A new study calculates the cost in the United States of not breastfeeding infants in their first six months of life at $13 billion each year, but others say it fails to take into account the costs women must pay to breastfeed in the first place.
The study, appearing in the most recent issue of Pediatrics, bases the $13 billion estimate on the increased medical costs of diseases caused by a lack of breastfeeding.
But besides saying the study fails to consider the costs of what would be needed to make breastfeeding easier for mothers, outside researchers say it may further stigmatize mothers who can't breastfeed.
"The biggest barrier to mothers continuing to breastfeed seems to be the fact that more mothers are in the workplace," said Dr. Lillian Beard, an associate clinical professor of pediatrics at the George Washington University School of Medicine and Health Sciences and an assistant professor at the Howard University College of Medicine.
"It's a very impressive number," she said of the $13 billion estimate, "but I want to know: Did the study take into account the cost for breastfeeding mothers?
"I think this report puts an unfair slant on it," Beard said. "It's not taking into account that for almost two thirds of U.S. families, women are either the co-breadwinner or the breadwinner. Returning to work is germane for the survival of the family."
Beard said that while a majority of women may want to breastfeed, outside constraints make it difficult and there is a drop-off in breastfeeding once they have to return to work.
"I think we have to continue to make efforts and create opportunities to increase breastfeeding rates, but we have to address the major barrier, which is the lack of workplace support," Beard said.
The study's lead author said that while people may question the cost estimates, the conclusions still stand.
"Breastfeeding is a very important economic and public health issue," said Dr. Melissa Bartick, an instructor in medicine with the Cambridge Health Alliance and Harvard Medical School. "We need to support families more if we hope to achieve higher breastfeeding rates."
The study itself spelled out the high cost estimates for current breastfeeding rates.
"The United States incurs $13 billion in excess costs annually and suffers 911 preventable deaths per year because our breastfeeding rates fall far below medical recommendations," the researchers write in the study. "Substantial gains could be made with exclusive breastfeeding for 4 months and any breastfeeding at 6 months."
While Bartick acknowledged that the study did not address costs of improving breastfeeding rates, she said some steps could be taken that did not have significant costs.
For example, she said, after a baby is born it should not be taken away and weighed and bathed, but should be placed in the mother's arms and against her bare chest so it can try and nurse within the first hour of life.
"We shouldn't be blaming mothers that our rates were so low," said Bartick, "because mothers are not supported well and their efforts to breastfeed are undermined by such things as poor hospital practices."
James McKenna, director of the mother-baby behavioral sleep lab at Notre Dame, said the current study likely would help mothers gain support in breastfeeding.
"You can't control the effects of any new insight," he said, allowing that some might use it to pass judgment on mothers who do not breastfeed.