Cost of infant formula

How much does infant formula cost?

We estimate that a baby needs about 300 litres (80 U.S. liquid gallons) of infant formula in the first year of life. This number can be used to calculate the local cost of infant formula. Families will have other associated costs, including the cost of bottles, thermometers, equipment washing, and sterilizing. The cost of infant formula leads some families to over-dilute infant formula, a dangerous practice that can lead to underfed babies and low levels of salt (sodium) in the baby’s blood. Store-brand infant formula is cheaper than name-brand formula and the ingredients are very similar. Powdered infant formula is cheaper than ready-to-use. Breastfeeding families must pay for the additional food needed to make milk (about 600 calories each day) and any breastfeeding equipment they choose to buy.

B) Costs of infant formula feeding

Formula pricing varies among countries and by:

Regular, store-brand, powdered formula is the cheapest and specialty, name-brand, ready-to-use is the most expensive. 

The following table shows prices per unit of name-brand formula from a large online shopping site (not including shipping costs) in 2018 and the cost of 300 litres (80 U.S. gallons).

Table: Infant Formula Cost in Canada Per Year (2018)

You can do the same calculations using your local cost of formula per litre or gallon.

Additional costs associated with formula use in Canada include roughly:

  • CAD $150 to buy bottles, paper towels, thermometers, and other sterilizing and washing equipment.
  • CAD $300 to heat formula and sterilize equipment (electricity, water, washing materials, use of appliances).

Our total estimated cost of using formula for one year in Canada ranges from CAD $1,725 to CAD $4,668.

In 2011, the Surgeon General of the US estimated the cost of formula to be between USD $1,200 to $1,500 for the first year (DHHS 2011). Costs have increased significantly since then.

C) Consequences of the high cost of infant formula

Having a new baby can be expensive and families may wish to consider ways to decrease their spending. Formula in particular can be very expensive.

1) Reduced funds for other need

Money that is spent on formula might have been used for other essentials such as housing, healthy food, and transportation. This can all add to the families’ stress (APPG 2018).

2) Over-diluting infant formula

Families with limited financial resources may resort to adding less powder than recommended (over-diluting) formula. One American study (Burkhardt 2012) reported that 27% of families studied who could not always meet their basic nutritional needs (food-insecure families) did this. It is a dangerous practice and can result in babies being underfed. With larger amounts of water, babies can develop low levels of salt (sodium) which can result in drowsiness, seizures, brain damage, and death (Keating 1991; Hansen 2017). 

The study also showed that half of families mistakenly believed that store-brand and name-brand formula were not equivalent thus keeping them from choosing more reasonably priced formula.

3) Starting solids early

The high cost of infant formula may drive families to start solid foods early, which increases the risk of illnesses such as diarrhea, fevers, wheezing, and obesity. 

4) Additional costs caused by illness within the family

Formula use increases the risk of expensive short- and long-term illness in both mother and child. One study (Ball 1999) in 1999 estimated the cost per family for medical care for illness due to not breastfeeding would be between U.S.D. $331 and $475. Health-care costs have increased significantly since then.

D) Keeping costs down

Formula costs may be reduced by:

  • Using powdered formula.
  • Using regular cow’s milk-based formula and not other costlier types formula.
  • Using store-brand formula instead of name-brand formula.
  • Using insurance policies or other programs that can defer the cost of specialty formula that is medically needed.
  • Using bottles and other tools that are re-usable.
  • Comparison shopping.
  • Buying in bulk.
  • Not buying formula with a “use by” date that is approaching and may need to be thrown out.

The following marketing tools violate the World Health Organization Code of Marketing of Breast-milk Substitutes and frequently undermine breastfeeding. They are legal options in some countries.

Samples, coupons, and other promotional items obtained from:

E) The cost of breastfeeding

Breastfeeding is not free but costs much less than formula.

1) The cost of extra food

Mothers’ bodies need to provide the calories to make breast milk and unless they choose to lose weight, will need to eat extra food. For example, as breast milk has about 77 calories in 100 millilitres (22 calories in a U.S. fluid ounce), a mother who is making 800 ml (27 oz) which is the typical amount of milk needed by a baby between one and six months, will need to eat an extra 600 calories each day to avoid losing weight.

For an idea of how much food this is, the following items add up to about 600 calories:

  • A peanut butter sandwich (350 calories)
  • Three-quarters of a cup of cooked pulses (lentils, chick peas, dried peas, or beans such as black, kidney, navy, and pinto) (175 calories)
  • An apple (100 calories)

2) Breastfeeding equipment and support

Mothers may need to buy a breast pump and various accessories and bottles and nipples for periods of mother-baby separation. Mothers who have breastfeeding challenges may need to pay for the help of a health-care provider or breastfeeding specialist.

Optional items to support breastfeeding include:

  • Breast pads: Reusable cotton ones are very inexpensive compared to single-use disposable paper ones.
  • Breastfeeding bras: Mothers can use a soft bra or bralette or tube top instead.
  • Breastfeeding shirts and tops: These are often very expensive and most mothers in our clinic do not use these.

Mothers can consider second-hand bras and breastfeeding clothing.

References

All-Party Parliamentary Group on Infant Feeding and Inequalities (APPG). Inquiry into the cost of infant formula in the United Kingdom. 2018
 
Ball TM, Wright AL. Health care costs of formula-feeding in the first year of life. Pediatrics. 1999 Apr;103(4 Pt 2):870-6
 
Burkhardt MC, Beck AF, Kahn RS, et al. Are our babies hungry? Food insecurity among infants in urban clinics. Clin Pediatr (Phila). 2012 Mar;51(3):238-43
 
Hansen R. Hyponatraemic seizure in a 6-month-old infant due to water intoxication. J Paediatr Child Health. 2017 Jul;53(7):717-719
 
Keating JP, Schears GJ, Dodge PR. Oral water intoxication in infants. An American epidemic. Am J Dis Child. 1991 Sep;145(9):985-90
 
U.S. Department of Health and Human Services (DHHS). The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.