New York State Paid Family Leave Law Associated with Increased Breastfeeding Among Black Women

While breastfeeding has increased during the past 50 years, disparities continue, with Black women having the lowest rates. Use of paid leave has been associated with longer breastfeeding duration. Evaluate the impact of New York (NY)'s Paid Family Leave (PFL) law on breastfeeding, after it became effective on January 1, 2018. Women in NY (excluding NY City), who gave birth in 2016-2019 and completed the Pregnancy Risk Assessment and Monitoring System (PRAMS) survey, were included. Data from PRAMS and the NY State Expanded Birth Certificate were combined. Changes in breastfeeding initiation and duration and use of paid leave were compared, before and after NY's PFL law became effective, with separate analysis by sociodemographic factors. Before NYPFL, Black women were least likely to initiate breastfeeding and breastfed for the shortest duration. After NYPFL went into effect, breastfeeding initiation and duration to 8 weeks increased for Black women, but not for other racial/ethnic groups; these findings persisted after adjustment for sociodemographic factors. Use of paid leave after childbirth increased 15% overall, with greater increases among Black women and Hispanic women. Implementation of the NYPFL law was associated with increased breastfeeding among Black women and increased use of paid leave by all. Greater increases in breastfeeding among Black women significantly reduced breastfeeding disparities by race/ethnicity. More widespread implementation of PFL programs in the United States would promote equity in the use of paid leave, which could reduce disparities in breastfeeding initiation and duration and possibly improve infant and maternal health outcomes.