The Really Big Money

The Mother’s Milk Cooperative agrees with and applauds the work of international expert in breast feeding – James Akre – that breast feeding is highly valuable and that its value can and should even be considered in economic terms. For example, think of the opportunity cost of breast feeding and pumping, the cost of additional calories needed to lactate, the short and long term savings in health care when infants are breast fed, and others.

JamesAkre.jpgJames Akre is the founder, chairman and CEO of the International Breastfeeding Support Collective, member of the editorial board of the International Breast Feeding Journal and of the Scientific Advisory Committee of La Leche League France, and and past member of the board of directors of the International Board of Lactation Consultant Examiners (IBLCE). He  is a powerful and knowledgeable expert on the benefits of breast feeding and international trends in infant feeding.

In Chapter 8: “The Really Big Money”, of his book The Problem With Breastfeeding: A Personal Reflection, Akre presents a view of breast feeding that might persuade even the most reluctant politician to prioritize the promotion of breast feeding in laws and policies. Here is an excerpt from Chapter 8:

There are some truly outrageous claims regularly made about the value of breast milk or, more accurately, the absence of value. One of the most infuriating that I see repeatedly is that breast milk is somehow free. Ironically, breastfeeding advocates sometimes unwittingly get caught up in this foolishness, even to the point of adopting that especially ugly advertising tautology “free gift” – as opposed to the kind we pay for? While we occasionally speak about the money breastfeeding saves, we mostly ignore what breastfeeding costs. Breast milk is most assuredly not free. In fact, I would start by describing it as priceless, even as breastfeeding itself has at least three price tags directly attached: a mother’s time (which far too many people erroneously consider to be on the house), the energy cost of producing milk (up to 500 kcal a day that need to come from somewhere) and the opportunity cost. You’ll have no difficulty recognizing the first two tags, which are an altogether spectacular bargain when you consider the payback in terms of positive lifelong consequences for children, mothers and thus the entire society. But the third one may not be so familiar. I’m borrowing from economic theory where “opportunity cost” refers to the cost of something in terms of an opportunity forgone – for example mothers who must choose between staying at home with their children and returning to paid employment outside the home to meet their families’ financial needs. As we all know from personal experience, there really is no such thing as a free lunch. 

Societies that are structured in lock-step fashion to favor normalized artificial feeding will remain largely unchallenged and unchanged as long as the true economic impact of more or less breastfeeding fails to register on national radar screens. There’s not much point in playing on politicians’ heartstrings in attempting to gather support for breastfeeding. My view is that we need to hit them in the pocketbook instead.

Since at least the 1970s there have been numerous attempts to assess the economic value of breast milk and breastfeeding, and various aspects of the financial burden from not breastfeeding. These range from the relatively unsophisticated, including literal formula-can-counting exercises; to estimates of the total volume and value of breast milk produced in a given setting and efforts to incorporate these figures in national food accounts; to complex cost/benefit calculations based on detailed morbidity and mortality data…

Unfortunately, this information has yet to capture adequately the attention of national and international policy-makers concerned with cost-effective decision-making. We need to ask ourselves why; but as we ponder prospects for change let’s be sure not to confuse ignorance and bad management with destiny. 

Perhaps the message hasn’t penetrated sufficiently because it’s not been adequately packaged, including by pointing out the full cost of artificial feeding, throughout the life course, for the entire society and not just the savings generated through breastfeeding. Or maybe the most compelling information has still to be assembled, analyzed, assessed and announced in convincing ways. 

Just how much longer are we going to have to wait for this to happen? Not long, I believe, provided that recent advances in our collective science-based understanding of the health – and therefore the economic – implications of more or less breastfeeding are honestly and thoroughly assessed, convincingly presented, and taken fully into account…

I’m of course referring to the continuing avalanche of truly stunning information about artificial feeding’s permanent impact in terms of, for example, impaired postpartum brain development and visual acuity; increased risk of premature child mortality; increased risk for children of multiple diseases including allergies, celiac disease, diabetes, diarrheal disease, ear infection, leukemia, necrotizing enterocolitis, obesity, respiratory ailments, sepsis and urinary tract disease; increased risk in later life of cardiovascular disease; and, for mothers, increased risk of anemia and hemorrhaging, breast, ovarian and endometrial cancer, osteoporosis and rheumatoid arthritis. When these facts and figures, thoroughly evaluated and correctly correlated, finally hit the newsstands, earlier calculations are going to seem trifling indeed.


bookcover.jpgRead all of Chapter 8: “The Really Big Money”, courtesy of James Akre.

Purchase The Problem With Breastfeeding: A Personal Reflection 

Listen to James Akre’s Expert-in-Lactation Lecture, “What is the Problem With Breastfeeding?”

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