256099 Estimated cases of child neglect and abuse averted, and related cost benefit, from a three-year program to promote breastfeeding duration

Tuesday, October 30, 2012 : 11:20 AM - 11:35 AM

Fred Molitor , Walter R. McDonald & Associates, Inc., Sacramento, CA
Melissa Rossi , Walter R. McDonald & Associates, Inc., Sacramento, CA
Background: Comprehensive breastfeeding support services, including one-on-one IBCLC contacts, help line calls, and support groups, were offered at 10 sites by the First 5 Sacramento Commission. Methods: Breastfeeding duration was assessed by a longitudinal survey (2007 to 2010) of randomly-sampled families with National Immunization Survey items. Four-month breastfeeding rates were calculated with survival analyses for children from families receiving breastfeeding versus other services, with race/ethnicity, language, and education controlled. Cases of neglect, emotional and physical abuse averted were estimated with relative risk ratios from Strathearn (2009), and substantiated case data from the California child welfare data system. The cost benefit of cases averted was calculated with direct (child welfare services, hospitalizations) and indirect (juvenile delinquency) cost estimates from Wang and Holton (2007) and other sources, adjusted for inflation. Results: 14,142 children had mothers who received breastfeeding services, 20,242 did not. Four-month breastfeeding rates were 75.5% and 63.5%, respectively. An estimated 1,729 additional mothers breastfed for four months due to comprehensive breastfeeding services. Estimated cases averted were neglect, 5.2; emotional abuse, 1.1, physical abuse, 1.0. The discounted cost savings was >$350,000. Conclusions: The health benefits of breastfeeding to mother and child are well documented, and from a cost benefit perspective are well worth the investment. This study suggests that return on averted cases of child abuse and neglect alone can cover a share of the cost of comprehensive breastfeeding services. Our findings likely underestimate the cost benefit of breastfeeding because comparison group mothers were exposed to messages promoting breastfeeding.

Learning Areas:
Biostatistics, economics
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe methods and findings from assessment of impact of comprehensive breastfeeding services on averting child neglect and abuse and related costs.

Keywords: Breastfeeding, Cost Issues

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Nineteen years of experience as evaluator of health promotion and prevention programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.