State paid family leave policies and infant maltreatment.

BACKGROUND: Growing research points to economic policies as protective mechanisms for vulnerable families. Research on pediatric abusive head trauma suggests that paid family leave (PFL) may protect infants in the general population from physical abuse. OBJECTIVE: To examine the association of state-level paid family leave policies with infant (ages 0-1) maltreatment rates. PARTICIPANTS AND SETTING: A state-level panel dataset was constructed from the National Child Abuse and Neglect Data System (2002-2019) data on infant maltreatment investigations among four states with PFL (California, New Jersey, New York, and Rhode Island) and 36 states without PFL. METHODS: A piecewise longitudinal model and a nested model comparison were conducted to estimate the treatment effect of PFL on the population rate of infant maltreatment investigations. Supplementary analyses examined the moderating effect of three covariates. RESULT: PFL reduced the linear rate of change in infant maltreatment rates in the states where it was enacted by a factor of 0.979 for each year post-policy implementation compared to states without such policies, B = -0.021, SE = 0.008, 95 % CI = [-0.036,-0.005]. Examining treatment states only, the slope of infant maltreatment became significantly shallower post-policy implementation, χ2(1) = 3.178, p = .075. Interactions testing the moderating effects of family poverty and adults with less than high school education were significant, B = -0.304, 95 % CI = [-0.564,-0.052]; B = -0.511, 95 % CI = [-0.799,-0.249], respectively. CONCLUSION: Results suggest that PFL has a beneficial effect on infant maltreatment rates and add to growing evidence that policies aimed to support household economic stability could be a vital child maltreatment prevention policy tool.

Ped Cast SBP: Empresa Cidadã

Em comemoração ao Agosto Dourado, o mês do aleitamento materno no Brasil, trouxemos um tema importante para todas as mulheres trabalhadoras que amamentam: o Programa Empresa Cidadã, que oferece o benefício da licença-maternidade estendida para 6 meses, como preconiza a Sociedade Brasileira de Pediatria (SBP). Para falar sobre esse tema, a nossa convidada desta edição é a dra. Dolores Fernandez, do Departamento Científico de Aleitamento Materno da SBP.

The Impacts of New York State's Paid Family Leave Policy on Parents' Sleep and Exercise.

OBJECTIVES: To assess changes in young parents' health behaviors following implementation of New York State's Paid Family Leave Program (NYSPFL). METHODS: We used synthetic control (N = 117,552) and difference-in-differences (N = 18,973) models with data from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) from 2011 to 2019 to provide individual-level estimates of the effects of NYSPFL on self-reported exercise in the past month and average daily sleep of adults aged 21-30 years living with one or more children under 18 years of age in New York and comparison states. RESULTS: Synthetic control model results indicate that the NYSPFL increased the likelihood of exercise in the past month among mothers, single parents, and low-income parents by 6.3-10.3% points (pp), whereas fathers showed a decrease in exercise (7.8 pp). Fathers, single parents, and those with two or more children showed increases in daily sleep between 14 and 21 min per day. CONCLUSIONS FOR PRACTICE: State paid family and medical leave laws may provide benefits for health behaviors among young parents with children under 18, particularly those in low-income and single-parent households.

Parental leave policies in general surgery residencies.

BACKGROUND: Prospective residents use program websites to glean information regarding parental leave policies. This study investigates the online availability and content of parental leave policies for general surgery residency programs. METHODS: Parental leave policy information was collected from general surgery residency program and Graduate Medical Education (GME) websites. Descriptive statistics and multivariable logistic regression were used for analysis. RESULTS: Of the 344 general surgery residency programs, parental leave policies were found on 6% of program and 52% of GME websites. Family Medical Leave Act policies were reported the most, followed by maternity, then paternity, and then adoption/other clauses. Academic programs, program location in the Southeastern US and larger program size were all significant predictors of online policy availability. CONCLUSIONS: General surgery parental leave policies vary and are not readily available online. These findings identify a significant opportunity for surgery residency programs to improve the disclosure of parental leave policy information.

Podcast RP Convida: Fim da licença-maternidade

A convidada do podcast especial sobre amamentação da revista Residência Pediátrica (RP) é a dra. Rosa Negri, do Departamento Científico de Aleitamento Materno da Sociedade Brasileira de Pediatria (SBP). Na nova edição, ela aborda os desafios e orientações sobre “o fim da licença-maternidade”.

Podcast RP Convida: Como manter o aleitamento materno na volta ao trabalho

Divulgação do podcast da série “RP Convida - especial Agosto Dourado”, da revista Residência Pediátrica (RP). No programa, o presidente do Departamento Científico de Aleitamento Materno da Sociedade Brasileira de Pediatria (SBP), dr. Luciano Borges Santiago, reforça a necessidade da rede de apoio à mulher – composta por pai, familiares, profissionais de saúde, empresa e outros – para a manutenção da amamentação no retorno às atividades laborais.

Podcast RP Convida: Qual a importância de ser uma Empresa Cidadã?

Edição especial Agosto Dourado com o podcast da revista Residência Pediátrica (RP) da Sociedade Brasileira de Pediatria, apresenta o tema "Qual a importância de ser uma Empresa Cidadã?". A Doutora Rossiclei Pinheiro, presidente do Departamento Científico de Aleitamento Materno da SBP, responde.

SBP comemora decisão do STF que garante licença-maternidade às mães de prematuros a partir da alta hospitalar

A licença-maternidade para mães de bebês prematuros passará a valer após a alta hospitalar da mãe ou do recém-nascido, no caso de internações superiores a duas semanas, e não na data do parto. A decisão, proferida pelo plenário do Supremo Tribunal Federal (STF), vale para as gestantes e mães amparadas pela Consolidação das Leis do Trabalho (CLT) e foi celebrada pelos pediatras brasileiros.

ONG Prematuridade.com elabora cartilha sobre Direitos no Contexto da Prematuridade

ONG Prematuridade.com elaborou uma cartilha que traz informações sobre a ampliação da licença maternidade com o passo a passo para obtenção do benefício.

Pregnancy in physicians: A scoping review.

BACKGROUND: The personal health and professional impact of physician pregnancy requires further study. We performed a comprehensive scoping review of physician pregnancy to synthesize and assess the evidence to aid decision-making for relevant stakeholders. METHODS: A search of 7 databases resulted in 3733 citations. 407 manuscripts were included and scored for evidence level. Data were extracted into themes using template analysis. RESULTS: Physician pregnancy impacted colleagues through perceived increased workload and resulted in persistent stigmatization and discrimination despite work productivity and academic metrics being independent of pregnancy events. Maternity leave policies were inconsistent and largely unsatisfactory. Women physicians incurred occupational hazard risk and had high rates of childbearing delay, abortion, and fertility treatment; obstetric and fetal complication rates compared to controls are conflicting. CONCLUSIONS: Comprehensive literature review found that physician pregnancy impacts colleagues, elicits negative perceptions of productivity, and is inadequately addressed by current parental leave policies. Data are poor and insufficient to definitively determine the impact of physician pregnancy on maternal and fetal health. Prospective risk-matched observational studies of physician pregnancy should be pursued.

5/8 - Conferência de Abertura: Apoiar a Amamentação para um Planeta mais Saudável

Palestra que integra os eventos alusivos à Semana Mundial do Aleitamento Materno 2020. Eventos: XII SEMINÁRIO ESTADUAL DA SEMANA MUNDIAL DE AMAMENTAÇÃO VII SEMINÁRIO ESTADUAL DA ESTRATÉGIA AMAMENTA E ALIMENTA BRASIL Palestrante: Nutricionista Regicely Aline Brandão

The Health Care Provider's Role in Securing Work Accommodations for Pregnant and Postpartum Patients.

Most women today are the primary, sole, or cobreadwinners for their families; their continued ability to work during and after pregnancy is crucial for their families' well-being. Midwives and other health care providers are regularly asked to provide work notes for patients who need adjustments to how, when, or where their job is done to continue working while maintaining a healthy pregnancy or breastfeeding. Whereas an improperly written work note can result in the patient being forced out on leave or losing their job, an effectively written work note from a health care provider can ensure the patient will receive the adjustments they need to stay safe and healthy on the job. Health care providers can also play an important role by incorporating discussions about workplace issues into care conversations. This article provides an overview of pregnancy-related employment rights, guidelines for writing effective work notes, and a discussion of common workplace issues patients face and how health care providers can respond.

The impact of paid family leave in the United States on birth outcomes and mortality in the first year of life.

OBJECTIVE: To evaluate the effect of paid family leave in California on statewide rates of preterm birth, low birthweight, postneonatal mortality, and overall infant mortality. DATA SOURCES: Live birth and death certificates from all in-hospital deliveries occurring in California (state exposed to the family leave policy) and two unexposed states (Missouri and Pennsylvania) from 1999 to 2008 (n = 6 164 203). STUDY DESIGN: We used a difference-in-differences approach to compare rates of infant health outcomes before and after implementation of the 2004 policy in California with rates in two states without paid family leave policies. Prespecified stratified analyses examined whether policy response differed by maternal characteristics. Conditional regression models using comparisons matched on a mother's likelihood of living in California in the pre-family leave period were then employed as sensitivity analyses to confirm our findings. DATA COLLECTION/EXTRACTION METHODS: Probabilistic methods were used to match live birth records to maternal and newborn hospital records. Only singleton births were included. Dyads were excluded if the infant gestational age was <23 weeks or greater than 44 weeks or if the birthweight was an outlier. PRINCIPAL FINDINGS: Compared to the unexposed states, adjusted postneonatal mortality rates decreased by 12 percent in California after 2004 (aOR 0.88, 95% CI 0.80-0.97). There were no significant effects on the other outcomes. There were no differences in the effect by race/ethnicity or insurance status except for increased odds of low birthweight among privately insured women in California after 2004. Point estimates in the propensity score-matched sensitivity models were similar to the results of the fully adjusted models for all four outcomes, but confidence intervals crossed one. CONCLUSIONS: Implementation of paid family leave policies in California was associated with a 12 percent reduction in postneonatal mortality after adjusting for maternal and neonatal factors.

Changes in maternity leave coverage: Implications for fertility, labour force participation and child mortality.

Analysing macro-panel data from 18 African and Asian countries over the period 1995-2016, this article investigates the effects of the level and duration of paid maternity leave on three dimensions of human development: fertility, female formal-sector employment and infant mortality. There is some evidence that, on average, extending the duration of leave leads to reductions in infant mortality and employment. However, there is no conclusive evidence that leave duration has a direct effect on fertility. In contrast, there is some evidence that higher maternity leave payments lead to higher fertility, but no evidence that payment levels have any effect on infant mortality or employment.

Supporting New Physicians and New Parents: A Call to Create a Standard Parental Leave Policy for Residents.

Parents taking leave after the birth of a child is associated with significant benefits for infants, mothers, and fathers. Although nearly 40% of residents have or plan to have children during residency, there is no standard parental leave policy for these trainees. In this Perspective, the authors discuss the benefits of parental leave, synthesize findings about maternity bias and other negative effects of the current variable approaches to parental leave during residency, and explore underlying causes of the lack of a standard parental leave policy for residents. They also call on the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties to work together to address this issue, recommending a standard parental leave policy that ensures a minimum of 8 weeks of paid leave for all residents without requiring them to extend training or making them ineligible to sit for board certification exams. Creating evidence-based and family-friendly guidelines for parental leave is important to the progress of academic medicine in the modern era, as it supports parental and child health, promotes resident wellness, and reduces gender disparities in medicine to the benefit of all.

Fellowship or Family? A Comparison of Residency Leave Policies With the Family and Medical Leave Act.

BACKGROUND: In 1993, the Family and Medical Leave Act (FMLA) mandated 12 weeks of unpaid, job-protected leave. The current impact of taking 12 weeks of leave during residency has not been evaluated. METHODS: We examined the 2018 Accreditation Council for Graduate Medical Education (n = 24) specialty leave policies to determine the impact of 6- and 12-week leave on residency training, board eligibility, and fellowship training. We compared our findings with a 2006 study. RESULTS: In 2018, five (21%) specialties had policy language regarding parental leave during residency, and four (16%) had language regarding medical leave. Median leave allowed was 4 weeks (IQR 4-6). Six specialties (25%) decreased the number of weeks allowed for leave from 2006 to 2018. In 2006, a 6-week leave would cause a 1-year delay in board eligibility in six specialties; in 2018, it would not cause delayed board eligibility in any specialty. In 2018, a 12-week (FMLA) leave would extend training by a median of 6 weeks (mean 4.1, range 0-8), would delay board eligibility by 6-12 months in three programs (mean 2.25, range 0-12), and would delay fellowship training by at least 1 year in 17 specialties (71%). The impact of a 12-week leave was similar between medical and surgical specialties. CONCLUSIONS: While leave policies have improved since 2006, most specialties allow for 6 weeks of leave, less than half of what is mandated by the FMLA. Moreover, a 12-week, FMLA-mandated leave would cause significant delays in board certification and entry into fellowship for most residency programs.