Why breastfeeding breaks pay off

Posted on October 14, 2013 in Health Policy Context

GuelphMercury.com – opinion/columns
Oct 12, 2013.   ByJody Heymann

How many new moms in Canada and the U.S. were able to participate in the recent national breastfeeding week?

In Canada and in the U.S., each for different reasons, it’s up to their employers. In most of the world, mothers and their children don’t need to rely on chance.

Sixty four per cent of Canadian women with an infant or toddler are in the labour force, as are 60 per cent of moms in the U.S. Yet neither nation ensures that working moms have the basic rights they need to care for their own health and that of their infants from day 1 — and both countries could afford it.

The good news is that Canada guarantees 15 weeks of paid maternity leave. Equally important, women and men have a chance to start their family and work lives on a near equal footing because Canada guarantees 35 weeks of paid leave that can be taken by either parent. This places Canada ahead of more than three-quarters of the world’s countries.

This is in sharp contrast to the U.S., which is near the back of the pack. The U.S. provides no paid maternity leave, making it one of only seven countries in the world failing to do so. Paid maternity leave brings with it many benefits, including increased chances for a newborn to have one-on-one care, increased likelihood that women will breastfeed and opportunities for parents to transition to their new role and form close relationships with their newborn.

But that’s where Canada stops being progressive. One of the most common reasons women stop breastfeeding is that they return to work. But working does not have to lead to lower rates of breastfeeding. The quantity and nutritional quality of breast milk are not undermined by maternal work or activity, including vigorous exercise. This is not about biology, it’s about not having the time, place or chance to breastfeed or express milk.

In Canada, there is no guaranteed right for working mothers to take short breaks from work to breastfeed or express milk (although some human rights commissions have interpreted barriers to breastfeeding as gender discrimination).

Canada is an outlier — paid breastfeeding breaks are guaranteed in 130 countries and unpaid breaks in an additional seven. Since the passage of the Affordable Care Act, even the U.S. makes this guarantee.

Earlier this year in the journal of the World Health Organization, I published a study with my colleagues that concludes breastfeeding breaks work. Our research shows that the guarantee of breastfeeding breaks for at least six months is associated with a significant increase in the number of women practising exclusive breastfeeding.

It doesn’t cost much. It’s hard to think of a workplace that can afford to give workers a lunch break but cannot find a way to give mothers a break to feed their infants. In fact, it’s hard to think of a cheaper way to promote health.

Breastfeeding is an important health-promoting step both for women’s health and that of their infants — it lowers the risk of diarrhoeal disease in the baby by four- to 14-fold and it lowers the risk of respiratory illness by five-fold.

Although the absolute benefits are greater in low-income countries, the risk of these illnesses is significantly reduced by breastfeeding in high-income countries as well — studies in affluent and poor nations alike have shown 1.5- to five-fold lower mortality rates among breastfed infants. Moreover, breastfeeding is associated with lower rates of chronic diseases such as diabetes and inflammatory bowel disease, and with improved brain development.

Moms do better too. Women who breastfeed have longer intervals between births and, as a result, a lower risk of maternal morbidity and mortality, as well as lower rates of breast cancer before menopause and potentially lower risks of ovarian cancer, osteoporosis and coronary heart disease. As a result, the World Health Organization recommends exclusive breastfeeding for at least six months.

There are moms who choose not to breastfeed, moms who aren’t able to breastfeed for health reasons, or who have difficulty in doing so. But the overwhelming majority, 85 per cent of Canadian moms, do start breastfeeding. The question is whether they have the chance to continue — when it brings such returns to both woman and child.

Paid breastfeeding breaks make good health and economic sense. So, which province is going to lead the pack in Canada — and follow much of the world — with a policy that provides some of the cheapest, most effective health benefits of any?

Jody Heymann is an expert adviser with EvidenceNetwork.ca and dean of the UCLA Fielding School of Public Health. Prior to becoming dean, Heymann held a tier 1 Canada research chair in global health and social policy at McGill University.

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