The Cost of Breastfeeding

Ruth Mantell has a post on WSJ blogs about “The Economic Consequences of Breastfeeding.” I would take issue with Mantell’s approach if it were intended as anything more than a typical blog post, but I could not be more thrilled that this is being discussed at all!

I love the fact that Mantell can share her considerations and that “CrunchyMBAmama” types can share how they had no problem pumping for over a year. I think that it is great that women such as Mantell are breastfeeding exclusively for the first six months of their child’s life and then continuing to breastfeed while with their child. Breastfeeding is excellent for both the mother and baby.

At the same time though, most of the evidence for the great power of breastfeeding is based on the first six months of the child’s life or else situations where the alternative is low-quality formula mixed with impure water. I see no reason to be concerned if women decide that exclusive breastfeeding after six months is simply not worth the effort.

Much more concerning is the question of which mothers never get anywhere close to exclusively breastfeeding for six months. In the United States there is no question about the correlation of breastfeeding with privilege. At six months of age the percentage of babies breastfeeding at all is:

30% of Black babies compared to 45% of white babies.
33% of babies whose mothers are high school graduates, compared with 58% whose mothers are college graduates.
27% whose mothers are unmarried, compared with 50% whose mothers are married.
34% who are below the poverty line, compared with 51% who are at 350% or above.

The national average of babies breastfeeding exclusively at six months is only 13.6%, but for babies from the poorest state, Mississippi, it drops to 4.6%.

I firmly believe that breastfeeding is important enough to demand significant social support. But as long as the most privileged women have support for long-term exclusive breastfeeding and choose to stop after six months due to convenience, I see no reason to be concerned about the “economic implications” for them as a group. What does concern me is the health implications for those mothers-babies never who never have a chance of getting to six months of exclusive breastfeeding due to their economic situation. Because one thing we do know is that the economic consequences of mothers never breastfeeding are huge for our nation.

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16 thoughts on “The Cost of Breastfeeding

  1. Trena

    Breastfeeding was so important to me that it was part of the reason I decided to only return to work part-time. (Although most of the reason was because I wanted to raise my daughter!) I knew how important breastmilk was for Mary Rene, and I knew that my chances of returning to work full-time would increase my changes of “giving up.” Sure, I could have worked full time and still continued to nurse, but the odds were against me. I know that. Sure my husband and I are struggling financially because of the decision I made. Sure, we actually had to stop contributing as much to my IRA, but when it comes down to it, we put our future in God’s hands. I can’t control that. All I can control, somewhat, is here and now. And right now, it is my job to provide for my daughter in the way she needs.

    Many low income women can get pumps for free by checking with their insurance company. And for those that don’t have insurance there are plenty of breastfeeding friendly organizations that would be more than happy to loan a pump so a woman can continue nursing. The long term benefits definately outweight the short term.

    1. Rae Post author

      I think that it is wonderful that you made breastfeeding (and taking care of your daughter in general) such a priority. I wish that more women had opportunities for part-time jobs, and that there was some way to guarantee it, so that clearly qualified women such as yourself would not have to worry about fighting their employers.

  2. Sarah

    I wonder what the reason is for poorer women not breastfeeding, seeing as its free. I’m assuming it has to do with working long hours and not being able to pump? Do you think educational level has to do with it; since women who are more educated are more likely to take a parenting/breastfeeding class and not give up if the baby doesn’t latch on right away?

    Thanks for this post; it’s really thought-provoking!

  3. Dawn Farias

    I’ve always been impressed by my younger sister: she became pregnant at 15/16 and then, when breastfeeding didn’t work out, secured a pump (for free) from WIC (I think) and pumped for a whole year!! We don’t come from an educated family. Our dad quit school at 8th grade or so (got his GED later). Her mom, my (ex)stepmom is a high school graduate but told me when my first was born, upon hearing that I was going to breastfeed, “Oh, gross!” LOL.

    She wasn’t being mean, just honest. So, where my sister got emotional support for breastfeeding/pumping is beyond me! She’s amazing.

    1. Rae Post author

      That is an amazing story. Good for your sister!

      I certainly don’t think that stats tell the whole story. My mother-in-law did not finish high school and was actually a lactation consultant. And one of my sisters with a BA never even considered breastfeeding.

  4. Erin

    **Warning – I judge a lot in my comment!

    This was an excellent post Rae. I remember in college I didn’t really understand when my feminists classes discussed that feminism was criticized for being too white. Now I get it. I get really annoyed at these websites saying (judgingly) that we should all be breastfeeding until the kids self-ween between 3 and 5. ?!?! First, I personally (judgingly) think that it is a tad “gross” when kids can request it, but more importantly – what an unrealistic goal for most of our population. I am always frustrated by “rich hippies,” which is my stereotype for these people.

    1. Rae Post author

      I suspect that we should all be a bit more adaptable when it comes to breastfeeding. I cannot imagine breastfeeding a 3-year-old, but if it works for others then yay for them. Of course I would not sound so relaxed if someone was suggesting that I had to breastfeed for 3 years to be a good mother!

      1. Mama Kalila

        I wouldn’t be so relaxed if anyone said I *had* to do xyz to be a good mother lol.

        As for the “rich hippie” thing.. Not all of us that are for self weaning are rich. I’m no where near rich… Of course I’m not so comfortable with the upper limits of the norms for BF ages (like you, if someone else is.. that’s great. Me not so much. If I ever have a child that wants to go past 3 I may have to change my views on that, but thankfully my first was closer to the 2 years I intended than 3 even) either. Agreed that it could be unrealistic for some people though. I’d be more worried about the ones who don’t have the resources to BF at all or make it to a year. We’re at the point here we need to start small. But at the same time, the information about extended BF and child led weaning shouldn’t be so hard to come by either or made to feel like those of us who choose to do it are weird or wrong.

    2. carrien (she laughs

      :) My 3rd child was still breastfeeding once a day at 3 1/2. I am by no means rich though.

      When the people in the WIC office ask how long I plan to breastfeed my newborn and I tell them how long I breastfed the others I get the distinct impression I’m a very small minority.

      I really think it’s more to do with feeling overwhelmed than anything else. The women I encounter who are facing economic challenges just feel like they can’t do it, like it’s one more thing to deal with when they are so stretched already. Just like making healthy choices is a bigger challenge for lower income demographics because every day feels like a struggle just to make it, and the tendency to reward w. cheap junk is strong. (can’t remember where I read that study.)

      Anyway, education and work situation is only a part of the problem. It’s a cultural and attitude shift as well.

  5. Kathleen

    I’m like Sarah; I’ve never understood why low-income women would choose the most expensive feeding option. Not in a judgmental sense, just a confused sense. Is it lack of education? Lack of exposure? I don’t get it.

    Erin–I think there has to be a middle ground. I don’t think there’ s anything wrong with extended breastfeeding; what you’re expressing is our own cultural prejudice. However, I’ve always run a middle ground, leading my kids toward weaning, but not forcing them, and we always are finished between 14-15 months. (“Always” is kind of a big word for somebody whose 3rd child is still breastfeeding, but anyway, you get the idea.)

    1. Erin

      I shouldn’t have been so flippant in discussing “rich hippies.” I live in Southern California, and sometimes I get annoyed hearing about peoples’ psychics/crystal readers/energy consultants – and I let that spill into our discussion.
      In case I haven’t said it earlier, I do not have any children (though I am ridiculously excited to get pregnant in December) and so I know very little on a lot of things. And I was clearly judgmental.
      What I dislike the most about my judging, and what I think Rae’s post addresses, is that there are A LOT of factors that go into parenting decisions (including money) and that everyone is trying their best and figuring out what works best for their families. Parenting, labor, nursing – it all sounds really hard. We should spend less time judging, and more time supporting. And I need to remember that :)

      1. Mama Kalila

        LOL – I’m sorry… We joke a lot about hippies here – my crunchy ways gets me called one, but I am so not like what you described I promise! That’d annoy me too…

        I like that last line though, because yes we should spend more time supporting each other. That and some people (not saying you, I’m thinking of people I know personally) need to learn to agree to disagree sometimes. I don’t have like like everything billy joe bob does, but I can be respectful :-j

  6. Rae Post author

    Sarah and Kathleen, I do not have any studies of why lower income is correlated with lower rates of breastfeeding, but in my health econ class was taught that it was largely due to employment issues. Women with good jobs can afford to take longer maternity leaves and then have work which accommodates pumping (and sometimes even having the baby in the office or an in-building daycare).

    I really appreciate the efforts of groups such as WIC, but I suspect that they can only do so much to work around employment issues. I for one would not want to try pumping in the bathroom of a fast-food restaurant. I wonder what would happen if we invested in giving new mothers six months of maternity leave. I imagine that as a society we could actually make up the costs in health benefits, but that is such an oh-so-socialist idea! ;-)

    Also, apparently a partner’s attitudes toward breastfeeding are also highly important. And maybe more privileged men are more aware of the studies in support of breastfeeding? I have no idea how that aspect works out.

  7. MyFeminineMind

    When our oldest was 8 month en utero, I was placed on modified bedrest and then lost my job because I was unable to work. My husband was a full-time student and I was the bread winner. We were poor before, but when our daughter was born, we were dirt poor. Hubby had made a little bit here and there designing websites and such, but it wasn’t neerly enough. We got on food stamps, heating assistance, WIC, and Medicaid. My breast pump I received free from WIC. They would have provided some formula too if we had chosen to formula feed, but I know from talking to other mothers, that it’s not necessarily all the formula the child needs. They still had to purchase some. We coslept, which allowed me more sleep and also the sense that my baby was getting cuddled all night since I couldn’t be with her that much during the day, then I woke at 5:00 to get ready for work, worked 8 hours, and commuted an hour each way. I was usually pretty tired and two or three times a week I would go to bed at 7:00 or even 6:00 because I was so exhausted. I can’t imagine if we had to deal with her getting colds, diarrhea, and such if we had formula fed, or even if we had to buy a couple of cans of formula. We didn’t have any money to waste, or spend on anything that wasn’t an absolute necessity. The WIC office had a breast feeding support group that gave so much helpful information and an AWESOME lactation consultant. I owe my 6 months of exclusive breastfeeding to them, because when I started I was going to breastfeed until the baby started teething, but at the end decided to allow her to self-ween.

  8. Lydia

    I breastfeed both my children, because it was what I felt was best for them but also because it was the ecnomical choice. But I never had support from most of my family or my community. Alot of people in my economic bracket- think that it’s gross. I don’t know why this is. We could’ve qualified to go on WIC but we don’t accept help in that way- we make our own way- but alot of lower income families do get alot of help with formula in this way. WIC is trying to promote breastfeeding, they even offer consultations and pumps if you are going back to work. I just think a stigma needs to be gotten through for breastfeeding in this sector to reach greater numbers.

  9. Calin

    Do you think that only mothers sacrifice in breastfeeding? :) You can image that from a husband point of view, breastfeeding has some (negative) implications on the dynamics of the sexual relationship, but above all, I have never thought of 1 second that my wife should not breastfeed, although we have 4 children. Actually living in Romania you are encouraged to breastfeed, ’cause the Government is more involved in this as the mother receives a pretty good allowance for staying home until the child is 2 years old.

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