Last year, amid a nationwide formula shortage that left parents scrambling to feed their babies, mothers who didn’t breastfeed faced heavy blame and criticism. But a new study quantifies just how expensive the decision to breastfeed can be.
Inspired by the rhetoric around the formula shortage, a team of Yale researchers wanted to examine how the barrier of cost may impact a mother’s decision to breastfeed. The team, led by Sarah Mahoney, a second-year MD-PhD student interested in the intersection of medicine and economics; Sarah Taylor, MD, professor of pediatrics (neonatal-perinatal medicine); and Howard Forman, MD, MBA, professor of radiology & biomedical imaging, public health (health policy), management, and economics, calculated both the direct and hidden costs of breastfeeding. In comparison to a year’s supply of formula, which may cost between $760 and $2,280, breastfeeding for one year may cost women more than $10,500. The team published its findings in the Journal of Perinatology on March 22.
“This is the first time that we’ve really taken a look at the cost borne by breastfeeding women in dollars and cents terms,” says Mahoney, who was the paper’s first author. “This is critically important if we want to develop any sort of effective policy to promote breastfeeding.”
Showing How Expensive Breastfeeding Can Be
To better understand the financial barriers to breastfeeding, the team first reviewed existing literature and identified the various costs associated with it. This included increased food intake by the nursing mother, supplies, vitamin supplementation, and time dedicated to pumping or feeding. Next, they calculated the cost of each of these factors.
The study found that the costs of breastfeeding for a year can range from around $7940 to $10,585. For low-income families, this is a huge barrier. The federal poverty limit for a family of two—e.g., a single parent and child—is a little over $19,700, and for a family of three, almost $25,000. Around 17.5% of children under 5 years of age live under this limit. “That suggests that almost one in five kids are living in households where breastfeeding would take up over half of the family’s yearly income,” says Mahoney. “When thinking about developing policies, this is something we ought to consider to help make breastfeeding more accessible to those families.”
Breastfeeding Expenses Involve More Than Money
Mahoney is also interested in looking beyond the acute period of breastfeeding—does taking time away from work to breastfeed have longer term implications in a woman’s career? “If a mother wants to breastfeed, we ought to do what we can to make that accessible to her,” she says. “So it’s important we have a sound idea of what challenges mothers face so that we can address those and make a difference.”
This is a study that Yale was uniquely equipped to do, Forman says. “Yale offers our students the ability to work across disciplines—benefitting from subject matter experts like Dr. Taylor while being able to lead an important contribution such as this one,” he explains. “This investigation is at the junction of public health, medicine, economics, and management—programs that are very much accessible to students at Yale.”
While there is little dispute that breastfeeding, when it is feasible for mother and child, is generally best for the baby’s nutrition and health, the study shows there are far more considerations involved than many assume. The American Academy of Pediatrics recommends exclusive breastfeeding for six months, followed by breastfeeding with supplementation of complementary foods for up to two years. “America as a whole is not even close to achieving that,” says Mahoney. The costs the study uncovered, she says, may be an important contributor.