Milk Matters

First comprehensive picture of health, economic benefits of breast-feeding

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Lower-than-recommended breast-feeding rates in the U.S. cause thousands of maternal and child deaths and cost the health care system billions of dollars each year, according to a new study published in Maternal & Child Nutrition.

The study—believed to be the most comprehensive picture to date of the health and economic benefits of breast-feeding in the U.S.—was based on a statistical model of existing data. The results suggest that breast-feeding affects women’s health more dramatically than once thought.

The authors said their findings underscore the importance of providing women with the support they need to breast-feed, beginning at birth.

“The results should lead to policies that help women breast-feed longer and breast-feed exclusively—policies such as paid family leave, workplace support and evidence-based maternity practices around infant feeding,” said the study’s lead author, Melissa Bartick, assistant professor of medicine at Harvard Medical School and a hospitalist at Cambridge Health Alliance.

For the study, the research team modeled two groups. One was an “optimal” group, in which the majority of mothers breast-fed as recommended: for a total of one year and exclusively for six months. That group was compared with a “suboptimal” group, in which mothers breast-fed at current rates in the U.S., which are less than the recommended guidelines.

Using existing research and government data, they projected the rates and costs of diseases that breast-feeding is known to reduce, along with the rates and costs of early deaths from those diseases.

Children’s diseases included in the evaluation were acute lymphoblastic leukemia, ear infections, Crohn’s disease, ulcerative colitis, gastrointestinal infections, lower respiratory tract infections, obesity, necrotizing enterocolitis and SIDS.

For mothers, the study included breast cancer, premenopausal ovarian cancer, Type 2 diabetes, high blood pressure and heart attacks.

The researchers found that suboptimal breast-feeding was associated with more than 3,340 premature deaths in the U.S. each year, costing the nation $3 billion in medical costs, $1.3 billion in indirect costs and $14.2 billion in costs related to premature deaths. The majority of the excess deaths and medical costs—nearly 80 percent—were maternal.

The authors concluded that raising breast-feeding rates to optimal levels could substantially improve public health and save more than $4.3 billion in health care and related costs annually.

“Breast-feeding has long been framed as a child health issue; however, it is clearly a women’s health issue as well,” said study co-author Eleanor Bimla Schwarz, professor of medicine at UC Davis Health System. “Breast-feeding helps prevent cancer, diabetes and heart disease, yet many women have no idea breast-feeding has any of these benefits.”

The study results underscore the importance of having policies that make it possible for women to breast-feed, according to senior author Alison Stuebe, distinguished scholar of infant and young child feeding at the Carolina Global Breastfeeding Institute and associate professor of obstetrics at the University of North Carolina at Chapel Hill.

“Currently, 22 percent of employed mothers return to work within 10 days of birth,” Stuebe said. “Paid leave keeps mothers and babies together, which is essential for breast-feeding. Enacting paid family leave will impact the lifelong health of women and children.”

The authors caution that their analysis extrapolates from data that merely linked breast-feeding to improved health outcomes and did not show cause-and-effect relationships.

The research was funded by the W.K. Kellogg Foundation.

Adapted from a Cambridge Health Alliance news release.