Nutrition International, and Alive & Thrive.



The Cost of Not Breastfeeding Tool aims to provide policymakers and advocates with a user-friendly tool to generate estimates of the potential health, human capital and economic benefits of scaling up breastfeeding promotion and support strategies. Evidence generated from the tool will be integral to raising awareness with government, industry and donors for scaling breastfeeding in accordance with the Global Breastfeeding Collective’s seven recommended policy actions.

The Cost of Not Breastfeeding Tool was first developed between 2017 and 2019 by Dr. Dylan Walters and Alive & Thrive, with funding from the Bill & Melinda Gates Foundation. This tool was instrumental in advocacy at the global level, being used for the Global Breastfeeding Collective’s Investment Case, and at the country level directly supporting efforts to advocate for policy changes and increase investments in maternal and child nutrition in numerous countries. In 2022, Nutrition International updated and developed the second version of the tool in partnership with Alive & Thrive and Limestone Analytics, with funding from the Government of Canada. This new version of the tool contains updated datasets, new indicators, a new function to calculate results for different breastfeeding rate scenarios or targets, and online access to the results for more than 100 countries.

Why Breastfeeding?

Breastfeeding saves lives. It helps protect against childhood infections, provides optimal nutrition, supports ideal growth, improves cognitive development, and is associated with reducing the prevalence of overweight and diabetes later in life.

It also has protective effects on preventing breast and ovarian cancer, and type I diabetes in mothers. The World Health Organization (WHO) recommends breastfeeding practices that consist of early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for six months, and continued breastfeeding with complementary feeding for at least two years.

Despite substantial evidence on the health and cognitive benefits of breastfeeding, more than 50% of children are not breastfed according to the WHO recommendations. The global rate of exclusive breastfeeding increased from 36% in 2000 to 44% in 2020, and the current rates of early initiation of breastfeeding and continued breastfeeding until two years of age are 48% and 65%, respectively. However, the current pace of increase in the rate of exclusive breastfeeding is insufficient for achieving the World Health Assembly’s global nutrition target of increasing the rate of exclusive breastfeeding in the first six months up to at least 50% by 2025.

For more information or support in using the tool, please contact