Drs. Bartick and Stuebe, please withdraw the fallacious Breastfeeding Savings Calculator


You have to give Drs. Melissa Bartick and Alison Stuebe credit for brazenness. Not only do they still insist that increasing breastfeeding rates saves money, despite a complete lack of evidence, they have created a “calculator” to estimate the fallacious savings.

Using current literature on the associations between breastfeeding and maternal and pediatric health, we modeled the costs of health outcomes for a US cohort of mothers and their infants born in 2002 and followed to age 70 years… The 9 pediatric conditions considered in this model were: acute lymphoblastic leukemia (ALL), acute otitis media (AOM), Crohn’s disease, ulcerative colitis, gastrointestinal infection (GII), hospitalization for lower respiratory tract infection (LRTI), obesity in non-Hispanic whites to age 4, necrotizing enterocolitis (NEC), and Sudden Infant Death Syndrome (SIDS). The 5 maternal conditions modeled were breast cancer, pre-menopausal ovarian cancer, type 2 diabetes mellitus, hypertension, and myocardial infarction…

Only lactivists would dare to “calculate” future savings from increasing the breastfeeding rate when they can’t manage to demonstrate past savings although the breastfeeding rate has tripled in the last 40 years. Barticle and Stuebe did not use “current literature,” they used only papers published by themselves. Moreover, they neglected to include the costs of breastfeeding such as hospitalizations for dehydration, jaundice, long term therapy for brain injury and deaths as a result of insufficient breast milk.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Rates of lymphoma, inflammatory bowel disease and breast cancer have been rising NOT falling as breastfeeding rates have climbed.[/pullquote]

To put the problem in context, we know that vaccines save money because we have seen dramatic decreases in the rate of vaccine preventable diseases and their associated costs. We know that ending cigarette smoking saves money because we have seen dramatic decreases in lung cancer rates and their associated costs. In contrast, we have seen almost NO decreases in the rates of diseases supposedly prevented by breastfeeding despite the fact that breastfeeding rates have increased from 24% in the early 1970’s to over 76% in the past few years.

What has happened to the rate of diseases supposedly prevented by breastfeeding?

Pediatric acute lymphoblastic leukemia

According to the National Cancer Insitute: “Cancer in children and adolescents is rare, although the overall incidence of childhood cancer, including ALL, has been slowly increasing since 1975. (my emphasis).

Crohn’s disease and ulcerative colitis

According to the paper Epidemiology of Pediatric Inflammatory Bowel Disease: A Systematic Review of International Trends:

Globally rising rates of pediatric IBD (due primarily to the rising incidence of CD) was demonstrated in both developed and developing nations … (my emphasis)

Breast cancer

This graph comes from the United States Preventive Services Task Force:


New cases of both invasive and non-invasive breast cancer have risen since 1975.

I have confronted Dr. Bartick in print about the fact that she is unable to demonstrate past savings from rising breastfeeding rates; and she couldn’t rebut it. Over 2 years ago I wrote this comment on an Academy of Breastfeeding Medicine post:

Breastfeeding rates have tripled in the past 50 years. Where is the evidence that term babies lives has been saved? Where is the evidence that the diseases you insist are decreased by breastfeeding are actually decreasing as a result of breastfeeding? Where are the billions of healthcare dollars you claimed would be saved as the breastfeeding rates rose? Where is the return on investment of the millions of dollars spent to promote breastfeeding?

Here’s how Dr. Bartick responded:

I have given you the evidence on NEC and SIDS. You can dig up the evidence on the other diseases. To my knowledge, no one has actually dug it up yet. It’s not fair to say “it doesn’t exist.” It would be wonderful if you gather your team of statisticians and experts, and did the research yourself and published your own paper on it, Dr. Tuteur, instead of saying the evidence doesn’t exist…

My reply:

Sorry, Dr. Bartick, that’s a cop out. You’ve given no evidence that the decreases in SIDS and NEC are caused by breastfeeding. You’ve given no population evidence of any kind for any of your other contentions.

Don’t tell me that I can dig it up on my own. If it were available, you would have already posted it…

So Drs. Bartick and Stuebe have created a fanciful calculator that “models” future savings from increasing breastfeeding rates despite the fact that they are utterly unable to demonstrate the central assumptions of their model. They insist that breastfeeding saves lives in theory even though there is no evidence that it saves lives of term babies or mothers in practice.

I don’t doubt that Drs. Bartick and Stuebe believe deeply that breastfeeding saves money, but wishing doesn’t make it so. The existing population data shows that increasing breastfeeding rates does not save money or lives of term babies or mothers. That’s not surprising since breastmilk is just one of two excellent ways to nourish a baby. In first world countries, it’s benefits are trivial.

Dr. Bartick and Stuebe ought to immediately withdraw their fallacious breastfeeding “calculator.” It is based on easily disproven assumptions, provides erroneous data, and reflects ideology instead of science.