Few empirical studies have examined the association between maternal employment and child illness. International studies suggest a negative link and report that delaying employment through generous parental leave policies is associated with a reduction in infant mortality (Ruhm, 2000; Tanaka, 2005). There are several possible explanations: One, delaying employment can support breastfeeding initiation and duration which are linked to positive health outcomes for children (Berger, Hill, & Waldfogel, 2005; Lindberg, 1996). Two, delaying employment could lead to delaying group child care participation where children are likely exposed to illness (Wald, Guerra, & Byers, 1990). And three, delaying employment likely increases parent time spent with the child (Jaeger & Weinraub, 1990) and mothers’ general knowledge of child development, both positively impacting children.

Alternatively, positive effects of employment may offset a negative association between early employment and child health. For example, working mothers tend to be less depressed (Crosby, 1991), provide a higher quality home environment (Brooks-Gunn, Han, & Waldfogel, 2010), and contribute to a higher household income, all associated with positive child outcomes (Goodman and Gotlib, 2002, Dearing, McCartney, & Taylor, 2001).

This paper examines associations between first-year maternal employment and child illness at age two. Additionally, the current study investigates process variables that may explain associations between maternal employment and child illness, including maternal knowledge of child development, maternal time spent with child, maternal depression, the home environment, type of child care, maternal income, and breastfeeding.

Data were drawn from the 9-month and 2-year waves of the Early Childhood Longitudinal Study - Birth Cohort a restricted-use dataset featuring a nationally representative sample of approximately 10,700 children born in the U.S. during 2001. Mothers reported on their employment and on whether the child had experienced asthma, respiratory infection(s), gastrointestinal infection(s), and/or ear infections. Mothers were classified as working full-time (30+ hours/week), part-time (less than 30 hours/week) or not at all. Children with no illness were compared to children with any illnesses by age two. OLS regression was used to test the association between employment and child illness while controlling for important family background variables. Structural equation modeling (SEM) was used to examine the mediating and offsetting roles of process variables between maternal employment and child outcomes.

Children with fulltime working mothers were about a tenth of a standard deviation more likely to have experienced an illness by age two than children of nonworking mothers. Maternal knowledge of child development, group child care participation, and fewer months of breastfeeding mediated the association. Decreased maternal depression associated with employment offset the association. Maternal time spent with the child, the quality of the home environment, and maternal income were not significant process variables.  

Findings suggest that full-time maternal employment can exert a negative influence on children's health, through pathways that are amenable to policy intervention. For example, increasing parental leave so that mothers can breastfeed longer and delay the entry of children into group child care is a possible avenue through which the negative effects on health could be reduced.