Breastfeeding is best initiated while a woman is still in the hospital with her baby. Image courtesy Eden Pictures, flickr creative commons
A nurse helps a newly delivered mom latch on. Breastfeeding is best initiated while a woman is still in the hospital with her baby. Image courtesy Eden Pictures, flickr creative commons

By Rose Hoban

The mother was at her job and she had no child care. So, every couple of hours during her shift, she would go out to her car to check on her two-month-old baby, sitting in a car seat, under some blankets.

But at the end of her shift one day, the woman found the child slumped over and lifeless.  The child died.

The story isn’t a drama from the Oxygen Network; it actually happened in 2015 in North Carolina. The tragic story (with names withheld) was recounted by Gerri Matson last week, during a meeting of the legislative Child Fatality Task Force.

Matson, a state Division of Public Health employee, works on a multidisciplinary team that annually reviews the deaths of children in North Carolina, looking for clues on how to prevent similar deaths.

She told members of the task force that reviewers from the state Child Fatality Prevention Team saw a trend in the 44 deaths they reviewed last year.

“There were at least six cases out of approximately 44 cases… where there was not safe nurturing child care available for the child that resulted in a death,” she said.

“I can’t say that if we had paid family leave would this definitely have resulted in different outcome” for this child, Matson said. “But it does highlight the importance of child care and paid parental leave after the birth of a child.”


Of more than 40 developed countries, including Cyprus, Croatia and Estonia, the United States is unique in not having specific policies allowing for paid leave for parents of newborns.

“People who work for a company that has more than 50 employees who work there full time can take off up to three months in a calendar year of unpaid leave” under the federal Family and Medical Leave Act, explained Ariel Shumaker-Hammond, a clinical social worker from Asheville. She said the problem with current policy, though, is that many people can’t afford to lose those months of income, not to mention the 28 percent of Americans who work in firms with fewer than 50 employees that are not required to provide leave.

“It affects a lot of people who are the lower socioeconomic status,” Shumaker-Hammond continued. “[They] may not have family to help out or who may have a partner who cannot afford to support them for three months while they take leave.”

She said there are mountains of new research showing that a lack of parent-to-child time and the stimulation that comes along with it, affects brain development.

“We know that those first few years are crucial to development, attachment, brain development, relationship development, which then lasts for the rest of that child’s lifetime,” she said. “If parents aren’t getting a chance to be part of that with their babies, then we’re really setting that whole family up for failure.”

In the past few years, there’s been a plethora of early childhood support programs popping up in counties across North Carolina. Among the programs are the Nurse Family Partnership, in which a nurse visits first-time mothers weekly for two years, Triple-P, which teaches parents how to manage behavioral challenges in children, and programs that allow for a handful of nurse visits to every new mom.

But those programs are not available in every county, or to enough families, argued Shumaker-Hammond. Only 11 percent of North Carolina private-sector workers have paid family leave, and according to the National Conference of State Legislatures, North Carolina workers are guaranteed only 4 hours per year to attend to their child’s school-related needs.

“Our country is not very good at prevention work, we’re not very good at early intervention work, we’re much better on reactive work,” she said.

Part of the conversation

That’s why child health advocates are gearing up to push state lawmakers to support paid family leave for workers, said Beth Messersmith, from the advocacy group Moms Rising.

Several municipalities around the state have committed to providing weeks of paid leave for their workers, including Greensboro, Durham city and county, and just this past week, Wake County. Only a handful of states – California, Rhode Island and Washington – require employers to provide paid leave.

“We’re seeing a shift in the conversation around the country,” Messersmith said. “We’re seeing lot of businesses getting on board, once they see how good it is for business.”

She pointed to research showing that workers who take advantage of family leave are more likely to return to their former places of work, are happier on the job, and are more loyal. Messersmith also pointed to the costs incurred by businesses of recruiting and retraining workers to replace workers who leave because of family care strains.

“Both candidates talked about it on the campaign trail,” she said, referring to the presidential contest between Donald Trump and Hillary Clinton. “Both parties are putting forward plans, making suggestions. Women are a major part of the workforce, paid family and medical leave has to be part of the conversation.”


In addition to the business case, child health advocates argue paid family leave could help address North Carolina’s stubbornly high infant mortality rate.

Moms Rising head Beth Messersmith was mother to a premature son. She says she watched many parents who had to leave during the day, who would return when work was over to care for their babies. “I was the only person in there during the day,” Messersmith says. “I was often the only parent in there until dinnertime, when other people would rush in after work.” Photo courtesy: Beth Messersmith

The United States ranks lower in infant mortality numbers than all of the European, and many of the Central and South American countries which offer paid leave. A review of the literature found multiple studies pointing to improved outcomes for kids with parents who were able to take some leave, including higher IQs and higher rates of secondary school graduation.

But most important was about a 2.6 percent drop in the infant mortality rate, which researchers attribute to increased monitoring, longer breastfeeding duration and increased skin-to-skin contact for children by their mothers.

According to Messersmith, extrapolated to North Carolina, that reduction would have resulted in 23 fewer infant deaths in 2015.

Melissa Johnson, a recently retired psychologist at the neonatal intensive care at WakeMed Hospital in Raleigh, recounted stories of parents who had to leave their premature babies behind in the unit’s incubators.

“[The moms] can’t pump milk, they can’t be there with this baby, who is now lying there alone, because there’s nobody there to do the support,” she said.

Medically fragile children go home from the NICU to parents who have to put them into child-care situations and go back to work. She said these children are at increased risk of catching viruses from the other children at daycare, because parents place them there when “they feel like they have no choice.”

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...