Nestle’s PR disaster did not set it back for long. It remains “the biggest player in the infant nutrition market,” according to The Motley Fool. It is one of the world’s most valuable brands, according to Forbes, with annual sales over $100 billion. And its formula division still makes 85 percent of its profits in the developing world. Its foremost competitor, Mead Johnson, an American company that sells Enfamil, has also been praised for its “stellar track record” and its “financial success and consistency.” Its annual profits are in the $150 to $190 million range, with “about 70 percent of its business in international markets.”

Breastfeeding, by contrast, has long been seen as the cheaper choice. (Though, as K.J. Dell’Antonia points out in a piece about the real costs of nursing, “It’s tough to make all that ‘free’ milk for your baby if you can’t afford to feed, clothe and shelter yourself.” And as Hanna Rosin wrote in The Atlantic, “It’s only free if a woman’s time is worth nothing.”) Still, there are products involved, products that become necessary, even mandatory, when breastfeeding mothers are forced back into the workplace ASAP by America’s shameful and highly unusual lack of paid parental leave.

Americans who want to nurse and yet remain employed often must rely on breast pumps. As a result, Pacific Standard recently reported, “among U.S. moms of healthy, full-term infants, 85 percent have used a breast pump at some point, 25 percent pump their milk regularly, and six percent pump exclusively.” Jill Lepore calls pumps “such a ubiquitous personal accessory that they’re more like cell phones.”

Good pumps don’t come cheap. Parents are advised not to buy them secondhand, because of concerns about contamination; luckily for them, though, the Affordable Care Act mandates that insurance companies now must cover even the models that cost several hundred dollars without charging a co-pay. These measures, in conjunction with the laws that have been passed in an attempt to accommodate women pumping at work, are still, Lepore notes, “such a paltry substitute for maternity leave.”

Are the interests of pump manufacturers what motivated that ACA affordance?There doesn’t seem to be much evidence, even in Jung’s account. In her book she writes:

In 2015 journalist Steven Brill published a remarkable 455-page book describing the political and economic interests behind the passage of the Affordable Care Act. Every company that stood to gain from health-care reform had lobbyists running all over Capitol Hill. When I asked him about how free breast pumps had made it into the legislation, he said he had not heard specifically of a breast-pump manufacturers’ lobby, but he would be surprised if they didn’t have one.



I didn’t find any evidence of such a lobby either, but breast-pump manufacturers certainly had a close ally in the Democratic senator from Maryland.

Yes, there is money to be made from breastfeeding, but Medela’s balance sheets, though they are growing, look positively anemic when compared to the billions of dollars generated annually by even less robust competitors such as Abbott, which makes Similac. There is, ultimately, no comparison between a successful company like Medela and Fortune 500 behemoths such as Abbott, Mead Johnson, and, especially, Nestle.