Gorsky K Griffin, Keefe-Oates Brianna, Lakshmanan Ashwini, Rogers Elizabeth E, Smith Louisa H
San Francisco Benioff Children's Hospital, University of California, San Francisco, CA.
Roux Institute, Northeastern University, Portland, ME.
J Pediatr. 2025 Aug;283:114621. doi: 10.1016/j.jpeds.2025.114621. Epub 2025 Apr 23.
To assess the association between paid leave and breastfeeding and mental health among mothers of infants with prolonged postnatal hospitalization.
Data were obtained from 13 states participating in the Centers for Disease Control and Prevention's Pregnancy Risk Assessment and Monitoring System from 2016 to 2021. Prolonged postnatal hospitalization was defined as hospitalization >14 days. Maternal leave-taking was categorized as paid, unpaid, or no leave. The primary outcomes included breastfeeding initiation and continuation at 4 weeks, and postpartum depressive symptoms. We fit adjusted logistic regression models to estimate adjusted odds ratios (aORs, 95% CI) and marginal probabilities of the outcomes.
Among 2622 mothers whose infants had a prolonged hospitalization, 53% reported paid leave, 39% unpaid, and 7.3% no leave. Mothers with paid leave were more likely to have at least some college education, private insurance, and identify as White. No leave was associated with significantly decreased odds of ever breastfeeding (aOR 0.34 [95% CI 0.15, 0.76]) and breastfeeding at 4 weeks postpartum (aOR 0.38 [95% CI 0.19, 0.76]) compared with paid leave; comparisons with unpaid leave were similar. Associations with postpartum depressive symptoms were not statistically significant (no leave compared with paid leave aOR 1.31 [95% CI 0.65, 2.65]).
Significant disparities exist in utilization of paid leave among mothers of infants with prolonged postnatal hospitalizations. Given the association between leave-taking and breastmilk provision, policies to support maternal leave-taking may promote breastfeeding in this population.
评估产后住院时间延长的婴儿母亲的带薪休假与母乳喂养及心理健康之间的关联。
数据来自2016年至2021年参与疾病控制和预防中心妊娠风险评估与监测系统的13个州。产后住院时间延长定义为住院时间>14天。母亲的休假情况分为带薪、无薪或无休假。主要结局包括产后4周的母乳喂养开始情况和持续情况，以及产后抑郁症状。我们拟合了调整后的逻辑回归模型，以估计调整后的比值比（aORs，95%置信区间）和结局的边际概率。
在2622名婴儿住院时间延长的母亲中，53%报告有带薪休假，39%无薪休假，7.3%无休假。有带薪休假的母亲更有可能至少接受过一些大学教育、拥有私人保险且为白人。与带薪休假相比，无休假与曾经母乳喂养（aOR 0.34 [95%置信区间0.15, 0.76]）和产后4周母乳喂养（aOR 0.38 [95%置信区间0.19, 0.76]）的几率显著降低相关；与无薪休假的比较结果相似。与产后抑郁症状的关联无统计学意义（无休假与带薪休假相比aOR 1.31 [95%置信区间0.65, 2.65]）。
产后住院时间延长的婴儿母亲在带薪休假的使用上存在显著差异。鉴于休假与母乳喂养之间的关联，支持母亲休假的政策可能会促进这一人群的母乳喂养。
