Thu Nov 16

We won’t get real equality until we price breastmilk, and treat breastfeeding as work

Written by: Julie P. Smith, Honorary Associate Professor, Australian National University

The Australian Women’s Economic Equality Taskforce delivered a major report last month drawing attention to what it called the “motherhood penalty ^[1]” – the 55% cut in earnings for Australian women in the first five years after having a child.

The report makes many good recommendations, including extending paid parental leave to 52 weeks and providing universal high-quality affordable early childhood education.

Yet it mentions “birth” only twice, and “breastfeeding” not at all.

Shying away from the reality that women breastfeed is in some ways unsurprising. Breastfeeding is divisive because it cuts across what some see as the most important goal for women’s empowerment – gender equity in unpaid work and the care of children, including infants.

Most care work can be reallocated

Women everywhere do disproportionate ^[2] amounts of unpaid or informal work, meaning they generally work longer hours and have less time for rest and leisure than men.

In Australia, women spend 3.4 ^[3] hours per day on “domestic duties”, whereas men put in 2.6. The gender gap widens for those with young children, where work intensity increases with multitasking.

The approach the Taskforce report adopts is a standard one ^[4] to “recognise, reduce, and redistribute” the care work done by women.

But in a paper just published in Frontiers in Public Health ^[5] we argue that breastfeeding is different from other care work: it can’t be redistributed, and shouldn’t be reduced.

Breastfeeding is an exception

We contend that breastfeeding ought to be recognised as a special category of “sexed” care work that should be supported rather than reduced or reallocated to others. We argue that to undermine women’s breastfeeding is profoundly sexist.

Thus, programs such as those put forward by Australia’s Women’s Economic Equality Taskforce should be assessed on their impact on women’s and children’s ability to breastfeed as well as on their impact on pay and employment.

It means breastfeeding ought to be counted as non-market production ^[6] in the national accounts so that when assessments are made of productivity, or of what increases or decreases in gross domestic product, breastfeeding is seen as productive.

At present, a drop in breastfeeding rates that leads to increased commercial formula sales is counted as an increase in measured GDP – making it look as if it has made society better off. The cost to women’s health, children’s health and development and the environment ^[7] is ignored.

Breastmilk is a traded and valuable product, sold for an official price of US$100 ^[9] (A$154) per litre in Norway’s human milk banking system.

The Mothers’ Milk Tool ^[10] developed at the Australian National University is a step toward counting breastfeeding in the national food supply, as Norway does ^[11], and making it easy to calculate the value of the milk mothers and countries produce in gross domestic product (GDP).

An improved Australian time-use survey ^[12] would also make it easier to count the productive value of this unpaid care work officially for the first time.

Critical for good health

The World Health Organization recommends breastfeeding children in all country settings for two years ^[13] or more, and exclusively for the first six months.

Global estimates suggest that infants not being breastfed as recommended is responsible for at least 595,400 ^[14] deaths of children each year (mainly from infectious diseases and malnutrition).

Even in high income countries like Australia, lack of breastfeeding is responsible for a large proportion of infant hospitalisations ^[15].

It has also been calculated that a worldwide 99 000 deaths of women ^[16] (mainly from breast cancer, ovarian cancer and type II diabetes) occur each year as a result of shortened breastfeeding duration.

Nearly all Australian women start out breastfeeding, but cite barriers to continuing beyond a few months, and “return to work ^[17]” is a prominent reason.

Breastfeeding at work is possible, but difficult.

Even where paid leave is available, women returning to work find it difficult to keep breastfeeding. Substituting formula for breastmilk is common, as bringing baby to mother or bottling expressed breastmilk for feeding at another location requires extra planning, dedication and time.

Where workplaces don’t support breastfeeding, women who attempt it run the risk of being marked down and suffering in pay and promotion.

The design of paternity leave matters. Shutterstock ^[18]

Extending parental leave to fathers can help, but not where it is taken separately to leave for mothers or in place of leave for mothers.

Women are consistently persistent in wanting to care for their babies. When Norway increased the number of paid weeks available exclusively to fathers at the expense of paid weeks available to either mothers or fathers in 2018, mothers took less paid leave ^[19] and more unpaid leave, potentially worsening their financial situations and pay equity.

So-called “use-it-or-lose-it ^[20]” paid leave available exclusively to fathers is often promoted as a way of getting new mothers back to their jobs while encouraging men to take up care work, but in practice it appears not to result in any meaningful change ^[21] in the balance of unpaid work.

In contrast, leave that gives fathers time to undertake domestic and care work alongside mothers, including as single days, benefits women ^[22], reducing the need for hospitalisations and anti-anxiety medications. Initiatives that encourage fathers to support breastfeeding can help too.

Brushing it under the carpet won’t help women

It’s unsurprising the Women’s Economic Equality Taskforce has entitled its report a 10-year plan to unleash the full capacity and contribution of women to the Australian economy ^[23].

It was asked to examine issues including the gender pay gap ^[24] and women’s workforce participation.

But unless the women it wants to participate in the paid workforce can breastfeed while doing it, its recommendations might not advance their interests.

The contribution that women make through breastfeeding is important. Brushing it under the carpet as part of a drive for equality in paid work harms them, their children and society more generally.

Roger Mathisen, director of Alive and Thrive East Asia Pacific, contributed to this article.