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Breastfeeding isn’t free. What if that work was included in the GDP?

‘What we measure reflects what we value and shapes what we do’

Analysis by
July 6, 2020 at 4:43 p.m. EDT

Of the nearly four million babies born in the United States every year, 4 out of 5 are breastfed at some point.

Almost half consume nothing but breast milk for three months. One-quarter consume nothing but breast milk for six months. Breast milk is a vital part of the nation’s infant food supply — and it isn’t free.

Six months of exclusive breastfeeding, as recommended by the American Academy of Pediatrics, will cost a mother an average of 17 to 20 hours a week, plenty of discomfort, and a lot of sleep.

Yet unlike formula, breast milk production is not included in gross domestic product, our primary measure of “the economy.” According to economists Nancy Folbre and Julie P. Smith, it’s not a trivial omission. The exclusion of breastfeeding from GDP is part of a broader problem with international systems for measuring economic activity. These largely ignore the contributions of unpaid work historically undertaken by women.

This erasure has real consequences, they say.

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“What we measure reflects what we value and shapes what we do,” write Smith and Folbre in a newly published compilation of academic work on how gender can transform the social sciences. “International systems for measuring the economy have institutionalized the devaluing of women’s unpaid productive and reproductive work, distorting the allocation of resources, and entrenching gender inequality.”

GDP was adopted as the primary measure of the economy after World War II in an effort to regulate the international monetary order. Nearly 80 years later, GDP remains the dominant indicator used to assess a nation’s economic strength and the efficacy of its public policies.

For decades, feminist scholars have noted that the framework underpinning the GDP formula leaves a lot out. For example, the creation of physical capital such as factories, buildings and machines count toward growth, but the creation of a human — an essential factor of the economy — doesn’t. Additionally, with few exceptions, GDP measures the market economy, leaving out “economic activity such as unpaid housework and care,” write Smith and Folbre.

In 1988, feminist scholar and former New Zealand Member of Parliament Marilyn Waring launched a movement when she called this formula “applied patriarchy” in her groundbreaking book “If Women Counted.”

“She took it apart blow by blow,” Smith said over Zoom from her office in Australia. It’s “just a stunning critique of what it doesn’t measure and how that biases what we value.”

As it is currently calculated, GDP skews our understanding of economic growth by failing to account for shifts between market and nonmarket activity. Because the child care provided by a stay-at-home parent (usually a mother) counts for nothing in our national accounts, the increase in GDP that results if that care is outsourced and she returns to the formal labor force will be exaggerated.

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This kind of mismeasurement inevitably distorts policymaking. “If the government’s just looking at the market sector, they’re being misled about trends in the economy,” Smith explains. “And they’re going to make decisions about what’s important and what’s worth investing in that are wrong.”

Because women shoulder the majority of unpaid work, they disproportionately bear the burden of these distortions. Ignoring nonmarket activities inevitably centers policymaking around traditionally male norms, values and priorities, tipping the allocation of resources in their favor, and entrenching gender inequality.

Breastfeeding offers an elegant example of how this lopsided measurement of the economic activity plays out.

According to Smith’s estimates, the breast milk produced in Australia each year is worth about $4 billion, significantly more than the baby food industry there. But it’s hard to prioritize a pocket of the economy that doesn’t officially exist. “Where does the government put its subsidies?” Smith asks. “It gives far, far bigger subsidies to the dairy sector, than the hundred thousand dollars a year it gives to the breastfeeding association.”

A more complete picture of the economic landscape would encourage support for a broader mix of industries.

Likewise, if the economic contributions of breastfeeding were visible, policymakers would have better grounds to prioritize legislation that encourages it, such as parental leave, which is known to improve breastfeeding success. For many people who breastfeed in the U.S., following the AAP’s breastfeeding recommendations while keeping their jobs is structurally impossible — or nearly so. As a result, women who want or need to continue working often have to stop breastfeeding.

The same, Smith argues, could be said of the care economy more broadly — the world would be different if its value “counted.”

“We’d be putting money into a lot more aged care, a lot more health care, a lot more family care. We’d be putting more into paid maternity leave. We’d have more flexible child care, we’d have breastfeeding friendly work. ... We’d have different priorities,” Smith explains.

As things stand now, care is undervalued, underprioritized and undersupported.

In the early 1990s, after realizing that developing countries rely heavily on unpaid household work, the formula used to calculate GDP was modified to allow subsistence household production into GDP, including backyard vegetable gardens. Technically, anything that can be stored and traded can be imputed into GDP, as long as there is a suitable market value for it.

Given the market for formula, as well as the growing milk banking systems in countries around the world, breast milk fits this description.

Including other unpaid care work would require a more radical revision, one that opponents believe would be too disruptive to the system.

Still, there is a growing acceptance of the need for change. “There’s a very deep dissatisfaction and a pretty wide understanding that GDP is a really appalling measure of economic value,” Smith says, “And especially since the global financial crisis, there’s a much greater questioning, even among economists, as to whether it’s a relevant indicator.”

For her part, Smith remains cautiously optimistic that a better understanding of child care’s role in the economy is emerging during the coronavirus.

“I’m hopeful that we could get some progress,” she says.