Impact of the 2022 Infant Formula Shortage on Breastfeeding and Infant Healthcare Costs Luis Seoane Estruel and Tatiana Andreyeva

Suboptimal breastfeeding rates in the U.S. contribute to significant health and economic costs, with structural, social, and policy factors driving disparities. The 2022 infant formula crisis, characterized by widespread shortages and safety concerns, may have influenced infant feeding behaviors. This study examines changes in breastfeeding continuity during the crisis and estimates reductions in pediatric illnesses and healthcare costs. Using 2017–2022 Pregnancy Risk Assessment Monitoring System (PRAMS) data, we applied Bayesian structural time-series analysis to assess changes in breastfeeding initiation, duration, and heterogeneous effects across subpopulations. We estimated reductions in infant disease incidence and healthcare costs resulting from increased breastfeeding. During the 2022 crisis, breastfeeding duration of at least four months increased by 3.20 percentage points (pp) (95% credible interval [CrI]: 0.97 to 5.37 pp). Statistically significant increases at one, two, and three months postpartum ranged from 2.51 to 3.59 pp. Breastfeeding initiation rose by 1.77 pp (95% CrI: 0.61 to 2.86 pp). Increases varied by maternal education, race/ethnicity, Medicaid status, WIC participation, and income, suggesting a potential narrowing of disparities. These breastfeeding gains translated to an estimated $415 million in healthcare cost savings (95% CI: $409–$420 million). The findings highlight the need for policies that sustain breastfeeding gains beyond emergency periods.