American Academy of Pediatrics Urges Adoption of Universal Paid Family and Medical Leave Policy

In its first policy statement endorsing universal paid family and medical leave, the AAP lays out the health benefits for families and moves toward economic equity in the workforce.

ITASCA, IL--In the United States, it’s costly – and for many families, impossible -- to take time off work to care for a newborn or sick family member because of lost wages. Yet the health benefits for children and families are clear and compelling.  

The American Academy of Pediatrics for the first time calls for universal paid family and medical leave in a policy statement published in the November 2024 Pediatrics (published online Monday, Oct. 28). The statement, “Paid Family and Medical Leave,” observes that the United States lacks universally available paid family and medical leave.

“When a new parent has that critical time at home to bond, to breastfeed and to establish routines with their infant, they set the stage for that child’s healthy development. It's great for babies, and it’s really important for parents, too,” said AAP President Benjamin Hoffman, MD, FAAP. “Paid family and medical leave allows families to manage costs and improves emotional health and wellbeing.”

Policy statements created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.

The AAP Council on Community Pediatrics, Council on Early Childhood, Section on Breastfeeding, and Section on Neonatal Perinatal Medicine wrote the policy statement, noting that the current Family and Medical Leave Act (FMLA) is unpaid and unavailable to a large swath of American workers.  

The Family and Medical Leave Act provides up to 12 weeks of unpaid, job-protected leave per year, but is available to fewer than 50% of U.S. employees because of restrictions on new or part-time employee status, independent contractors, and business size. Because the family and medical leave is unpaid, many caregivers and parents are unable to use the program. Those disproportionately affected are low-income and racial and ethnic minority families, including those who are American Indian/Alaska Native, Black, Hispanic or Native Hawaiian/Pacific Islanders.

“The need for a healthy life-work balance transcends race, ethnicity, gender and socioeconomic differences,” said Christiane E.L. Dammann, MD, an author of the policy statement. “A paid family and medical leave has the power to improve an entire generation’s health.”

Paid family and medical leave, available to only 6% - 27% of the workforce today, is associated with lower rates of preterm birth, fewer child hospital admissions, reduced neonatal, infant, and child mortality rates; higher rates of breastfeeding; and higher timely vaccination rates. For parents, research shows that paid family and medical leave is associated with reduced rehospitalization rates following delivery, increased breastfeeding initiation and duration rates; decreased postpartum depression rates; and better spousal relationships; all of which improve infant neurodevelopment.

The AAP recommends that a federal paid family and medical leave policy be created that is comprehensive, is at least 12 weeks long, and provides parity across all leave categories, including leave for parents of newborn infants; parents of newly placed children (adopted or fostered); workers caring for loved ones who are seriously ill, injured, or disabled; or workers’ own serious health problems. 

The AAP also recommends:

• Ensure paid leave is provided equally for both parents, including nonbirthing parents.
• Provide incentive grants and other supports for workplaces to become more family friendly.  
• Expenses could be funded through a national social insurance program. 
  Structure financing of paid leave programs in a progressive manner so that sufficient wage replacement can be provided with up to 80% to 100% for lower-income workers.  
• Educate parents, community partners, policy makers, and others about the benefit of paid family and medical leave on child development and physical and relational health between parents and child.
• Pediatricians, clinics, and hospital systems can promote research and advocacy on the benefits of paid family and medical leave.

In the long term, advancing universal paid family and medical leave in the United States has the potential to provide cost savings for businesses and strengthen the national economy, according to research.  

“The positive ripple effects of paid family and medical leave are significant,” Dr. Hoffman said. “When family relationships are strong, children perform better in school and parents can work better as partners involved in childcare and housework. Stronger families make for a stronger country.” 

More resources:

• AAP video: Paid Family and Medical Leave: Why Every Worker Should Have it
• Healthy Children article: Paid Family & Medical Leave: Caring for a New Baby or Sick Family Member - HealthyChildren.org

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.