Abstract
BACKGROUND: Breastfeeding provides multiple maternal and child benefits, but breastfeeding rates are suboptimal. Parental leave access and use have been associated with higher breastfeeding rates, however, there have been a lack of studies examining fathers' use of parental leave. The objective of this study was to measure the associations between fathers' work leave and infant breastfeeding among a representative sample of fathers from Georgia, United States. METHODS: This cross-sectional study used data from a novel public health surveillance pilot study, the Pregnancy Risk Assessment Monitoring System (PRAMS) for Dads. We tested the association between leave (paid leave [yes/no] and leave length [≥ 2 weeks or < 2 weeks] with 1) breastfeeding initiation and 2) breastfeeding at 8 weeks using multivariable logistic regression adjusting for paternal, maternal, and infant characteristics. RESULTS: Among the 240 (92.3%) employed fathers, 172 (73.4%) reported taking leave (paid or unpaid) after their infant's birth. Among fathers who took leave, median leave length was 2 weeks. White fathers had a higher percentage of paid leave use compared to other racial and ethnic groups (p <.001). Fathers who took paid leave were more likely to report taking leave ≥ 2 weeks (p <.001). In adjusted models, fathers who took ≥ 2 weeks of leave reported higher rates of infant breastfeeding at 8 weeks (79.3% vs. 60.5%; aPR [adjusted prevalence ratio] = 1.31; 95% CI, 1.09-1.57) compared with those who took < 2 weeks of leave. There was no association detected between breastfeeding at 8 weeks and paid leave (aPR = 1.06; 95% CI, 0.85-1.33). CONCLUSIONS: This study adds to the growing evidence linking fathers' work leave with family benefits, namely improved breastfeeding duration, which has important workplace and health policy considerations for the use and availability of parental leave for fathers.