New tool calculates economic value of breastfeeding for mothers and society

By Dr. Liji Thomas, MDApr 26 2023

Breast milk has long been recognized as the ideal food for babies and infants, with exclusive breastfeeding recommended for babies up to six months of age. Earlier researchers have attempted to quantify and evaluate in economic terms the production of breast milk by the world's mothers but with varying results. Researchers use the Mothers' Milk Tool (MMT) across a few selected countries to illustrate how much society gains from breastfeeding in purely economic terms. The paper is published in the journal Frontiers in Public Health.

Study: The volume and monetary value of human milk produced by the world's breastfeeding mothers: Results from a new tool. Image Credit: mentalmind / Shutterstock

Introduction

Breastfeeding is well known to be the best food for infants and young children. However, when limited, as it often is because of multiple factors, it could cause heavy health costs, losses of human life, and increasing strain on the economy. In fact, noted economists Amartya Sen and Joseph Stiglitz described the failure to include breastmilk in measurements of economic goods and services such as the gross domestic product (GDP), which are fundamental to economic policymaking, as a "serious omission in the valuation of home-produced goods, which is clearly within the SNA production boundary, is quantitatively non-trivial and has important implications for public policy and child and maternal health."

The obvious fallout of such an omission over the ages includes the lack of adequate paid maternity leave, and the widespread marketing of breastmilk substitutes, while a counterattack may be seen in the spread of breastfeeding-friendly facilities in healthcare and maternity services. In 1993, the System of National Accounting (SNA) was changed to allow for the inclusion of breastmilk production as an economic item in the GDP.

Ignoring the value through the nonmarket role of breastmilk also involves a neglect of the role played by families in developing human capital. Despite SNA changes, public policies are still woefully bereft of any insight into assigning a correct value to breastfeed in economic terms.

Studies on breastfeeding in these terms typically take one of three forms. They may assess the cost of not breastfeeding or the cost of supporting breastfeeding, the economic value of breastfeeding, and of lost milk. Two tools are available at present that allows any country to count the cost, in economic terms, of not breastfeeding, allowing for a more accurate assessment of the financial investment required to promote this practice. These tools are the Cost of Not Breastfeeding (CNB) Tool and the World Breastfeeding Costing Initiative (the WBCi Costing Tool).

The MMT is a new online tool brought about by a team of scientists interested in putting a value label on the unpaid work done solely by women in breastfeeding infants and small toddlers. The design for this tool came from a thorough review of existing tools and literature to pick out its current and potential uses, the required features, and the data it would need to incorporate.

The scientists also identified the best open-access data so that the tool's database could be constantly updated. Analysis of future options, testing of predictive models to provide data where gaps in breastfeeding information have already been reported, and validation of the MMT using prior research and people likely to use it in the future were all part of the development process.

The MMT tells the user how much milk is produced by women for children up to three completed years and how much is lost compared to the amount that could be produced without imperiling the woman's well-being. This calculation is available for individuals, as well as on a national and global level.

Further development is required, such as enabling real-time updating of data on breastfeeding indicators, births, and currency exchange rates.

What does the MMT show?

The MMT shows that breastfeeding is responsible for approximately 35.6 billion liters of milk a day. This figure represents about half the potential production under optimal circumstances. Conversely, social barriers or difficulties due to the cultural surround and infrastructure deficiencies have resulted in the loss of 38% of this milk, which would come to US$ 2.2 trillion annually (around US$ 100 a liter ).

Countries represented for this study include Australia, Brazil, Canada, India, Indonesia, Ireland, Kenya, Nigeria, Nepal, Norway, the Philippines, the UK, the USA, and Vietnam. Interestingly, high-income countries produced between four million liters (Ireland) to 605 million liters (the USA). In Ireland, 80% of potential production was lost, while in Australia, with 51 million liters, two-thirds were lost.

Conversely, over 220 million liters in Nepal, representing 95% of potential production, were maintained, with a third or less being lost in Kenya, Nigeria, Indonesia, and Vietnam. With the largest population among the selected countries, India produced about 8.7 billion liters but lost 40% of its potential production.

In financial terms, Nepal lost S$ 900 million but India over US$ 146 billion.

Overall, the researchers highlight the "crucial but largely invisible" nature of human milk nationally as a nourishing, sustainable, and safe food resource for infants and young children. Its importance lies in the food security and improved health it provides to this large segment of society at national and global levels. Measuring women's milk production in terms of its value to the economy will help greatly in assigning it a place in financial thinking and in the thoughts of individuals, societies, and governments.

This would result in better support for breastfeeding mothers in terms of changes in cultural access and infrastructure, such as feeding rooms. This protects women's health and drastically relieves food pressures on the environment. Thus, routine acceptance of breastfeeding is, in reality, "an important national capital asset with large economic value."

What are the implications?

"Breastfeeding provides food security for a country's children while minimizing food system pressures on the environment."

The MMT clearly delineates the economic loss due to the deprecation of this important source of infant nutrition. To prevent this, governments and investors must promote breastfeeding and provide adequate support via national programs and projects.

The tool could help mothers and those involved in public health policymaking, government officials, food scientists, policymakers, and those concerned with national accounts and statistics. It could help put breastfeeding on the paper when it comes to food balance sheets and economic production. Further, it could track the loss of potential production and help calculate environmental savings and the adverse impact of increased greenhouse gas emissions (GHGE) and water use on the environment.

"The tool supports the 2015 Call to Action by the Global Breastfeeding Collective by facilitating the tracking of progress on breastfeeding targets." It may be used along with existing tools for cost estimates of various programs and policies.