Abstract
We looked at 10 pediatric diseases and had to exclude one important expensive disease, type 2 diabetes in youth, which is growing in epidemic proportions. Just looking at the pediatric data, we actually only analyzed exclusive breastfeeding for 6 months for one of the 10 diseases, gastroenteritis. This disease represented a fairly small proportion of the total. In fact, we could negate most of the $13 billion in losses if we could get our exclusive breastfeeding rates up to 90% at 4 months and our rates of any breastfeeding at 6 months up to 90%.
We did not look at any costs for maternal disease related to suboptimal breastfeeding; these are likely to be substantial. For example, risk of cardiovascular disease is higher for women with fewer than 24 months of lifetime lactation. This disease costs our country over $500 billion per year, according to the American Heart Association (AHA). 2 If even 1% of these costs can be cut with improved breastfeeding durations, that is still $5 billion.
So, many have asked, is it even possible to achieve such high breastfeeding rates in the United States? I think we can make substantial progress toward these goals with a strategic nationally coordinated approach, and improvements in maternity care practices will play a major role. We also need to rethink the ways our nation addresses family-friendly values in the workplace, thinking not only about the economic consequences but also about the humaneness of separating very young infants from their mothers all day long.
We know that optimal maternity care does not happen in most U.S. hospitals and that U.S. women struggle mightly with worksite issues as well as access to lactation care and services. Yet, women are crucial to the U.S. economy, and women's biology cannot be ignored. Nearly half of our workforce now comprises women. Therefore, accommodating women's reproductive needs is essential for our economy.
Think of what the AHA has done to prevent heart disease and stroke, and imagine that kind of reach to turn breastfeeding around. They have standardized resuscitation protocols that every cardiac nurse and hospital doctor in the United States is required to know. Millions of ordinary people now know cardiopulmonary resuscitation. Can we have something similar for breastfeeding? The AHA has created massive public education in recognizing the signs of stroke and heart attack. Everyone knows about their Go Red for Women campaign to raise awareness of cardiovascular disease in women—coincidentally, an area impacted by breastfeeding. Not only can we learn from the AHA, but we should consider partnering with them and other nontraditional organizations to extend our reach and influence.
In the last several decades, breastfeeding and women and children have not been valued. Breastfeeding was just a lifestyle choice made by people who were not considered very important. But now we have some monetary value on it that allows us to talk about breastfeeding in terms that the world's leaders can understand: economics. To effect real change, we need to be speaking the same languages as all the stakeholders; we cannot speak public health if the stakeholders think in terms of business plans and dollars.
In conclusion, there is much we can do in the United States to improve breastfeeding. Some of it needs to come from legislation, some from regulation and policy, and some from providing incentives for best practices in the hospital setting. We need to build a national infrastructure to get this done. That means funding and coordination across government agencies. To accomplish this task, we must share the vision that breastfeeding has real economic and social value and that women play a key role in our nation's economy and health.
Footnotes
Disclosure Statement
No competing financial interests exist.