Background: Sales of commercial milk formula products (CMF) are rising rapidly. This study aims to analyse the key economic and environmental impacts CMF feeding in Indonesia.
Methods: We assessed the economic and environmental impacts of CMF in Indonesia in 2020 using the Mothers’ Milk Tool (MMT), the Green Feeding Tool (GFT) and the Cost of Not Breastfeeding Tool (CONBF). We compared estimated values from these tools and assessed them against calculations using Euromonitor data on CMF retail sales in Indonesia.
Results: In 2020, according to the MMT, women in Indonesia produced around 455 million litres of breastmilk for infants aged <6 months, which had an estimated monetary value of US$45.5 billion. The MMT and GFT shows substantial economic losses from displacement of breastfeeding in Indonesia; 62-96 million litres of breastmilk were lost in 2020 compared to the biologically feasible potential. The GFT tool calculates a carbon footprint of 214-272 million kg of CO2 eq. and a water footprint of 92,460 million litres. The CONBF estimates that the annual cost to families of purchasing CMF for infants aged <24 months was US$598.6 million. By comparison, Euromonitor retail sales data suggests that in 2020, the retail value of sales of CMF products targeting this age group was around US$2.25 billion. Euromonitor also reports 27,200 tonnes of CMF products targeting infants <6 months were sold in Indonesia in 2020. We calculate a carbon footprint from these sales of 299-381 million kg CO2 eq. and a water footprint of 129,064 million litres, considerably higher than the GFT estimate.
Conclusions: Breastfeeding's economic importance to Indonesia far surpasses the retail value of CMF sales. Displacing breastfeeding has high but largely undocumented economic and environmental costs. Economic losses are higher when measured as a food resource than when measured as health costs, lost lives, or cognition losses. Environmental impacts that are estimated using sales data are considerably higher than from using survey data. Our results expose a critical gap in national statistics, and a renewed imperative to recognise the milk women provide through breastfeeding as an economically valuable, healthy and sustainable national resource in Indonesia.