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      The cost of not breastfeeding: global results from a new tool

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          Abstract

          Evidence shows that breastfeeding has many health, human capital and future economic benefits for young children, their mothers and countries. The new Cost of Not Breastfeeding tool, based on open access data, was developed to help policy-makers and advocates have information on the estimated human and economic costs of not breastfeeding at the country, regional and global levels. The results of the analysis using the tool show that 595 379 childhood deaths (6 to 59 months) from diarrhoea and pneumonia each year can be attributed to not breastfeeding according to global recommendations from WHO and UNICEF. It also estimates that 974 956 cases of childhood obesity can be attributed to not breastfeeding according to recommendations each year. For women, breastfeeding is estimated to have the potential to prevent 98 243 deaths from breast and ovarian cancers as well as type II diabetes each year. This level of avoidable morbidity and mortality translates into global health system treatment costs of US$1.1 billion annually. The economic losses of premature child and women’s mortality are estimated to equal US$53.7 billion in future lost earnings each year. The largest component of economic losses, however, is the cognitive losses, which are estimated to equal US$285.4 billion annually. Aggregating these costs, the total global economic losses are estimated to be US$341.3 billion, or 0.70% of global gross national income. While the aim of the tool is to capture the majority of the costs, the estimates are likely to be conservative since economic costs of increased household caregiving time (mainly borne by women), and treatment costs related to other diseases attributable to not breastfeeding according to recommendations are not included in the analysis. This study illustrates the substantial costs of not breastfeeding, and potential economic benefits that could be generated by government and development partners’ investments in scaling up effective breastfeeding promotion and support strategies.

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          The Role of Cognitive Skills in Economic Development

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            The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis.

            A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality. Using methods similar to those in the 2001 study, we computed current costs and compared them to the projected costs if 80% and 90% of US families could comply with the recommendation to exclusively breastfeed for 6 months. Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity. We used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars. If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective.
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              Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?

              Public Health Nutrition, 19(14), 2540-2550
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                Author and article information

                Journal
                Health Policy Plan
                Health Policy Plan
                heapol
                Health Policy and Planning
                Oxford University Press
                0268-1080
                1460-2237
                July 2019
                24 June 2019
                24 June 2019
                : 34
                : 6
                : 407-417
                Affiliations
                [1 ]Nutrition International, 180 Elgin St, Ottawa, ON, Canada
                [2 ]Alive & Thrive, 60 Ly Thai To Street, Hoan Kiem, Ha Noi, Viet Nam
                Author notes
                Corresponding author. Nutrition International, 180 Elgin St, Ottawa, ON, K2P 2K3, Canada. E-mail: dwalters@ 123456nutritionintl.org
                Article
                czz050
                10.1093/heapol/czz050
                6735804
                31236559
                efabe44d-2efe-42ea-afe9-b5b33e250714
                © The Author(s) 2019. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 May 2019
                Page count
                Pages: 11
                Funding
                Funded by: Bill & Melinda Gates Foundation 10.13039/100000865
                Categories
                Original Articles

                Social policy & Welfare
                breastfeeding,nutrition,maternal and child health,economic evaluation
                Social policy & Welfare
                breastfeeding, nutrition, maternal and child health, economic evaluation

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