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No such thing as a free lunch: The direct marginal costs of breastfeeding

Journal of Perinatology volume 43, pages 678–682 (2023)Cite this article

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Abstract

Understanding costs associated with breastfeeding is critical to developing maximally effective policy to support breastfeeding by addressing financial barriers. Breastfeeding is not without cost; direct costs include those of equipment, modified nutritional intake, and time (opportunity cost). Breastfeeding need not require more equipment than formula feeding, though maternal equipment use varies by maternal preference. Meeting increased nutritional demands requires increased spending on food and potentially dietary supplementation, the marginal cost of which depends on a mother’s baseline diet. The opportunity cost of the three to four hours per day breastfeeding demands may be prohibitively high, particularly to low-income workers. These costs are relatively highest for low-income individuals, a group disproportionately comprising racial and ethnic minorities, and who demonstrate lower rates of breastfeeding than their white and higher-income peers. Acknowledging and addressing these costs and their regressive nature represents a critical component of effective breastfeeding policy and promotion.

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Notes

  1. These estimates of per-unit cost represent an average of over-the-counter (i.e. without insurance subsidy) prices from approximately a dozen online and retail pharmacies, including the largest national corporate pharmacies and retail operations in the United States.

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Author information

Authors and Affiliations

  1. Yale School of Medicine, Yale University, New Haven, CT, USA

    Sarah E. Mahoney

  2. Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, CT, USA

    Sarah N. Taylor

  3. Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, USA

    Howard P. Forman

  4. Yale School of Management, Yale University, New Haven, CT, USA

    Howard P. Forman

  5. Yale School of Public Health, Yale University, New Haven, CT, USA

    Howard P. Forman

  6. Department of Economics, Yale University, New Haven, CT, USA

    Howard P. Forman

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  1. Sarah E. Mahoney
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  3. Howard P. Forman
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Contributions

SEM and HPF conceived of the study. SNT contributed clinical expertise, and HPF provided guidance on methods. SEM performed the calculations and wrote the manuscript with support from SNT and HPF.

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Correspondence to Sarah N. Taylor.

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SNT serves as a consultant for the Vermont Oxford Network. The other authors declare no competing interests.

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Mahoney, S.E., Taylor, S.N. & Forman, H.P. No such thing as a free lunch: The direct marginal costs of breastfeeding. J Perinatol 43, 678–682 (2023). https://doi.org/10.1038/s41372-023-01646-z

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