Lack of breastfeeding negatively impacts the health of children and their mothers

A lack of breastfeeding is associated with an increased risk of the following disorders and illnesses in childhood and through adult life (Ip et al., 2007; Horta et al., 2007; León-Cava et al., 2002):

• lower and upper respiratory tract infections (including acute otitis media);
• diarrhoea;
• atopic dermatitis and asthma in young children;
• overweight and obesity in older children and adults;
• high blood pressure and total cholesterol;
• type 1 and type 2 diabetes mellitus;
• childhood leukaemia and other childhood cancers;
• SIDS;
• necrotizing enterocolitis in preterm newborns.

Based on these well known associations, formula fed infants may have a slightly increased risk of mortality in high income countries (Chen & Rogan, 2004). This effect is, however, much more significant in low income countries, where it is estimated that increasing the rate of exclusive breastfeeding at six months to 90% could prevent 1.3 million childhood deaths per year (Jones et al., 2003).

In general, the harm associated with lack of breastfeeding is proportional to the exclusivity and duration of formula feeding: the longer the lack of breastfeeding and the shorter its exclusivity, the greater the harm.

Lack of breastfeeding is also associated with increased risks for the mother, in relation to the following conditions and illnesses:

• type 2 diabetes;
• pre-menopausal breast and ovarian cancer;
• shorter periods of amenorrhea and intervals between births;
• possibly postpartum depression.

There are direct and indirect costs associated with a lack of breastfeeding

Breast milk is virtually free; powder infant formula, which is much cheaper than liquid and special formulae, costs between 10 and 25 € per kg. Together with the cost of preparing, storing and administering artificial milk and sterilizing the equipment, this is an extra cost that families must meet if they decide to formula feed their babies. This cost is proportionally higher for low income families. In addition, the health and social system has to meet the extra cost of care caused by the increased risk of illness. This extra cost has been estimated at around 100-300 € per infant in the first year of life (Ball & Wright, 1999; Cattaneo et al., 2006). The total cost, including the extra health care needed later in childhood and through adult life, may amount to several billion dollars a year in a country like the USA (Weimer, 2001).

In addition to direct health care costs there are indirect costs, such as the time parents will spend at home and in the hospital, the cost of transport and the periods of absenteeism from work. Finally, formula feeding has a heavy impact on the environment, due to agricultural activities around cow milk production, the industrial process of manufacturing and distributing the product, the energy needed to maintain the cycle of production, transport and consumption, and the management of an enormous amount of waste.

Also see EUphacts Diabetes, Overweight, Blood pressure and Breast cancer.