Leave

Oct 10, 2016
Originally published on October 10, 2016 6:55 pm

Paternity leave can make a big difference in a dad's long-term engagement with the child, doctors find. Paid family leave also fosters breastfeeding and reduces the incidence of maternal depression.

As part of All Things Considered's series Stretched: Working Parents' Juggling Act, NPR talked with Dr. Benard Dreyer, a developmental and behavioral pediatrician at the New York University School of Medicine and president of the American Academy of Pediatrics, to get a better sense of what the scientific evidence says about the health benefits of paid family leave.

The AAP is the leading U.S. pediatricians' organization, with approximately 66,000 members, including pediatricians and other pediatric care providers. It's one of several medical groups calling on Congress to pass the Family and Medical Leave Insurance Act, which would create a nationwide social insurance program that enables eligible workers to take up to 12 weeks of paid leave to care for themselves or a family member.

Here are a few highlights from our interview, edited for length and clarity.

Interview Highlights

On the optimal length of family leave

We know that at least 12 weeks of parental leave does make a significant difference. Paid maternity leave of at least 12 weeks increases early childhood checkups and immunizations.

But there is research that shows parental leave is better the longer it is. There's no cutoff for the increased benefits of longer leave. Frankly, if I were to suggest it, I'd say six to nine months should be the minimum. I know we're so far away from that, that it's hard to even speak about, but by six months the parent is really in a different place with their child. Leaving them part of the day and finding child care is also easier at that point.

When it comes to family leave, America's an outlier among high-income countries. In most of Europe and Canada, there's paid maternity leave of six to 12 months, and paid paternity leave.

We've focused primarily on the needs of newborn children and their parents, but paid family leave for a child's illness is also very important. It's especially critical for parents of children with chronic or complex diseases who need their parents' care. Parents often lose their jobs because they have to stay home with their kids. Or, if they know they can't afford to lose their jobs, they can't stay home with their kids and provide them with the care a child needs when sick.

On the ways paid leave benefits the whole family

There's very strong evidence that family leave decreases maternal depression. This is key, because maternal depression prevents mother-infant bonding and has negative effects on a child's cognitive, social and emotional development.

This is true for fathers, too. When fathers take some time from work around the time the child is born they're more likely to spend time with their children in the months following. This decreases stress on the family and contributes to father-infant bonding. Just two weeks or so of paternity leave can make a big difference in fathers' long-term engagement with their children.

How family leave increases breastfeeding and the child's health

Studies from California and Canada show that family leave increases breastfeeding. Breastfeeding has many known positive effects, including bonding between the mother and child. It stimulates positive neurological and psychosocial development. It strengthens the baby's immune system. It also decreases the risk of many health problems such as acute diarrhea, respiratory illness, asthma, sudden infant death syndrome and obesity.

Why the early months matter most

Research tells us that infancy is a critical period for health and child development. In the first year or two of life, 700 new synapses are forming every second in the child's brain. As a developmental and behavioral pediatrician I know firsthand that the first six to nine months of life is a critical bonding time for the parents and the child, and bonding is the basis of the parent responding to the child's needs.

Without paid and job-protected family leave, most parents — especially low-income, working parents — will not take time off. They just can't afford it. But I don't think we, as a society, can afford to not have them nurture their child during this critical period.

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Over the past week we've been talking a lot about parental leave in a series we call Stretched about the lives of American working parents. As we've said, the U.S. is the only developed country with no national paid parental leave policy, and without paid or job-protected leave, many Americans go back to work very soon after the birth of a baby.

We've heard from parents about how hard that situation is. Today we hear from a physician about how this affects the health of American families. Dr. Benard Dreyer is president of the American Academy of Pediatrics.

BENARD DREYER: Research tells us that infancy is a critical period for infant health and child development. Nurturing or the lack of nurturing can cause epigenetic changes which can lead to lifelong problems in social-emotional health and school performance.

SHAPIRO: And he says there's more. When mothers have limited time with their new children, breastfeeding is often cut short or doesn't happen at all. Babies are less likely to be brought in for checkups and immunizations. In short, Dr. Dreyer says this is not good for kids.

DREYER: We are really putting these children in jeopardy.

SHAPIRO: And it's not good for parents either.

DREYER: The stress of going back to work early means that there's going to be an increase in both parents' stress and especially, we know, in maternal depression

SHAPIRO: That's why the American Academy of Pediatrics is now heavily involved in the push to bring American parents more paid, job-protected time off with new babies. The group supports national legislation and has helped lobby successfully for paid leave laws in several states. Dr. Dryer says ideally, parents would have six to nine months with a new baby.

DREYER: Now, I know we're so far away from that, that it's hard even to speak about that.

SHAPIRO: So more realistically, his group is pushing for a minimum of 12 weeks paid leave. And Dreyer is optimistic.

DREYER: This is an issue I feel that's approaching a tipping point. A consensus has built up over years that this is something we need to do.

SHAPIRO: We'll talk more about this and other issues that impact American working parents in the coming days in our series Stretched. And we want to hear from you, too. If you're a working parent, what was the hardest part about going back to work and trying to strike that elusive work-life balance? Tell us in a voice memo, and send it to us at nprcrowdsource@npr.org. One mom we've heard from is Angie Barronton in Athens, Ga.

ANGIE BARRONTON: It's more that I've lost a little bit of passion for my career, and that's what breaks my heart.

BARRONTON: She's a speech language pathologist at a nursing and rehab center. Her baby Ruby Louise is 3 months old, and Angie's been back to work for more than two months already. Leaving her baby so soon has been really hard, and it's changed the way she sees her job.

BARRONTON: I've always been a very hardworking, very passionate individual, and that's how I felt in grad school. I absolutely loved my field and was fascinated by every aspect of it. And I think just since this experience, I've lost some of that. And I think it's partly from, you know, having a new focus.

But it's also partly - if I had been better support, I think that I would feel more comforted in the fact that, OK, I can take this time and devote it to my daughter, and then I can come back and devote myself to my company again when she doesn't need me so vitally.

SHAPIRO: Keep your stories coming. We'll air more of them as our series continues. Transcript provided by NPR, Copyright NPR.