Breastfeeding and the U.S. economy.
BACKGROUND
A recent study showed that current suboptimal U.S. breastfeeding rates cost the U.S. economy $13 billion per year in 2007 dollars for pediatric health cost and premature death. Cost data of excess maternal disease are not yet published but are thought to be substantial. Little is known about other costs.


METHODS
The approximate annual costs of many entities that impact breastfeeding or are impacted by breastfeeding were calculated and converted to 2010 dollars. Calculations assumed the United States went from 2007 breastfeeding rates to 90% compliance with medical recommendations. We included pediatric health costs, formula costs, cost of extra food for lactating women, paid leave, and additional factors.


RESULTS
If 90% of mothers could comply with current medical recommendations around breastfeeding, our economy could save $3.7 billion in direct and indirect pediatric health costs, with $10.1 billion in premature death from pediatric disease. We would spend $3.9 billion less per year on infant formula. Additional food for nursing mothers would cost up to $1.6-2.1 billion, and more Baby-Friendly® (World Health Organization, Geneva, Switzerland/UNICEF, New York, NY) births would cost $0.145 billion. Paid leave would cost $6.2 billion for 12 weeks at 55% pay. Note that current formula company rebates of $2 billion to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are equal to 32% of net WIC expenditures.


CONCLUSIONS
Even including paid leave, the net cost to our economy of our suboptimal breastfeeding rates would still be at least $8.7 billion. Paid leave would be expected to improve breastfeeding duration and reduce disparities. The WIC budget is dependent on formula company rebates, a conflicting situation.
Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge Hospital, Cambridge, Massachusetts 02139, USA. melissabartick@gmail.com
Melissa
M
Bartick
D001942:Breast Feeding / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000191:economics*; D061213:Mortality, Premature; D009765:Obesity / Q000517:prevention & control; D010372:Pediatrics / Q000191:economics*; D014481:United States