{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:52:32Z","timestamp":1777852352560,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to examine the economic, environmental, and health impacts of changes in 10 different breastfeeding rates across various scenarios and to estimate the associated costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A quantitative research design was employed, based on cost projection analysis. The Cost of Not Breastfeeding Tool and the Green Feeding Tool were used to evaluate the health, environmental, and economic outcomes of breastfeeding. In addition, linear regression analysis was performed to assess the reliability of the estimated health effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Scenario analysis demonstrated that a 10% increase in breastfeeding rates leads to substantial environmental, health, and economic benefits. Accordingly, a 10% increase prevents an average loss of 7\u2009million litres of breast milk, reduces carbon dioxide emissions by ~9.2\u2009million kg, and saves 3.976\u2009million L of water. With regard to health outcomes, a 10% increase in breastfeeding rates was associated with a statistically significant reduction in both number of cases and deaths (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.05). From an economic perspective, it is estimated that a 10% increase in exclusive breastfeeding rates alone could generate an average cost saving of US$32\u2009million.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results indicate that direct breastfeeding plays a crucial role in reducing water and carbon footprints, preventing disease burden and associated mortality due to not breastfeeding, and lowering the costs related to these outcomes. Promoting and supporting midwives\u2019 active role in increasing breastfeeding rates is essential for both health and environmental sustainability, and national policies should be reinforced to support this objective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344261431656","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:54:49Z","timestamp":1776693289000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic, Environmental, and Health Impacts of Changes in Breastfeeding Rates in T\u00fcrkiye: A Cost Projection Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7095-2758","authenticated-orcid":false,"given":"Zeynep Dil\u015fah","family":"Kara\u00e7am Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Midwifery Department, Health Sciences Faculty, Marmara University, Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3063-3579","authenticated-orcid":false,"given":"Ceyda","family":"\u015eapo\u011flu","sequence":"additional","affiliation":[{"name":"Midwifery Department, Health Sciences Faculty, Marmara University, Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Agostoni C. 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Rollins N. C. R\u00f6\u00f6s E. (2019). The carbon footprint of breastmilk substitutes in comparison with breastfeeding. Journal of Cleaner Production 222 436\u2013445. https:\/\/doi.org\/10.1016\/j.jclepro.2019.03.043","DOI":"10.1016\/j.jclepro.2019.03.043"},{"key":"e_1_3_3_11_1","doi-asserted-by":"crossref","unstructured":"Ley S. H. Chavarro J. E. Li M. Bao W. Hinkle S. N. Wander P. L. Rich-Edwards J. Olsen S. Vaag A. Damm P. Grunnet L. G. Mills J. L. Hu F. B. Zhang C. (2020). Lactation duration and long-term risk for incident type 2 diabetes in women with a history of gestational diabetes mellitus. Diabetes Care 43(4) 793\u2013798. https:\/\/doi.org\/10.2337\/dc19-2237","DOI":"10.2337\/dc19-2237"},{"key":"e_1_3_3_12_1","doi-asserted-by":"crossref","unstructured":"Li D. P. Du C. Zhang Z. M. Li G. X. Yu Z. F. Wang X. Li P. F. Cheng C. Liu Y. P. Zhao Y. S. (2014). Breastfeeding and ovarian cancer risk: A systematic review and meta-analysis of 40 epidemiological studies. 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