[Editor's Note: We support parents in making the best infant feeding choices for their family, whether that be formula feeding, breastfeeding, pumping, donor milk or any combination of feeding methods.]
Feeding babies takes a lot of effort, no matter what a baby is eating. Parents need support whether their baby is drinking breastmilk, formula or both, but we know mothers often don't feel supported in either choice. Mothers who choose or have to use formula often feel stigmatized, while mothers who breastfeed often get shunned for public breastfeeding or find themselves needing to pump in a workplace that offers no lactation room.
Individual mothers pay when society doesn't support parents in breastfeeding their babies. Formula can be expensive, but when workplaces discriminate against nursing moms, it's an expense some women have no choice but to take on. But that's not the cost we're discussing here.
A new website created by breastfeeding researchers Phan Hong Linh, Roger Mathisen and Dylan Walters suggests that, on a global scale, failing to support breastfeeding is costing an estimated $341 billion a year.
The Cost of Not Breastfeeding tool was developed by Alive & Thrive, an initiative to save lives and prevent illness worldwide through "through optimal maternal nutrition, breastfeeding, and complementary feeding practices." To be clear, the site isn't targeted at individual parents who are unable or choose not to breastfeed their babies. Rather, it's a tool that illustrates the global economic losses that might be attributed to the low percentage of breastfed babies.
The researchers behind the tool hope policymakers will look at it and decide to commit more resources to support parents.
Using the tool, you can use a dropdown menu to see how these costs break down for 34 different countries. In the U.S., where only 24% of children are exclusively breastfed, the tool estimates that it costs more than $28,000,000 in healthcare just to treat diarrhea and respiratory infections in children that could be prevented if more mothers were supported in breastfeeding.
Though many of the developing countries in the tool have higher percentages of breastfeeding than the United States, the costs of not breastfeeding the remaining children are higher. This is presumably because the risk of the associated diseases is already higher in those countries (due to factors like poverty, water quality, etc.).
Alive & Thrive gathered data on mortality (of children and mothers); cases of diarrhea, pneumonia, and obesity in children that could be attributed to not breastfeeding; cases of breast cancer, ovarian cancer, and type II diabetes in mothers; the cost of medical care for those conditions; the cost of formula; and then the future cost to the economy of the loss of children's lives and having unhealthy children and mothers.
Many of these numbers are estimates based on estimates, but it's hard to argue against the bigger-picture argument of the tool's developer, health economist Dylan Walters.
"We need to be sensitive to the constraints and hardships faced by mothers and families in a world that lacks basic support systems for their physical, psycho-social, and economic well-being," Walters said in a post on Alive & Thrive's website. "Even more, mothers and families are up against a constant barrage of corporate marketing of alternatives and misinformation spread that undermines what should be boringly second nature and not stigmatized by society."
The organization recommends a minimum of 18 weeks of paid family leave and more support of nursing mothers on work sites. It also states that governments should enforce laws limiting the advertisement of infant formula.
Such laws may make sense in countries where access to clean water makes formula feeding difficult, but in wealthy nations like the United States, where formula feeding is a safe and legitimate choice, some worry limiting information about formula stigmatizes and patronizes mothers who are capable of choosing what is best for their babies.
The World Health Organization recommends that babies exclusively breastfeed for their first six months, and then receive a combination of breast milk and other nutrition until they are 2 years old. UNICEF estimates that globally as of 2016, 43% of children are exclusively breastfed during the first 6 months of life, and 46% continue until age 2. A recent survey found 1 in 4 Americans do not believe moms should be allowed to breastfeed or pump in the clear view of the public, and while 90% of Americans say they believe women should be allowed to pump at work, about 1 in 3 do not believe employers should be required to provide a lactation room.
The discrepancy here between what is recommended and what is actually supported is shocking. Mothers are being told to breastfeed, but then are also being told to cover up, or that they can't pump at work. When there are so many obstacles to breastfeeding it shouldn't be shocking that breastfeeding rates in America are lower than the WHO would like.
This lack of support and mixed messages are making the work of motherhood—something that is already deeply emotionally and mentally draining—even harder. The conversation about infant feeding should not be about supporting one type of infant feeding over another, it needs to be about supporting women in motherhood and in their choices. The cost of not doing so is staggering.