Objectives <p>This study analyzes how the Massachusetts Paid Family Medical Leave (PFML) program impacts parental leave utilization and breastfeeding duration and exclusivity. Multiple organizations recommend exclusive breastfeeding for the first six months of life to protect against disease and promote cognitive growth.</p> Methods <p>We used data from the Massachusetts Pregnancy Risk Assessment Monitoring Surveillance System to calculate prevalence and duration of parental leave and breastfeeding. The sample included 3,480 Massachusetts residents who gave birth in state between 2016 and 2022, oversampled by race and Hispanic ethnicity. We used survival analysis to identify how parental leave and other factors affect breastfeeding duration and exclusivity.</p> Results <p>In 2021–2022, an additional 3.7 weeks of leave were taken on average in comparison to prior years (14.4 weeks vs. 10.7 weeks, <i>p</i> &lt; 0.05), and 73.3% of women reported taking paid leave, compared to 46.2% in 2019 (<i>p</i> &lt; 0.05). Those utilizing only unpaid leave were 48% more likely to stop breastfeeding compared with the paid leave group [HR 1.48, 95% CI (1.25–1.75)]. After adjusting for confounders such as race, education and marital status, there was no association between type of leave and breastfeeding duration (<i>p</i> &gt; 0.05).</p> Conclusions <p>These results suggest that PFML in Massachusetts may have contributed to increased utilization and duration of parental leave, but there was no identifiable impact on breastfeeding duration and exclusivity after controlling for confounders. Future research should review socioeconomic factors as barriers to breastfeeding and the long-term effects of PFML on maternal and child health.</p>