Food and Rural Economics Division, Economic Research Service, U.S. Department of Agriculture. Food Assistance and Nutrition Research Report No. 13.
Successfully promoting and supporting breastfeeding in the United States may depend on persuading both mothers and society that breastfeeding is not only nutritionally sound but economically beneficial as well. Current U.S. rates of breastfeeding are 64 percent for mothers in-hospital and 29 percent at 6 months postpartum, below the recommendations of the Surgeon General (75 and 50 percent, respectively). This analysis concludes that a minimum of $3.6 billion would be saved if the prevalence of exclusive breastfeeding increased from current rates to those recommended by the Surgeon General.
These savings would result from reducing both direct costs (such as formula costs and physician, clinic, hospital, laboratory, and procedural fees) and indirect costs (such as time and wages lost by parents attending to an ill child).
The American Academy of Pediatrics (AAP) and the American Dietetic Association (ADA) endorse breastfeeding as the most beneficial method to ensure the health and well-being of most infants. The U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has initiated a national program by Federal, State, and local WIC programs to promote breastfeeding to WIC mothers. This report delineates that a number of studies demonstrate that breastfeeding improves infants’ general health and development and protects against a number of acute and chronic diseases.
A number of reasons are cited for why more mothers do not breastfeed: aggressive formula product marketing, lack of support from friends/family, insufficient knowledge among medical professionals, maternity hospital practices, cultural attitudes, and an increasing number of women in the work force.
This report reviews the few studies that have been conducted in the United States to assess the economic benefits of breastfeeding. Most earlier studies that addressed this issue looked at the economic effect of breastfeeding in the context of comparing breastfeeding with formula feeding, both within and outside the WIC program. These studies indicated that breastfeeding was economically advantageous and that the promotion of breastfeeding could be an effective costcontainment measure. By and large, these studies looked at the economic effect of breastfeeding at specific sites (State WIC clinic, local health maintenance organization (HMO), or health clinic) and from an individual perspective. The analysis reported in this study goes one step further in measuring the reduced costs to society as childhood illnesses and premature deaths are prevented.
This analysis uses incidence rates from published studies to estimate the reduction in the number of cases of otitis media, gastroenteritis, and necrotizing enterocolitis that could be expected for varying prevalences of breastfeeding. Cost data, both direct and indirect, were derived from published literature and extracted from U.S. Government sources. This analysis indicated that a minimum of $3.6 billion would be saved if the prevalence of exclusive breastfeeding increased from current rates to those recommended by the Surgeon General.
This figure reflected approximately $3.1 billion attributable to preventing premature deaths (necrotizing enterocolitis), and an additional $0.5 billion in annual savings associated with reducing traditional medical expenditures (for example, doctors’ or hospital visits, laboratory tests, among others) and indirect costs, such as lost earnings of parents.
The $3.1 billion figure probably underestimated the total savings likely because it reflected the savings in treating only three childhood illnesses. That figure also excluded the cost of purchases for over-the- counter medications for otitis media and gastroenteritis symptoms, physician charges for treatment of necrotizing enterocolitis, and savings due to reduced long-term morbidity. Although this study provided an analysis from a different perspective than previous studies, the results are consistent with those from prior investigations in demonstrating potentially substantial cost savings from breastfeeding.
Given that breastfeeding provides immunologic protection against a variety of childhood illnesses, health care providers, corporate administrators, and State and Federal policymakers may be able to reduce their programs’ medical costs, over the long term, by promoting and supporting breastfeeding. However, further research on health and cost benefits from breastfeeding is needed, ideally, large-scale studies for an entire range of child-related illnesses focusing on differences in rates of hospitalization, duration of hospitalization, health service use, and medical costs between breastfed and formula-fed infants. Without such studies, employers, insurance companies, and Federal health-policy decisionmakers are unlikely to provide financial incentives either to encourage breastfeeding or to encourage health providers, such as physicians, to provide better support and care for breastfeeding mothers.