abstract: 'Introduction Among all barriers to breastfeeding, the need to work has

  been cited as one of the top reasons for not breastfeeding overall and

  for early weaning among mothers who seek to breastfeed. We aimed to

  examine whether extending the duration of paid maternity leave available

  to new mothers affected early initiation of breastfeeding, exclusive

  breastfeeding under 6 months and breastfeeding duration in low-income

  and middle-income countries (LMICs).

  Methods We merged longitudinal data measuring national maternity leave

  policies with information on breasffeeding related to 992 419 live

  births occurring between 1996 and 2014 in 38 LMICs that participated in

  the Demographic and Health Surveys. We used a difference-in-differences

  approach to compare changes in the prevalence of early initiation and

  exclusive breastfeeding, as well as the duration of breasffeeding, among

  treated countries that lengthened their paid maternity leave policy

  between 1995 and 2013 versus control countries that did not. Regression

  models included country and year fixed effects, as well as measured

  individual-level, household-level and country-level covariates. All

  models incorporated robust SEs and respondent-level sampling weights.

  Results A 1-month increase in the legislated duration of paid maternity

  leave was associated with a 7.4 percentage point increase (95\% CI 3.2

  to 11.7) in the prevalence of early initiation of breasffeeding, a 5.9

  percentage point increase (95\% CI 2.0 to 9.8) in the prevalence of

  exclusive breastfeeding and a 2.2- month increase (95\% CI 1.1 to 3.4)

  in breasffeeding duration.

  Conclusion Extending the duration of legislated paid maternity leave

  appears to promote breasffeeding practices in LMICs. Our findings

  suggest a potential mechanism to reduce barriers to breasffeeding for

  working mothers.'
affiliation: 'Chai, Y (Corresponding Author), Univ Calif Los Angeles, Dept Epidemiol,
  Fielding Sch Publ Hlth, Los Angeles, CA 90095 USA.

  Chai, Yan; Heymann, Jody, Univ Calif Los Angeles, Dept Epidemiol, Fielding Sch Publ
  Hlth, Los Angeles, CA 90095 USA.

  Nandi, Arijit, MGill Univ, Dept Epidemiol Biostat \& Occupat Hlth, Montreal, PQ,
  Canada.

  Nandi, Arijit, MGill Univ, Inst Hlth \& Social Policy, Montreal, PQ, Canada.'
article-number: e001032
author: Chai, Yan and Nandi, Arijit and Heymann, Jody
author-email: yc448@ucla.edu
author_list:
- family: Chai
  given: Yan
- family: Nandi
  given: Arijit
- family: Heymann
  given: Jody
da: '2023-09-28'
doi: 10.1136/bmjgh-2018-001032
files: []
issn: 2059-7908
journal: BMJ GLOBAL HEALTH
keywords-plus: 'WORKING MOTHERS; UNITED-STATES; FAMILY LEAVE; EMPLOYMENT; HEALTH;

  ASSOCIATION; PROMOTION; IMPACT; POLICY; INTELLIGENCE'
language: English
month: SEP
number: '5'
number-of-cited-references: '64'
orcid-numbers: Heymann, Jody/0000-0003-0008-4198
papis_id: c70d76196af750cc65d3566d50f50f10
ref: Chai2018doesextending
times-cited: '65'
title: Does extending the duration of legislated paid maternity leave improve breastfeeding
  practices? Evidence from 38 low-income and middle-income countries
type: Article
unique-id: WOS:000457716300040
usage-count-last-180-days: '1'
usage-count-since-2013: '10'
volume: '3'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2018'