In this issue, ‘The Cost of Not Breastfeeding’ (Walters et al., 2019) launches a tool for estimating economic losses from low breastfeeding rates. The study concludes that global economic costs of not breastfeeding are substantial, around US$341 billion annually, but can be addressed by investing resources in key breastfeeding strategies and interventions.
Most children are not breastfed as recommended (Victora et al., 2016), with a contemporary worldwide boom in commercial milk formula sales (Baker et al., 2016). International agencies and non government organizations (NGOs) are increasingly aware of the economic significance of this, and of the urgency for adequately resourcing enabling breastfeeding policies (Holla-Bhar et al., 2015; Kakietek et al., 2017; Walters et al., 2017). In 2015, the Vice President of the World Bank (Hansen, 2015, 386) declared that ‘in sheer raw bottom line economic terms, breastfeeding may be the single best investment a country can make’.
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The new tool for estimating the country costs of not breastfeeding is an important advance that highlights the extent of women’s invisible economic contribution to national economies and health care systems in caring for infants and young children.
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The tool excludes the costs of additional unpaid household care for sick children, making its cost estimates highly conservative. Ironically, the costing tool entrenches thereby gender bias in economic and health care measurement.
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Such exclusion gives rise to the startling paradox that Norway presents as having comparatively high-economic costs of not breastfeeding.
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Properly accounting for costs of not breastfeeding requires more adequate national time use data collection, and cost analyses that incorporate non-market household production.