Preventing child deaths with paid family leave


By Elaine Cabinum-Foeller - ECU Brody School of Medicine



I am a pediatrician and a member the North Carolina Child Fatality Prevention Team. Each year we review dozens of cases to see what policy or practice changes could be implemented to prevent future child fatalities. In the past, we’ve recommended strengthening seat belt laws, graduated drivers licenses, and bicycle helmet laws, all of which have led to a drastic reduction in North Carolina’s child fatality rate.

Over the years we’ve noticed a potential connection between the death of a child and the lack of options for working parents caring for a new baby or sick child. That’s why the North Carolina Child Fatality Prevention Team has recommended that the General Assembly enact legislation that requires family-friendly workplace polices that enable families to accumulate paid family leave to use after the birth of a child or to care for children when they are sick and not able to attend child care or school.

As a practicing pediatrician in Greenville, I’ve seen what happens when parents are forced to choose between staying home with a child and keeping their job. It’s an excruciating decision for any parent who does not feel like they are ready to return to work yet after the birth of a child or when they don’t have good child care options if their child is sick. I have seen mothers who were unable to continue to breastfeed or closely attach with their infant, because they had to return to work immediately after giving birth. I have seen parents forced to use makeshift options for child care that worried them, because they couldn’t take time off of work to care for their sick child. In a few cases, I have had parents whose child was injured or killed by a caretaker who was not a licensed provider.

In North Carolina, 1.46 million workers in the private sector have no access to paid leave. That’s 44.7 percent of the private sector workforce. What we’re learning is that the children of these working parents can suffer dire consequences as a result.

There are solutions. One of which is establishing a paid family and medical leave policy, which has been done in a few localities and states around the country. Recently Durham County announced a policy that allows for 12 weeks of paid parental leave for its county employees.

Access to paid family and medical leave means working parents do not have to jeopardize their employment or paycheck in order to provide and arrange for safe and stable care after the birth of a child and when a child is sick. This results in a variety of health and safety benefits for children.

A growing body of research shows that paid parental leave policies lead to a reduction in infant mortality, which has been a persistent problem in North Carolina for decades. One recent study showed that every additional month of paid family leave is associated with a 13 percent reduction in the infant mortality rate.

Access to paid leave also gives parents time to find appropriate and stable child care, which enables them to go back to work less stressed knowing their children are in safe and stable environments. In Rhode Island, nearly seven out of 10 people who used the temporary caregiver insurance (TCI) program reported satisfaction with their ability to arrange child care, compared to just four out of 10 people who did not use the program. The impact is particularly dramatic for workers in lower paying jobs.

Other studies have linked paid leave to a reduction in child maltreatment and increased involvement from fathers, both of which are protective factors in the prevention of child fatalities.

In fact, the American Academy of Pediatrics supports 12 weeks of paid leave for parents so employees can care for themselves or their families. Research has demonstrated that this increases children’s health by increasing duration of breastfeeding, reducing parental stress, and increasing likelihood of child receiving regular well child care and immunizations by their physician.

None of this research should be surprising. It makes good sense that children thrive when parents are able to provide them with a safe environment without the prospect of losing their job. I’m proud that the NC Child Fatality Prevention Team has recommended paid family leave policies for North Carolina. Now it’s time for our legislature to follow suit to protect the lives of our children.

Elaine Cabinum-Foeller is Associate Professor of Pediatrics at ECU Brody School of Medicine and Medical Director at the TEDI BEAR Children’s Advocacy Center where she oversees child abuse education, evaluation, prevention, and treatment for children and families in 20 eastern North Carolina counties.

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By Elaine Cabinum-Foeller

ECU Brody School of Medicine

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