Recorded presentation

Gabriel M Leung, MD, MPH¹, Tai-Hing Lam, MD, MSc¹, Lai-Ming Ho, PhD¹, and Yu-Lung Lau, MD². (1) School of Public Health, University of Hong Kong, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong, +852-2819-9209, gmleung@hku.hk, (2) Department of Paediatrics and Adolescent Health, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong

Background. We examined the effects of breastfeeding on health services utilization in Hong Kong Chinese infants. Methods. A population-based birth cohort of 8,327 infants were followed up for 18 months. Main outcome measures were higher (defined by the sample median) utilization of outpatient visits and hospitalization episodes due to jaundice, gastrointestinal or respiratory/febrile illnesses, and all causes. Results. Breastfeeding protected against doctor consultations for all causes throughout the first 18 months of life, where the benefits were statistically significant for infants exclusively breastfed for 2-3 months (odds ratio for higher utilization (OR) = 0.75, 95% confidence interval (CI) = 0.59, 0.95) and for >4 months (OR = 0.59, 95% CI = 0.48, 0.73) compared to those who were only formula-fed. The level of risk reduction demonstrated clear dose-response gradients according to the intensity and duration of breastfeeding. Diagnosis-specific analyses however show that breastfed infants had significant excess risks of 121% to 702% for being a higher outpatient utilizer due to jaundice, particularly in the first 3 months. Any breastfeeding also increased jaundice-related hospital admissions, the effects of which were most acute in the first 3 months (OR for mixed breast- and formula-fed = 2.25, 95% CI = 1.56, 3.24; OR for exclusive breastfeeding <1 month = 4.26, 95% CI = 2.57, 7.06; OR for exclusive breastfeeding 2-3 months = 2.85, 95% CI = 1.62, 5.03; OR for exclusive breastfeeding >4 months = 3.14, 95% CI = 1.90, 5.18). Conclusions. Breastfeeding reduces doctor visits overall but increases both outpatient and inpatient utilization due to jaundice in Hong Kong Chinese infants.

Learning Objectives:

• To examine the effects of breastfeeding on health services utilization in Hong Kong Chinese infants.
• To recognize the importance of a questioning approach in evaluating "accepted" practice.

Keywords: Breast Feeding, Health Care Utilization

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation