An analysis that is missing half the equation

I was pleased to see Melissa Bartick’s effort to appraise US policy-makers of the economic costs of suboptimal breastfeeding. However, any analysis that is missing the effects of lactation on maternal health will grossly underestimate the true costs to the US of suboptimal breastfeeding.

As the 2007 AHRQ report stated, “a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer” for mothers. In addition, over the last 3 years, considerable evidence has accumulated showing that lactation also has important effects on maternal risk of hypertension, hyperlipidemia, and cardiovascular disease (PMID: 19110223; PMID: 19384111; PMID: 20027032), the leading cause of death for US women.

According to the American Heart Association, the cost of cardiovascular diseases and stroke in the United States in 2009 is estimated to be $475.3 billion (http://www.americanheart.org/presenter.jhtml?identifier=4475)

According to the American Diabetes Association the US spent $116 billion in direct medical costs and another $58 billion for the costs of disability, work loss, and premature mortality for folks with diabetes (http://www.diabetes.org/diabetes-basics/diabetes-statistics/)

Diabetes and cardiovascular disease are big, costly diseases that affect a lot of US women, and more commonly affect women who don’t breastfeed, SO, while Bartick and colleagues did a nice job summarizing the costs for infants of not being breastfed, we really can’t afford to ignore the other half of the equation. Breastfeeding is important to the health of both mothers and children.

Eleanor Schwarz, MD, MS, is a physician and researcher with the Departments of Medicine, Epidemiology, Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Center for Research on Health Care.