Infant and Child Health and Wellbeing

From the moment an infant is born, the brain begins to form one million new neural connections per second through experience, their environment, and warm, responsive interactions with adults, building the architecture of all future learning, behavior, and health. At two months, infants begin to smile and recognize caregivers’ faces. At four months, they can hold their heads up unsupported. By six months, infants have begun to form healthy or unhealthy attachment patterns to caregivers, based on the quality of the caregivers’ responsiveness, which research has found is an important predictor of a child’s future academic, social, and emotional success and wellbeing.

While some studies show limited links between extending leave and improved child health, other studies have found that supporting families in the early years with an adequate duration of paid family leave can contribute to fewer low birth weight and early term babies, particularly for children of single and African American mothers, fewer infant deaths, higher rates of breastfeeding, well-baby care and immunizations, longer parental lifespan, improved mental health, and increased long-term achievement for children.

“The relatively consistent findings about paid leave predicting increased birth weight and fewer preterm babies is somewhat puzzling, given that the leave is usually taken post birth,” said Taryn Morrissey, public policy professor at American University and author of Cradle to Kindergarten: A New Plan to Combat Inequality. “But it may be that pregnant mothers experience less stress when they don't have to worry about what will happen economically or to their children post birth.”

• Infant mortality: The U.S. has one of the highest rates of infant mortality and SIDS deaths of all advanced economies. A seminal study of paid leave duration and health outcomes in 16 European countries from 1969 to 1994 found that a 10-week extension of paid parental leave reduced post neonatal infant mortality (28 days after birth) by 2 to 3 percent, and child fatalities by 1 percent. Job-protected paid leave of 40 weeks showed the greatest reduction to mortality. Another study of 20 low- and middle-income countries found an even greater impact: each month of paid maternity leave was associated with a 13 percent decrease in infant mortality. The benefits of unpaid, leave, however, are not equally shared. One 2011 study of the Family Medical Leave Act in the United States found unpaid leave is associated with small increases in birth weight, decreases in premature births, and a substantial decrease in infant mortality, but only for college-educated married mothers, presumably because lower-educated and single mothers are unable to afford unpaid leave.
• Long-term achievement: Researchers have been following the lives of Norwegian children who were born before 1977, when mothers were entitled to 12 weeks of unpaid leave, and children born after 1977, when a new law guaranteed mothers an additional four months of paid leave. The longer paid leaves led to a 2.7 percent decline in high school dropout rates and a 5 percent increase in wages at age 30, with positive outcomes even greater for those whose mothers were less educated.
• Child maltreatment: A study of hospitalizations due to abusive head trauma, the chief cause of deaths from child abuse, found a significant decrease among children younger than two after California’s six week paid family leave law went into effect in 2004.
• Chronically sick children: Children who have special health care needs make up 13 to 17 percent of the child population in the U.S. One study found that the longer the leave, the more parents felt that time benefited their child’s physical and emotional health. Longer unpaid leaves, however, were also associated with greater reported financial problems and perceived negative job performance.