Suboptimal Breastfeeding Costs the U.S. $100 Billion Annually
Failure To Address Barriers To Breastfeeding Incurs Cost by Impacting the Health of Mother and Child
Cambridge, MA—Despite the well-documented health benefits of breastfeeding for both women and children, less than half of infants worldwide begin life with optimal recommended breastfeeding practices—exclusive breastfeeding for the first six months of life, continuing up to two years as new foods are introduced. The first comprehensive review of the economic costs of breastfeeding in more than a decade reveals the United States faces annual losses in excess of $100 billion annually, with global losses reaching an estimated $300 billion a year. Published in the journal Health Policy and Planning, and led by a researcher at Mount Auburn Hospital, the analysis underscores the growing recognition of breastfeeding as a public health priority and a foundational strategy for optimizing overall population health.
“Most of costs come from children not reaching their full cognitive potential in terms of IQ points, which affects lifetime earnings and has significant economic consequences,” said senior author Melissa Bartick, MD, MS, MPH, a breastfeeding researcher and hospitalist at Mount Auburn Hospital. “We should think of breastfeeding the same way the think of other public health issues that affect childhood cognitive development. Think of what we could accomplish if we invested as much in breastfeeding as we do in prevention and treatment of lead toxicity.”
Bartick and colleagues—health economists Briana J. Jegier, PhD, of Baptist Health Sciences University and Julie P. Smith, PhD, of Australia National University—analyzed 36 studies estimating the economic impact of suboptimal breastfeeding published between 1996 and 2023. The studies were conducted across diverse countries and examined outcomes for both women and children.
The investigators found that, while research methods varied across the literature, the immense financial impact of suboptimal breastfeeding consistently totaled more than $300 billion worldwide. In addition to the loss of cognitive potential, costs included medical expenses for treating conditions linked to suboptimal breastfeeding such as obesity, leukemia, and gastrointestinal illnesses in children, as well as breast and ovarian cancer, diabetes, and cardiovascular diseases in mothers. Notably, the researchers also found that the economic losses from cognitive deficits due to low breastfeeding rates are significantly higher than previously estimated, particularly in high-income countries.
Future research should include a broader range of countries to account for different health systems and social contexts that influence both breastfeeding practices and associated costs, the scientists said. The review also identified several technical weaknesses in the existing literature, including a disregard for the economic value of unpaid work typically done by women and family members worldwide, such as caregiving and housekeeping.
“Our review highlights that while there is now more diverse and global research available, it often lacks quality and interdisciplinary collaboration,” added Bartick who is also an assistant professor of medicine at Harvard Medical School. “The findings underscore the urgent need for increased investment in quality epidemiological research and cross-disciplinary collaboration between economists and public health experts. By addressing methodological weaknesses and improving the measurement of breastfeeding and maternal health impacts, policymakers will be better equipped to prioritize breastfeeding as a fully funded strategy for population health.”
The authors have declared that no competing interests exist.
About Mount Auburn Hospital
Mount Auburn Hospital was founded in 1886. A teaching hospital of Harvard Medical School, its mission is to provide clinically excellent care with compassion and to teach students of medicine and the health professions.
Mount Auburn Hospital is a part of Beth Israel Lahey Health, a healthcare system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,700 physicians and 39,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.
