We already know that breastfeeding isn’t free—but how much does it cost to breastfeed a child for a year, exactly? That query is what a team of Yale researchers set out to explore—not just in abstract terms, but in actual dollars. Inspired by the stressors and limitations placed on parents of young children during the 2022 formula shortage, in which families across the country who relied on formula were left to resort to unsafe feeding methods when they couldn’t find the formula their babies needed, the team worked to calculate the direct and hidden costs of breastfeeding.
A year’s supply of formula may cost between $760 and $2,280, the researchers found, whereas breastfeeding for one year may cost women more than a whopping $7,940 to $10,585, when factoring food, equipment and time spent. You read that right: The actual cost of breastfeeding may reach nearly $11,000 for the first year. But given that the American Academy of Pediatrics (AAP) now recommends exclusive breastfeeding for 6 months with extended breastfeeding alongside solid foods until at least age 2, that total cost could actually be significantly more.
The team published its findings in the “Journal of Perinatology” in March 2023. “This is the first time that we’ve really taken a look at the cost borne by breastfeeding women in dollars and cents terms,” says Sarah Mahoney, a second-year MD-PhD student interested in the intersection of medicine and economics, who is the paper’s first author. “This is critically important if we want to develop any sort of effective policy to promote breastfeeding.”
Assessing the cost of breastfeeding
The researchers first reviewed existing literature around the cost of breastfeeding in order to identify the variables that need to be considered when determining the costs associated.
They then calculated the cost of each of the following factors:
- Increased food intake for the nursing parent (breastfeeding requires an additional 400 to 500 calories per day)
- Vitamins and supplements to support breastfeeding, such as prenatal vitamins or supplements to promote milk production (known as galactagogues)
- Breastfeeding supplies, such as milk storage and pumping supplies and nursing-friendly bras and clothing
- Time spent pumping and feeding
It’s estimated that breastfeeding parents spend an average of 3 to 4 hours nursing their child each day, though of course that can vary depending on age and even factors such as illness or teething.
There are several other factors that may be necessary along one’s breastfeeding journey, especially when facing challenges, like low milk supply. That may mean professional lactation support (which may not always be covered by insurance), or tools to manage mastitis, clogged ducts and other infections or issues.
For low-income families, the cost of breastfeeding may be a significant financial barrier. With the federal poverty limit (FPL) at a little over $19,700 for a family of 2 (that’s a single parent and child), or nearly $25,000 for a family of three, breastfeeding costs would take up a large portion of that amount. It’s estimated that 17.5% of kids under 5 live under the federal poverty limit. “That suggests that almost 1 in 5 kids are living in households where breastfeeding would take up over half of the family’s yearly income,” says Mahoney. “When thinking about developing policies, this is something we ought to consider to help make breastfeeding more accessible to those families.”
Using the cost of breastfeeding to inform policy changes
Formula, though still expensive, requires less time cost for parents and caregivers—as long as it remains accessible. The 2022 formula shortage put millions of families in a bind when they couldn’t find their baby’s formula. Recent research shows that close to 50% of parents resorted to unsafe feeding practices during the shortage to ensure their babies were fed, such as using homemade formula, turning to expired products, watering down formula, or informal sharing of human milk.
As a result of the formula shortage, experts have called for policy changes to give families better clinical prenatal and postnatal lactation support, as well as enhanced access to banked donor milk and more commercially available formula products. But there are more factors to consider: Inadequate paid parental leave can disrupt early breastfeeding success—and though the recently passed PUMP Act offers workers more lactation-friendly policies in the workplace, breastfeeding and pumping at work may still be unsustainable for those in jobs with limited flexibility.
“If a mother wants to breastfeed, we ought to do what we can to make that accessible to her,” Mahoney says. “So it’s important we have a sound idea of what challenges mothers face so that we can address those and make a difference.” But as for meeting AAP recommendations to breastfeed for up to two years? “America as a whole is not even close to achieving that,” she notes. Understanding the true costs of breastfeeding may be an important first step on that path.