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The Economics of Breastfeeding: A Cost-Benefit Analysis 

This month two very different positions have emerged about the economics of breastfeeding. Someone reading either of these stories on their own could be led to believe a conclusion about the financial aspects of breastfeeding that is not entirely complete. I want to tell you a bit about what they both said and then try to create a more objective view of the economic pros and cons of breastfeeding.

Image credit: epSos.de on flickr

Nursing by the Numbers: How Breastfeeding Boosts the National Economy

This month Mothering posted a web exclusive article by Olivia Campbell called Nursing by the Numbers: How Breastfeeding Boosts the National Economy. In this article, Campbell mentions that we all know how breastfeeding is beneficial to a baby's health and parents' finances (to the tune of the $700 to $3000 that a year of formula would cost). However the article says that few people understand the extent to which breastfeeding benefits the mother's health and how breastfeeding results in savings for the whole country.

A few examples:

  • In 2001, the USDA concluded that if breastfeeding rates were increased to 75 percent at birth and 50 percent at six months, it would lead to a national government savings of a minimum of $3.6 billion (and this only considered a few of the health benefits of breastfeeding, not all of them).

  • The AAP says each formula-fed infant costs the healthcare system between $331 and $475 more than a breastfed baby in its first year of life. The cost of treating respiratory viruses resulting from not breastfeeding is $225 million a year.

  • Health benefits for the nursing mother include a reduction in risk of many cancers and other serious diseases, during and after lactation. The National Cancer Institute reported the national expenditure on breast cancer treatment in 2004 was $8.1 billion, meaning extended nursing could save upwards of $4 billion a year. (I posted about this my post called Save Yourself, Save our Healthcare System, where I documented the estimated costs in breast cancer treatments in Canada resulting from formula feeding at $225 million per year).

  • There would be a drastic reduction in required treatment for type 2 diabetes for women that breastfed. Currently, the cost of their treatment and lost wages is roughly $78 billion a year.

  • For WIC, supporting a breastfeeding mother costs about 45 percent less than a formula-feeding mother. Every year, $578 million in federal funds buys formula for babies who could be breastfeeding. (for more info on this topic see WIC and infant formula by Emily @ Adventures in [Crunchy] Parenthood).

  • For employers, there is a cost due to formula feeding moms taking more days off to care for sick children, resulting in decreased productivity.

This study has some fabulous statistics on the cost of formula feeding to our healthcare system, social programs and company productivity. What it doesn't do, however, is look at the costs of breastfeeding to a mother's earning potential and it doesn't look at the cost, to a company, of holding a position for a woman who is on extended maternity leave and back-filling her position while she is gone.

Is Breastfeeding Truly Free? The Economic Consequences of Breastfeeding for Women

This is a case of Hanna Rosin strikes again. When she wrote her "Case Against Breastfeeding", I responded. Many other people responded too. And now she's come back for more. Yesterday, on Slate, she posted an article called Breast-feed More, Earn Less. In her post, she references a study by Phyllis L. F. Rippeyoung from Acadia University and Mary C. Noonan from the University of Iowa called Is Breastfeeding Truly Free? The Economic Consequences of Breastfeeding for Women.

In this study, the researchers hypothesized that:

...it is plausible that the relationship between breastfeeding and women's work status also operates in the opposite direction. Particularly considering that, temporally, the act of breastfeeding a newborn precedes a mother's return to work after childbirth, it seems plausible that, compared to a mother who formula feeds her child, a mother who breastfeeds her child may be more likely to leave paid employment, either partially or fully, or be more likely to switch to a "family-friendly" job in order to accommodate breastfeeding. These modifications in work behaviour may, in turn, lower the breastfeeding mother's current and future earnings. Furthermore, a mother who combines breastfeeding and paid work may be viewed by her employer as less committed and productive than another, similar employee who formula feeds her child.

Essentially, this study is trying to address exactly the gap that I mentioned above with regards to the Mothering article. However, it is doing so to the exclusion of most of the data presented in the Mothering article.

The other thing the researchers said in their introduction that was conveniently not mentioned by Hanna Rosin in her article is that "should breastfeeding be shown to have a negative impact on work outcomes, our study will provide evidence that breastfeeding promotion needs to be coupled with protections for women's work and earnings". They said protection for women's work and earnings....not formula feeding. They also mused about the findings potentially opening up further discussion on breastfeeding and feminism (I'm always up for discussion).

The study puts a lot of emphasis on the possibility that employed breastfeeding mothers may reduce their work hours, take longer maternity leaves, switch to more family-friendly work, or quit work altogether in order to breastfeed. What the study did not consider is that perhaps professional women choose to do these things because they want to and because they can afford to. That they are making the choice to stay home with their children as part of an overall package deal of being a dedicated parent, which happens to also include breastfeeding. It isn't about breastfeeding or not breastfeeding. It is about choosing to care for your own child or choosing to have someone else care for them. When you choose to care for your child yourself, then yes it is easier and cheaper to breastfeed. This is a luxury. I understand that. But it isn't a case against breastfeeding.

In the study, they do attempt to prove the opposite, but don't really do a convincing job of it. They say that public health pressures on women to breastfeed are so great that if a mother finds it difficult to balance the demands of breastfeeding and work, they may feel greater pressure to sacrifice work for breastfeeding in order to be "good mothers".

The researchers did a really good job of citing references in almost all parts of the paper. And then this. They come out with a whammy of a sentence, with no reference, no footnote. This unsubstantiated finding is that "increased breastfeeding duration has had no effect on overall physical or pscychological health outcomes of either children or mothers." Says who? (Note: The researchers have since provided me with the missing reference : Maternal Employment, Breastfeeding, and Health: Evidence from Maternity Leave Mandates. I read it and commented on it in my post on the Scientific Benefits of Breastfeeding )

The researchers do some really interesting demographic analysis around who breastfeeds and who doesn't. This is good information and I'll bookmark it for use in other posts. But after saying that white married Northern educated professional women are more likely to breastfeed than those with the opposite characteristics, they end with this:

Although a general picture of the differences between breastfeeders and formula-feeders can be seen from these descriptive statistics, further analyses will be conducted shortly to assess how breastfeeding versus formula feeding impacts women's wages and work characteristics over time.

Hardly the cut and dry conclusion that Hanna Rosin was talking about in her article. Now, either Hanna Rosin linked to the wrong study from her article or she is making up quotes. In her article, Rosin quotes this from the study:

Although, at two years before birth, both breastfeeding groups earned statistically higher incomes than the formula feeders, by year 10 this advantage has disappeared - formula feeders and short-duration breastfeeders do not have significantly different incomes, and long-duration breastfeeders earn significantly less than formula feeders.

That quote is nowhere to be found in the study that Rosin linked to, so I have no way of evaluating the context (we know Rosin is good at taking things out of context) or the validity of the approach used.  Assuming that this is in a follow-up study that Rosin conveniently forgot to link to, without seeing the context, my reaction would be that they probably did not differentiate between long-duration breastfeeders that wanted to go back to work quickly versus long-duration breastfeeders that wanted to stay home.

The cost-benefit analysis

Yes, I do this for a living. Yes, I'm fed up with doing economic cost-benefit analysis at the moment because I'm a bit burned out from a few intensely difficult projects that I managed to work on while breastfeeding and increasing my earning potential...oh my! But, just for you, dear readers, I will do a high-level analysis of the  economic costs and benefits of breastfeeding (sorry, I'm not pulling out my spreadsheet for this, but maybe if I actually get access to the mystery survey Rosin mentioned, I might do that one day).

Economic Pros of Breastfeeding

  • Money saved by not buying formula

  • Decreased healthcare costs for the baby

  • Decreased healthcare costs for the mother

  • Fewer work days lost to care for sick children or to tend to mother's health

  • Lower costs for government agencies and not-for-profit organizations that provide formula to low income mothers

Economic Costs of Breastfeeding

  • Decision to take longer maternity leave limits short-term earnings and may limit long-term earning potential (still looking for the link to the "missing" study that Rosin quotes)

  • Decisions to take on "family friendly" jobs, which frequently have a lower earnings trajectory

  • Decision to work part-time, resulting in lower earnings

  • Pumping at work may take time away from the job - the researchers propose a total of 15 workdays during the child's first 6 months (note: most women that I know that pump at work do it on the breaks that they are already entitled to or pump hands-free while working)

  • If pumping at work, the mom will need to buy a pump

  • Mom may choose to buy nursing bras and nursing clothing (although I rarely wore them)

  • Perceived lower productivity of breastfeeding mother leads to her being passed by for promotions

  • Fewer tax dollars earned taxing the profits of formula producers

One important thing to note about these benefits and costs is that the benefits are benefits of breastfeeding. Period. However, on the cost side, most of the costs are costs of the decisions that women may or may not make with regards to the way that they choose to balance breastfeeding and work.  The costs are changeable. The benefits are here to stay.

Concluding Thoughts

I want to go back to the remark made in the study about the economic consequences of breastfeeding for women. The researchers said: "breastfeeding promotion needs to be coupled with protections for women's work and earnings". I agree. I think this is important because of breastfeeding and it is also important outside of the breastfeeding context. Having these types of protections in place will allow more parents to make the decision to care for their families at such a critical time in a child's development without it impacting their long-term earning potential. I'm not sure that we can entirely escape it having some short-term impact (but if we could, that would be great).

We need people with influence in our society to push for those changes. I know that the woman who is earning minimum wage at a low-skill job in a poor economy is not likely to feel that she can insist on accommodations for pumping at work or a flexible schedule that would allow her to breastfeed her child frequently. However, people like me and people like Hanna Rosin are in a position to be able to take a leadership role on those types of issues. It is too bad that Rosin chose to use her soapbox and megaphone for her ongoing diatribe against breastfeeding rather than using it to promote greater support for breastfeeding women in the workplace.

Where I live, we are also seeing an increasing number of men taking paternity leave, with 1 out of 2 men in Quebec now using some of the leave that is available to parents. It would be interesting to look at the impact of those decisions on the earning potential of those men. I have a feeling that the decreased earning potential raised in the study that Rosin quotes is related more so to the decision by a parent, who happens to be a breastfeeding mother, to stay at home for a while and make parenting a priority, than it does with breastfeeding.

What do you think? Is there a strong economic case against breastfeeding? Or is there a strong economic case for breastfeeding? Leave a comment or write a post (if you write a post and link back here, I'll link up to you too).

Note: I wrote a follow-up post to this called More questions than answers: A follow-up on economic consequences of breastfeeding.

« Out of sight, out of mind, out of job: The reality of job protection while on maternity or parental leave | Main | PLAY! Definitive Resource on Play and Parenting »

Reader Comments (67)

Excellent post. Being that it is midnight (or just about) I will only say that living in Canada makes it easier for women who have babies, because for the most part, women can take one year of maternity leave to breastfeed if they choose while they're at home. I breastfed my boys for 6 months each. I went back to work at 6 months with my first-born, and took the full year off with my second born. I will probably write a post next week about this. Thanks for this, there is a lot to think about.

April 25, 2009 | Unregistered CommenterLoukia

Excellent! My brother is a nurse and a friend of his wanted his wife to breast feed because his hours were getting cut. She is a stay at home mom but refused to even TRY breastfeeding. I mean not even taking into account the health benefits, but if my husband was getting his hours cut I would do what I could to lighten the load financial and formula is damn freaking expensive. Unfortunately I doubt USA's breast feeding rates will ever improve dramatically because of our poor maternity leave. Six weeks is hardly enough time home with baby. At 8 weeks I was just getting over the cracked-nipple-of-doom, if I had had to go to work there would have been no way I could have kept up with breastfeeding. I would say more but it's late and I'm not forming complete sentences in my own head, let alone typing one.

April 25, 2009 | Unregistered CommenterKristen

Wonderful post.

When I read Ms.Rosin's bit today all I was left with was a feeling like she was bullying women to feel the same resentment towards nursing as she does. She clearly sees it as weighing her down, affecting her personal economy because she keeps fishing for evidence( questionable perhaps) to support her emotional issues with breastfeeding.

I also have to disagree that breastfeeding looses it's free pass with feminism, did it ever have one to start with? If anything this should be another example of something feminist like myself should be fighting for their sisters and daughters. Every working mom whether she works at 7-11, a daycare center or in the executive ranks of a corporation needs to feel the same confidence in demanding their rights without fearing retribution. That needs to start with all of us, whether we formula feed or breastfeed - women need to stand up for themselves, their babies and each other. Rosin doesn't seem to get that.

April 25, 2009 | Unregistered CommenterAllie

Is the economic case against breastfeeding a viable case as breastfeeding is not the sole factor in the decisions made by women to reduce their time in the workforce.
As you stated, earning potential is partly based on the parent's (male/female) decision to prioritize parenting over career not just the decision to breastfeed.
If you want to look at the economic effects, one must consider long term outcomes. For example, what is the earning potential of breastfed/formula fed babies?
In reviewing your summation of the costs of breastfeeding, I can't help but chuckle and look at my experience.

* Would "family friendly" jobs have lower earning trajectories if the impact of attached parenting on earning potentials were analyzed? (I am unaware of a current study or its outcome and simply making a personal assumption.)

* As a pump at work mother, I can personally say that I am probably more productive as I 1) work while I pump and 2) ensure meetings are timely and necessary. How many times have you been caught up in formalities of committees, subcommittees and working groups only to find you've wasted 3 hours of valuable time without decisions or results?

Lastly, you forgot the add the loss of income from lactation professionals, scholars and services. During my first month post partum, I saw 3 lactation consultants, 1 lactation physician and attended numerous lactation support groups, some free, some paid. Since lactation consultants are not covered by most major insurances, these fees were all out of pocket. I bought more than my share of tops, bras and pumping devices (3 pumps - 1 professional grade rental for >6 mths). I bought enough herbal supplements to effect the smell of nyc (I swear I was the source of the maple syrup smell this past summer.).

Sorry to cut this short. My breastfed baby is beckoning. Wonderful article! Keep up the great work and I look forward to reading more!

April 25, 2009 | Unregistered Commenterpantrygirl

I almost forgot, Kristen is right. Has anyone ever studied the economic effects of the US' maternity leave policy compared to the UK's policy? I'm sure if we weren't so pressured to return to work immediately (let's not even get into the Hollywood effect-slim down before your post partum visit), the benefits of breastfeeding, economic, medically and socially (yes, i believe there are social benefits) would be farther reaching.

April 25, 2009 | Unregistered Commenterpantrygirl

I can't cite any articles here, only personal experience. I chose to become a stay at home mom with the birth of my second child a month ago. I made this choice for a great number of reasons, but breastfeeding was not one of them. The fact that I am able to breastfeed round the clock is only a benefit.

My number one reason (aside from simply wanting to stay at home with my girls while they are both so young) was the cost of childcare. When I was working, I made just enough money to pay for care for my daughter and to pay the car insurance each month. While we could certainly afford to pay the car insurance out of my husband's check, it was nice to have it taken care of and be able to spend that extra money on things we want or need - or even put it back into savings! Now that I have two children, my paycheck wouldn't even cover the cost of childcare. There is no point in my working if it is only going to cost us money.

I won't go into my other reasons for not returning to work as I feel I've made the point I wish to make. Yes, I am a breastfeeding mom, but I'm not in any hurry to drive my family into debt just so I can keep my job.

It's late, and I'm not 100% sure that last sentence made sense... I think I'm going to head to bed - but this was a fantastic post and I will be checking back to see what others have to say about it.

April 25, 2009 | Unregistered CommenterErin W.

@Erin W. That is an excellent point. I agree that the cost of childcare is likely to be a bigger deciding factor than breastfeeding too.

April 25, 2009 | Unregistered Commenterphdinparenting

Excellent post. I was upset enough when I read the original 'The Case Against Breastfeeding" but now this? Thank you for analyzing the article so well and summarizing both sides.

I see the benefits of breastfeeding everyday - the physical health of my children, the social benefits and the economic benefits (sure, it's free and that's a huge benefit to us!). Yes, I stay at home but it wasn't just to nurse (although, the fact that I did certainly made it easier) but I don't feel I'm losing my earning potential. What the studies can't capture is that personal choice and gratification in choosing to breastfeed or be at home with your children has a significant impact on the well-being of the family as well. I am happy and healthy, don't require stress leave, my husband is happy to know that I am with the kids and supports my nursing 100% (without feeling 'left out' might I add!).

Also, in certain cases perhaps the earning potential of the mother is maintained because she takes courses to add to her education, develops a small cottage business or works from home - all would contribute to either the family income or her 'resume' for when she re-enters the work force. More and more women are becoming industrious while off in different ways - and as you point out, the impetus is typically not breastfeeding.

Great analysis - thank you!!

April 25, 2009 | Unregistered CommenterRebecca

Why should it matter anyway, even if breastfeeding did make me financially poorer (which it doesn't) I'd still do it, it makes life richer.
When lying on my death bed, I won't remember how much money I had, I'd remember the good things in life and I have many fond memories of nursing my children.

I still don't get the fuss, we have babies and when you choose to have babies you then accept the conditions. To me babies breastfeed, it's what they do, what mothers do. It's just normal life.

April 25, 2009 | Unregistered CommenterTracy

I really think Hanna Rosin is seeking attention. Bashing breastfeeding worked once, so she's doing it again.

Beyond that, I agree that we need policies that allow women to combine mothering and working (and not necessarily at the same time), whether you breastfeed or not. Many of the problems with breastfeeding studies arise because researchers can't distinguish the benefits of breast milk from the benefits of bonding and time spent with a primary caregiver. Which means, in my mind, that we need better maternity leaves and more family-friendly work arrangements.

As for whether breastfeeding provides economic benefit or not, I would say it does. It saves money. But I'm Canadian. Most moms I know take a full year off, independent of how they feed their babies. It levels that particular playing field very effectively, eliminating the purported 'downsides' of breastfeeding.

April 25, 2009 | Unregistered CommenterAmber

I think another aspect (tangent?) to this debate is the fact that we identify ourselves with jobs that pay us a wage. It's difficult to calculate the cost benefit of staying at home when there is no wage attached to it - just lots of sacrifice. I wonder, too, what the long term benefits are for children whose mothers did make that sacrifice (when able) and how it impacts society on a much grander scale than cost of formula vs. cost of breastfeeding. As a breastfeeding mom it's nice to have confirmation that my choices are economically savvy. But breastfeeding and parenting approach go way beyond spiffy reports and scientific studies.

April 25, 2009 | Unregistered CommenterCarole

Thanks for the link! And another great article. I always enjoy your thoroughness and attention to detail.

I agree with others that breastfeeding is least factor among all the factors that go into total earning potential. The greatest, of course, being maternity leave policies and child care. I can guarantee that low income women are not debating how whether or not to breastfeed affects their earning potential.

And I wholeheartedly agree with Tracy. Life isn't a contest to see who earned the most at the end. Money is transitory, family is forever. This Rosin article, as you pointed out, is just another attempt to garner cheap publicity, at the expense of the general American populace, who only believe what they read in magazines.

April 25, 2009 | Unregistered CommenterEmily Jones

It is frustrating to me that this seems to just be a recast of working outside the home v. working inside the home debate but put in a context that it seems okay to criticize one decision or the other. Shouldn't we be looking to allow women to choose what they want? Isn't that the point of feminism?

It also depresses me that it seems making money is the secret to happiness. How much you make should not define you, although I certainly understand that an analysis of the financial impacts of lower wages for women or inadequate health options is valuable.

In any event, I really appreciate the detailed analysis that you did of this issue and the referenced articles and studies. I have to say that I breastfed my kids. My son for 10 months exclusively, and then at night for several more months. I breastfed my daughter for 14 months. I also went back to work as an attorney after about 10 weeks for both, so I pumped at work. Yes, I had an office so it made it easier. I also had a trial and the judge accomodated my pumping (tho I had to do it in the public bathroom). So, at least for this professional woman, I was able to conintue breastfeeding, using pumped milk, without staying at home. That was my choice. I also helped some staff members when the firm was not as accomodating, making sure that a locked room other than the bathroom was available. That is what we should be doing - making sure all women have the option to do what they choose.

Wonderful post. Very thought-provoking. If maternity leave policies were better in the US, the economic/job considerations would be less of an issue for women deciding whether or not to breastfeed. This is sad because personally I feel this decision should be based primarily on what is most beneficial for the child's health and development, not economics. Unfortunately for many moms finances may play a big role in this decision. That's one thing the cited articles don't really address--why and under what circumstances women choose one decision over the other. I think the focus of the debate should focus on why we don't have better maternity leave policies for women of all income levels, rather than Rosin's focus on who's the better mother/smarter/making more money, etc.

April 25, 2009 | Unregistered CommenterAmy

#1) The USA needs paid maternity leaves. Yes, it would be a "loss" economically to the government or employers, but has anyone ever looked at the cost-benefit analysis for Canadian maternity leaves? Is our government reeling from paying us mat leaves? Or does it pay off in the end? The USA is so worried about spending more money on social programs at the risk of becoming "socialists" it seems as thought they prefer ignorance of the benefits to the bliss of their, um, recession(?)
With my first daughter I had a paid year of mat leave and then I decided I needed to stay home with her and left my well-paying job in mental health to become a child care provider in my home. The face value of that decision showed a decrease in my pay cheque. But purely speaking economics here, it turned out I was making more because at least I could keep my whole pay cheque, because I didn't have to pay over half of my would be former job's paycheque on child care and gas, as I lived an hour away from my workplace.
Sometimes it takes getting creative in order to make money and stay home with your child. it wasn't exactly what I wanted to do to make money, and I still miss my old job immensely, but the benefits to my children and my family have been worth it. And I am sure I breastfed longer because I have been home.

April 25, 2009 | Unregistered CommenterMelodie

Excellent essay. The two thoughts which jumped out at me when I was reading Ms. Rosin's article are the fact that she does not mention 'household income'. Perhaps the group of women who breastfeed past 6 months AND have lower incomes actually have a higher household income, due to no childcare costs and higher husband pay. Sometimes if one spouse stays home the other one can focus more on their job, take higher-paying positions which involve travel, etc...

April 25, 2009 | Unregistered CommenterAlina

My other thought is that she doesn't mention the number of children those women have. A woman who breastfeeds past age 6 months and is financially secure might be more inclined, as a majority, to have multiple (3+) children. This would further necessitate a parent leaving the workforce! However just because one parent leaves the workforce doesn't mean the overall household income declines!

April 25, 2009 | Unregistered CommenterAlina

It amazes me that any educated person at this point tries to make an argument against breastfeeding. Do we live in a time when people can choose an alternative, yes. But I think people should make informed choices and part of being truly informed is acknowledging the scientifically proven benefits of breastfeeding as well as the proven risks associated with formula feeding. Likewise woman must look at breastfeeding as one more piece to the puzzle when deciding whether to say home or not.

For me personally the decision was a choice, though to go back after would have made no economic sense as childcare would of almost negated my salary as a teacher.

That said it seems Hanna Rosin has decided undermining breastfeeding is the best way for her to get attention. How unfortunate for women everywhere. I am a new reader of your blog and am so pleased to find such a well informed, intelligent, articulate voice to provide balance to self serving writing such as hers.

I look forward to future essays. Thank you.

April 25, 2009 | Unregistered CommenterMaria

I forgot to mention, on a personal note, that as a long-term breastfeeder I have more than doubled my income since I started breastfeeding 4.5 years ago. I know that one example is not statistically valid, but in my case I decided that I wanted the flexibility to focus on my family when I wanted to and on my job when I wanted to. That meant becoming self-employed. It has paid off wonderfully both in terms of the financial rewards and my ability to take long vacations and work part-time during some parts of the year.

April 26, 2009 | Unregistered Commenterphdinparenting

Thanks for the great post. I wish slate magazine was publishing you, not Rosin.
Here's my perspective: my two year old son just weaned, and now in retrospect I feel like breastfeeding is such a small part of the parenting decisions I made with him. When I negotiated with my bosses for family friendly hours, breastfeeding was never mentioned and I don't think I ever thought of it as the reason I needed to be near my son. I needed to be near him because of my parenting philosophy, which was that Mama cannot not be replaced, not because of my breastmilk, which could easily be pumped into bottles. Now it is definitely true that mothers who believe in dedicating more time to their children often tend to be mothers who breastfeed. But that's just because those two interests dovetail, not because the only reason you'd possibly want to be around your child for most of the day is if you are attached by the nipple. I'm done nursing, and I'm nowhere near done being an attached parent.
My sense of Rosin's first article was that her main reason for being anti-breastfeeding is that breastfeeding forces you to actually spend time near your baby, which she resented.
I'd love to hear you talk more about the so-called feminist issue. Is this really an agreed-upon fact that in order to be feminist, you need to make as much money as possible? If a woman gives up on a big paycheck at some corporate job because she'd rather follow her dreams and become an artist, or because she'd rather do something more idealistic and save the world, does that make her a non-feminist? Or is it just if you leave your job to be with your child that you are branded as breaking with the feminist cause?

April 26, 2009 | Unregistered CommenterChanna

I read the Rippeyoung & Noonan article when it was posted on a forum earlier in the week. I read the entire article waiting for the section where they actually reported results that indicated lower earning potential for "breastfeeders". It didn't materialize. Their data replicated standard breastfeeding demographic data, and promised more data later. At the moment, their hypotheses are just that - hypotheses. I haven't read Rosin's follow-up article (not sure I really want to....) but quoting from this academic article at this point tells me she's trying too hard to bolster her position.

If, in the end, it does turn out that women who breastfeed end up with flatter career trajectories overall (and I'd love to see how something that typically lasts for a year affects a woman for life... if there is a correlation I bet that breastfeeding and other parenting decisions are co-incidental, not causational), well I guess like others, my response would be "so...?".

I've chosen to work part-time since having my daughter. Best decision I ever made. Did I lose part of my salary? Yes. And I gained SO much more.

April 26, 2009 | Unregistered CommenterJuliette

Excellent post! I worked and pumped for 15 months after having my son. I always worked while pumping (conference calls or typing emails, etc) using my hands-free aparatus and my decision to leave THAT work force had nothing to do with breastfeeding my son - but everything to do with SPENDING MORE TIME WITH MY SON. At 15 months we were still breastfeeding, but I was no longer pumping at work. I left my corporate job to spend more time with my son and to start a business designed to HELP OTHER MOTHERS BREASTFEED. This is an excellent post Annie - thanks for writing it!!

April 26, 2009 | Unregistered CommenterJudy @ Mommy News Blog

I also know many stay-at-home moms who formula fed and left the workplace to stay with their children - so the "cons" against breastfeeding are "cons about having children" but not cons against breastfeeding.

April 26, 2009 | Unregistered CommenterJudy @ Mommy News Blog

[...] A Cost-Benefit Analysis of Breastfeeding over at PhD in Parenting. [...]

Thanks for responding to this article. I just wanted to add my own personal experience -- when I had my first child, I planned to breastfeed for 6 months tops, and planned at some point to be a SAHM. Instead, I went back to work after my year mat leave, still breastfeeding, and continued to nurse my son until he was 2.5 years old. I have no proof, but have always said that he was sick much less than the other children in his daycare because he was nursing. Therefore, I missed less work, as did my DH. I am now back at work after having a second child -- I am still nursing him at 18 months and again plan to continue to 2 years and beyond. It is true I'm not as driven in my career as I was pre-kids, but that was a choice I made way back when I decided to have a family, and at that time, I planned to breastfeed "if I could" and to wean to formula. Yes, having the Canadian mat leave helped with breastfeeding immensely (chances are slim I would have stuck it out with my first if I'd had to go back to work at 6 weeks, we were still learning at that point; and going back after 12 months meant I could skip pumping), and I definitely think more options should be available to American working moms. But I agree with what seems to be the consensus -- many of us choose to take a step back from our careers to focus on family, regardless of feeding method. To agrue that breastfeeding alone brings down our earning potential is ridiculous -- but let's just say it's true. So what? Some things are worth the cost, and the simple fact remains: babies were born to be breastfed.

One other thing I wanted to throw out there, if we're talking costs -- what of the cost to the environment of formula feeding? The processing of the stuff, the packaging, the shipping, the production and disposal of bottles...Imagine how much of this would be reduced if formula was used only by those who actually need to use it?

(I also wonder, if a breastfeeding mother makes less than a formula feeding mother, does the cost of formula actually eat up the difference? And that's only the short-term impact...)

April 27, 2009 | Unregistered CommenterAndrea

[...] include Adventures in [Crunchy] Parenting on WIC and Infant Formula, and PhDinParenting’s The Economics of Breastfeeding: A Cost-Benefit Analysis. Looking forward to hearing what everyone thinks. Share and [...]

I have no mental energy to dissect her completely ridiculous argument, so I will reduce it to this:

I made $34,000 annually when I was formula feeding.
I make $48,000 annually while I'm currently breastfeeding.

Using my anecdotal evidence to prove that formula feeders earn less makes just about as much sense as whatever it is she's trying to prove here. Ughggh... that woman exhausts me. But, if a mom is trying to make an irrational argument for why she just shouldn't "have" to breastfeed her kid, I bet Hannah Rosin looks like a patron saint!

What Rosin is really saying is "I made a stupid argument last month that got a lot of smart people pissed at me, so now I'll make up for it by making an even stupider argument. The Kool-Aid drinkers will follow me."

April 27, 2009 | Unregistered CommenterTheFeministBreeder


I don't think she is trying to use anecdotal evidence. She is linking to a study that proposes to use documented statistical evidence to prove a hypothesis. The thing is, the hypothesis hasn't been proven yet and Hanna Rosin is pretending that it has.

But even if it can be proven that breastfeeding moms earning trajectories are someone lower than formula feeding moms, I think we need to consider more than just earnings into the economic cost/benefit analysis. If you earn a bit more, but end up having to pay for expensive breast cancer treatments, do you come out ahead?

April 27, 2009 | Unregistered Commenterphdinparenting

Right - which is why she's using her own anectodal evidence to try to prove that it falls in line with a hypothesis which hasn't even been proven yet. But hey! At least this time she's at least TRYING to support it with "evidence." In the last article she just said that women who breastfed "couldn't work in any meaninful way" - that's that - no statistical evidence required! Why? Because SHE didn't. Now she's attempting to statistics to prove that it happens a lot.

She's trying to prove that because SHE left full-time, paid employment, then "most" breastfeeding moms will too. It's a crap argument - especially when most every mom I work with is right back here at work, pumping away in the mothers room just 12 weeks after the birth of their baby. In my world, returning to work does NOT equal giving up breastfeeding. Why does she insist that it does??

I take such huge offense to the blanket statements she makes with her twisted view of the facts. It makes my Feminist blood boil.

April 27, 2009 | Unregistered CommenterTheFeministBreeder

I'm pretty sure that between the healthcare savings, the potential IQ boost, savings on lost income when the child is sick and needs to stay home, etc. add up to a savings, especially when the exorbitant cost of infant formula is factored in.

Add in the cost of WIC & foodstamps formula, paying for the healthcare of the low-income babies whose moms are not breastfeeding.. It's pricey.

But.. Even if breastfeeding was a LOSS.. A complete and utter loss in terms of money..

It's worth it.

It's a privilege I'd pay for. It's a healthy food I'd pay for.

April 27, 2009 | Unregistered CommenterSara

A couple of thoughts, probably in highly garbled form:

1. I don't think it's necessarily true that 'most of the costs are costs of the decisions that women may or may not make with regards to the way that they choose to balance breastfeeding and work' (i.e. optional). Lots of women simply don't work in jobs that would be possible to do during the pumping breaks, so pumping for those women *would* mean special accommodations/breaktime/time away from the job, whatever. Not everyone has the wherewithal to change jobs or set up their own business instead. For a lot of women, pumping *would* require changes that would mean that they'd spend less time working. Which doesn't necessarily mean that it wouldn't all work out as cost-effective, just that I don't think you can assume that the bulk of the costs can feasibly be eliminated just by women making decisions that allow them to work during the time spent pumping/feeding, because that often won't be possible.

2. All of this debate seems to have had one basic unquestioned assumption: that the choices are between the mother taking time off from her work, or the child going into childcare. Ahem? What about the other parent who's generally required to produce a child? For some families, it does work out better for the husband to be the one who takes parental leave or a career break to care for the child; so, for those families, if the woman is going to breastfeed as well, then that may mean extra cost if she's not in a position to work during pumping breaks.

April 27, 2009 | Unregistered CommenterSarah V.

Hang on, just noticed - you didn't put the cost of pumps/hands free bras in that analysis.

One other point to bear in mind: It's not necessarily a clearcut either-or whereby a woman either pumps at work or spends money on formula. From my own experience, with Child 1 I couldn't pump nearly enough milk so we ended up buying lots of formula anyway (between that, the cost of the pump and the hands-free bras, the cost of the journey to get his tongue tie snipped, and the extra maternity leave I took, I may well be one of the few women to have made an overall loss from breastfeeding). Second time around, I pumped plenty of milk and we then discovered that my daughter was much happier on formula. So we had to buy formula for her anyway. (The milk bank did very well out of it, though.) So, I had costs of pumping *and* costs of formula feeding. (I have no regrets at all about this, but am just making the point that it's not a clear-cut either-or.)

April 27, 2009 | Unregistered CommenterSarah V.

@Sarah V.

Thanks as always for your thoughtful comment. A few thoughts in reply:

1. a. Even in jurisdictions with no protections specifically for breastfeeding moms and in jobs where you cannot pump at your desk, I am not aware of any jurisdiction that does not have legislated break time for all employees. I have worked with a lot of working and pumping moms as moderator on a message board for years and by talking through individual situations, we are usually able to find something that will work. For a mom with low supply and difficulty getting sufficient breaks, it may not result in her being able to provide 100% breastmilk, but there is usually a workable solution and most women are able to figure something out that doesn't require supplementing due to too few breaks.

1.b. When I say "However, on the cost side, most of the costs are costs of the decisions that women may or may not make with regards to the way that they choose to balance breastfeeding and work. The costs are changeable. " I don't mean that individual women can change them in all cases (some can, some can't). What I mean is that as a society we can change those. We can advocate for better protection for women at work and for their earnings.

2. Of course. My husband is a stay-at-home dad. I worked and pumped while he was at home with the kids for a total of 21 months between the two kids. I didn't mention childcare costs in this anywhere. That wasn't really part of the cost/benefit analysis. I know it got raised in the comments and I think it is a real consideration for some people whose husbands are not going to stay home. With regards to pump breaks, I answered that in 1.a.

3. a. With regards to hands-free pumping, I had two options. First, a hands-free kit came free with the purchase of my pump. Second, I found an even better solution after that...that cost probably a total of about 33 cents: http://www.kellymom.com/bf/pumping/hands-free-pumping.html

3.b . I did forget the cost of a pump though, so I added that in. I also referenced nursing bras and nursing clothing, although I don't see it as essential and rarely used it.

April 27, 2009 | Unregistered Commenterphdinparenting

[...] 27, 2009 This website has some great info on more reasons why breast is best, and how it would benefit society in general [...]

I'm another one who didn't really consider breastfeeding as a reason when I decided to not push as hard at work anymore. Sure, I would love to put the pump away completely and nurse my daughter, but it's just the thought of her spending all day with someone else that gets to me. She prefers me to anyone else and when I am home we are practically attached to each other. It feels natural, and if I could stop working completely I would it no matter how I was feeding her. I work enough to stay competative but I get home as early as possible, not so I can nurse her, but so I can snuggle her.

April 27, 2009 | Unregistered CommenterLaine

"3.b . I did forget the cost of a pump though, so I added that in. I also referenced nursing bras and nursing clothing, although I don’t see it as essential and rarely used it."

I love these topics. How many times can I respond to a post before I get blocked? :-)

I had no nursing clothes (never understood the need for them) and pumping was free for me. My employer provides us with a hospital grade Double Lactina pump that has been used by lots and lots and lots of women at the company. They made a small investment in it, and we all reaped the benefits. You can pump two breasts in 15 minutes, saving the company money on time spent away from duties.
It meant I really didn't need to buy one of my own.

I do have one of my own though, that I didn't pay a red cent for. Insurance provided it - actually my friend got hers through insurance and she didn't need it so she gave it to me. But neither one of us "paid" for it. If you're looking for a free pump, check out your insurance policy. They usually cover the cost of a pump purchase or pump rental - it falls under "Durable Medical Equipment." WIC also provides them in IL. The State of IL sees the investment in breastfeeding promotion as a way to save lots and LOTS of money on sick kids and buying formula.

April 27, 2009 | Unregistered CommenterTheFeministBreeder

@TheFeministBreeder Respond all you like! I won't block your comments...

April 27, 2009 | Unregistered Commenterphdinparenting

I love all these comments. I feel like I've found a group of like-minded people for a change. I don't have anything new or brilliant to say, only that I'm frustrated, too, but can't articulate it nearly as well as the folks here. Although I do http://thisisworthwhile.blogspot.com/2009/04/sweaty-hamster.html" rel="nofollow">try.

It's a tricky lot, modern motherhood. We should put THAT on our resumes:

-Able to nimbly navigate slippery corporate employee rights
-Increased home and office functioning on little or no sleep
-Created, sustained, and nurtured a human being while also meeting deadlines, social expectations, and personal goals

And so forth and so on...

Good news! Phyllis Rippeyoung, one of the researchers that wrote the "Is Breastfeeding Truly Free? The Economic Consequences of Breastfeeding for Women" study got in touch and has shared with me the draft results of their study (the ones that Rosin had and quoted, but didn't link to).

I'll be giving them a thorough read through and will write a follow-up post sometime later this week.

April 28, 2009 | Unregistered Commenterphdinparenting

I appreciate your note that the costs and benefits can to a great extent be seen as differing short-term/long-term. I am waiting for my twins to be born, and thinking that if I was going back to work at 3 months post-partum, it might be very difficult to extend nursing past that initial period. Short term I will be losing money by not going back to work for 6 months, but I am invested in the health and other benefits of breastfeeding (including those with longer-term payoffs).

Research has suggested that there are socioeconomic factors in the decision to breastfeed. People in Oregon are working on a paid-family leave program, which could influence the decision to stay home (and to breastfeed longer) for lower income women. Makes me want to compare breastfeeding rates for lower income women in Canada and the USA.

April 30, 2009 | Unregistered Commenternonlineargirl

[...] I mentioned in the comments to my post on The Economics of Breastfeeding: A Cost Benefit Analysis, Phyllis Rippeyoung got in touch with me after reading my post to clarify some of the points that [...]

[...] choose to breastfeed their children while trying to make a career. This insightful analysis of the costs and benefits of breastfeeding on PhD in Parenting tries to put things in perspective and draws attention to the gap between our [...]

I wrote a follow-up post after reading the actual study on the economic consequences of breastfeeding: http://www.phdinparenting.com/2009/04/30/more-questions-than-answers-follow-up-on-economic-consequences-of-breastfeeding/

May 1, 2009 | Unregistered Commenterphdinparenting

I am a public health professional and breastfeeding/pumping for my 8 month old daughter. My problem with Rosin's analysis is that she is accepting an unfair premise rather than challenging it. Even IF their are economic consequences to choosing to breastfeed (which I'm not convinced of, especially from a public health cost perspective), but even so, the answer is NOT to encourage women to stop breastfeeding (and sacrifice the numerous health benefits to mother and baby), but instead to change the system into one that respects and values the role of healthy parenting--mom or dad. Good NPR article from a few weeks ago talking about this as a personal decision and the various factors that go into it: http://www.npr.org/templates/story/story.php?storyId=102361013

May 1, 2009 | Unregistered CommenterDanny

[...] is a debate going on about the hidden cost of breastfeeding. Over at PhD in Parenting, you can find out about research on “how breastfeeding is beneficial to a baby’s health and [...]

I agree with you, but the only point which seems to be lacking is the incentive effect of greater protection for breastfeeding mothers (and for women of childbearing age and potential generally) on hiring and promotion decisions. And I think it's also a bit inevitable. For me it's not so shocking to discover that there may be an economic price to pay for looking after your children properly. It involves sacrifice of personal interests very narrowly construed for the interests of the child. This is what parenting is about. In the end the cost-benefit is enormously positive, provided that you have the right metric and objective function ! These are complex societal issues to which I don't think anyone has perfect answers, but yes, again, broadly I agree with you.

Unfortunately I think you have also forgotten the major economic benefit as well. Insofar as breastfeeding proxies for attachment parenting (and I'm afraid it does), the result is happier, healthier, and more productive future adult members of society, less likely to engage in destructive and self-destructive behavior and more likely to help others and generally increase the overall level of happiness in society. Now that really is important....!

May 10, 2009 | Unregistered CommenterSean

[...] my post on the Economics of Breastfeeding: A Cost-Benefit Analysis and the follow-up to that post, I mentioned a study called Maternal Employment, Breastfeeding, and [...]

[...] humiliated, I don’t sulk. I post. That was true when I lashed out at Hanna Rosin in the Economics of Breastfeeding and in The Case Against Breastfeeding: Is it Anti-Feminist. It was true when I told facebook what I [...]

All I can do is laugh after reading the case against breastfeeding and other works. Really?? Is there even a case against it, I still have not heard ANYONE deny that it is preferred. And Economics is a SOCIAL science, there is no simple cost/benefit analysis that can be reduced to simply a loss of income by breastfeeding. Ha ,what a joke, I think the author actually makes her case in favor of breastfeeding by showing that more educated women (that earned the higher wages before they even had children) are the ones breastfeeding.

June 24, 2009 | Unregistered Commenterlauren

[...] We need to keep providing medical, technical and moral support to women who are struggling with breastfeeding. That will always be a requirement. But to truly facilitate breastfeeding, we need to break down these barriers so that all families and all babies can benefit from the health benefits of breastfeeding and the economic benefits of breastfeeding. [...]

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