Opinion | ‘Just Breastfeed’ Will Not Solve the Infant Formula Shortage

As the federal government steps up its response to the infant formula shortage, many new parents are being confronted with heightened encouragement to switch to breastfeeding. The calls to “just breastfeed” are often paired with the statement, “breastfeeding is free.” Though these statements may be (mostly) shared with good intentions, statements like these ignore and minimize the reality that breastfeeding is not actually free.

This statement is rooted in an understanding that birthing people naturally produce breast milk to feed their infant; therefore, breast milk is often thought to be a free resource. But there are costs — monetary, physical, and emotional — associated with producing breast milk and successfully breastfeeding.

Producing breast milk requires several resources. First, nutrients. A breastfeeding person requires more daily calories than folks who are not breastfeeding to produce nutritious breast milk. The CDC recommends breastfeeding people consume 2,000 to 2,800 calories per day. Increased intake of iodine and choline, two nutrients that support lactation, is also recommended. Food provides those calories and nutrients. However, food costs money, and given inflation, costs are exceptionally high right now.

Breastfeeding also takes time. On average, infants are fed every 2 to 4 hours. Breastfeeding people also may need to express, or pump, milk every few hours. Feeding sessions and pumping can take 20-30 minutes or more depending on breast-milk production. Over a course of a year of breastfeeding, this could equate to 1,800 hours. To compare, a typical Federal civilian employee works 2,087 hours a year. Many breastfeeding people return to work 6 weeks after birth, including low-wage workers. Some of these hours occur during the workday. Yet, not all employers are required to provide enough paid break or leave time to cover the time needed to pump or breastfeed, which can result in lost wages.

Despite widespread encouragement to breastfeed — from the media, government agencies, and other sources — only 51% of employers have worksite lactation support programs. During breastfeeding, milk must be expressed every few hours. During a regular workday, that might mean needing to express milk up to four times. People who are breastfeeding may not have enough paid time to pump milk; thus, every break taken to express milk could mean a smaller paycheck. Black and Hispanic women are overrepresented among low-wage workers. These workers are also less likely to have access to workplace breastfeeding supports. Research also suggests there are indirect costs related to working and breastfeeding. Breastfeeding duration is associated with declines in average earnings; those who breastfeed for 6 months or more are more likely to have higher earning losses compared to those who breastfeed for less time.

Beyond lost wages, there are also other monetary and physical costs to successfully breastfeeding. Breast pumps can cost at least $30 for a manual pump, and $200 or more for electric pumps. Some may believe that all breastfeeding people need is a pump. But there are more costs to consider. Bottles and breast milk storage supplies are needed to store breast milk. Breastfeeding can lead to physical pain, such as clogged ducts and cracked nipples, requiring ointments or doctor’s visits to resolve. Depending on where one breastfeeds, due to social, cultural, or policy requirements, nursing covers may be needed. Those who are breastfeeding may need to buy these supports more than once. Under the Affordable Care Act, most insurance plans cover some of these costs, but not all.

We can’t ignore the emotional costs of breastfeeding. Although some research suggests that breastfeeding supports emotional and mental health, challenges with breastfeeding, like an insufficient milk supply, medication use that limits one’s ability to breastfeed, and latching difficulties can be emotionally draining for a breastfeeding person. Breastfeeding people who face such difficulties may be at higher risk of postpartum depression and may struggle with feeling like a “failure.” Support from health professionals, like lactation consultants, may be needed to address these concerns. Multiple visits, which costs time and money, may be needed to resolve the challenges. These visits may cost between $150 to $350 per hour; for those who are uninsured or underinsured, these costs can quickly add up.

Breastfeeding can be a natural, healthy, and satisfying experience for those who are able to successfully do so. It can support infants’ health. But the assumption that breastfeeding is free and easily accessible for all new parents leads to less resources available to support breastfeeding. And at the current moment, it’s a dangerous narrative that threatens to lessen the significance of the baby formula shortage. Understanding what it actually costs to breastfeed is the first step we can take to ensure all breastfeeding people — and new parents who aren’t breastfeeding or can’t breastfeed — have the support and resources they need.

Jessica Owens-Young, PhD, is an assistant professor in the Department of Health Studies at American University in Washington, D.C.