By: Christiane E.L. Dammann, MD
From the very start, parents and caregivers create a safe, nurturing place where children can thrive. But in the United States, families are often forced to make difficult choices between a paycheck and taking time to care for a new baby or sick family member.
That is why the American Academy of Pediatrics (AAP) supports paid family and medical leave—including at least 12 weeks of leave for parents of newborn infants or newly adopted children—for all working adults.
AAP policy explained
In our policy statement, "
Paid Family and Medical Leave," we recognize the challenges U.S. parents face caring for their children and themselves. Current options force far too many people back to work during a key time to strengthen parent-child bonds and healthy routines like breastfeeding. It also makes burdens shouldered by low-income parents harder to bear and contributes to unequal treatment of women, families of color, ethnic minorities and many other groups.
We call on health care providers to join with employers, public health officials and lawmakers to work together for a better solution.
How would children and families benefit from universal paid leave?
Studies from across the globe link paid family and medical leave to many healthy outcomes. Here are just a few examples:
Lower rates of premature birth and low birth weight and fewer child hospital admissions
More parents choosing to breastfeed (and being able to breastfeed longer) with positive health effects on the breastfed infant and their breastfeeding mother
Lower death rates among newborns, infants, and children
Higher vaccination rates, protecting kids from serious health risks
For parents, lower rehospitalization rates following delivery, decreased postpartum depression rates and better spousal relationships—all of which support a child's healthy physical and
mental development.
In particular, parents of
kids with special health needs report that paid family leave is the key to providing care that helps their children grow and thrive.
Don't we already have a national program for family and medical leave?
In 1993, Congress passed the Family and Medical Leave Act (FMLA) to give employees time off to care for themselves or their loved ones. The law offers up to 12 weeks away from work and guarantees that employees will have a job when they return. But FMLA falls far short of what many families need because:
FLMA only offers unpaid leave. Employees must be able to give up their paychecks while they are away, which millions of parents and caregivers cannot afford to do.
Less than 50% of employees qualify. FMLA does not cover employees with less than a year of service or those who work fewer than 1,250 hours per year. It applies only to employees of larger companies, leaving out workplaces with fewer than 50 employees in one geographic area. And in a time when many parents work exclusively from home, it does not cover people who telecommute.
Do certain employees have access to paid family leave already?
As of 2024,
several states have set up mandatory paid leave programs. A few more have chosen voluntary systems that may operate through private insurers. Many employers, regardless of where they're located, also offer paid leave as a way of attracting and keeping employees.
These plans are a step in the right direction, but they do not cover most of the U.S. workforce. Without a nationwide program in place, only an estimated 6% to 27% of all employees benefit from paid family and medical leave.
How can we do better for families and children?
The AAP strongly supports a paid leave program that will benefit families in all 50 states.
As pediatricians, we support the FAMILY Act.
In early 2024 we endorsed the Family and Medical Insurance Leave (FAMILY) Act, a federal law that would create a permanent right to paid, job-protected family and medical leave for all U.S. employees.
While Congress considers the proposed law, the AAP has taken its own work a step further. Our policy on paid family and medical leave is based on successful programs in the U.S. and around the world. Studies show that paid leave is healthy for kids, parents and employers, too. Here are key recommendations from the AAP policy. Paid leave should be available to all employees.
This would include people working for small organizations, along with contractors, part-time workers and gig workers who might serve more than one employer.
Family needs should be front and center.
Paid leave should cover employees who welcome a new family member through birth, adoption or foster care. Employees should also qualify for leave when they are seriously ill or injured or need to care for sick, injured or disabled family members of any age.
Longer leave times are better for family health.
Based on successful programs in the U.S. and other nations, we recommend at least 12 weeks of paid leave per calendar year.
Employees with children should qualify for extra support, especially if their kids have complex medical needs.
This might include flexible work scheduling, remote work options or subsidies that help pay for medical day care or home care.
Fairness and equity must be built into paid leave programs.
Paid leave is provided equally for both parents. It should have no barriers or restrictions relating to gender, race, ethnicity, religion, sexual orientation, or physical or intellectual abilities. Low-income employees should qualify for a higher percentage of replacement income than peers who earn more.
Job protection is key.
Employees must be able to return to their jobs when leave ends. Employees should feel safe in choosing to go on leave, without fear of payback or retaliation from their employer or work colleagues.
How would employers handle universal family and medical leave, especially small businesses?
The AAP urges federal and state lawmakers to work closely with employers in creating a new blueprint for family and medical leave. As pediatricians and family doctors, we do not make laws or decide how to structure or fund new programs. We speak out as medical professionals devoted to the health of parents, families, and children.
Research that shows paid leave is healthy for employers, too.
Offering paid leave helps companies attract and keep employees, which fuels productivity and profits. Hiring and training costs are lower and job satisfaction is higher—another plus for employers looking to build an efficient, committed workforce.
Since pediatricians are often small business owners, we're aware that smaller employers may worry about finding replacement staff or managing the costs of paid leave. But studies have shown that small organizations offering paid leave saw better morale and lower per-employee costs.
What can I do to support paid family and medical leave?
Ask your employer about paid leave.
It's possible that these benefits are already available in the workplace for you and your partner. If so, thank your employer for supporting family health! If not, let your employer know that paid leave matters to you. Ask them to support it at the company, state, and federal level.
Voice your views.
You can keep track of proposed laws and advocate for change through nonpartisan, nonprofit groups such as
Paid Leave for All or the
National Partnership for Women & Families. In doing this, you won't be alone:
8 out of 10 voters say they support a nationwide paid leave program that will benefit every worker – and the families who depend on them.
More information
About Dr. Dammann Christiane E.L. Dammann, MD, is a member of the AAP Section on Neonatal Perinatal Medicine and the Sections Advocacy Leadership Council and lead author of the AAP policy statement, " Paid Family and Medical Leave and Family Friendly Policies. " Dr. Dammann is a Professor of Pediatrics at Tufts University, School of Medicine and Neonatologist at Tufts Medicine Pediatrics/Boston Children's in Boston.
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