2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

326444
Suboptimal Breastfeeding in the United States: A Comprehensive Cost Analysis of the Maternal and Pediatric Health Conditions


Tuesday, November 3, 2015 : 5:15 p.m. - 5:30 p.m.

Melissa C. Bartick, MD, MS, Department of Medicine, Cambridge Health Alliance, Cambridge, MA
E. Bimla Schwarz, MD, MS, Dept. of Medicine, University of California, Davis, Davis, CA
Brittany Green, PhD(c), Dept. of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA
Alison Stuebe, MSc, MD, Department Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC
Debra Bogen, MD, Dept. of Pediatrics, University of Pittsburgh, Pittsburgh, PA
Tarah Colaizy, MD, MPH, Carver College of Medicine, Department of Neonatology, University of Iowa, Iowa City, IA
Briana Jegier, PhD, Health Science-Healthcare Administration, College at Brockport - SUNY, Brockport, NY
Arnold Reinhold, MBA, Alliance for the Prudent Use of Antibiotics, Boston, MA
Andrew Schaefer, PhD, Dept. of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA
Background: Breast milk feeding (BMF), directly from the breast and/or through expressed breast milk from the biological mother, is associated with improved pediatric and maternal health outcomes and lower societal costs. However, no study has examined maternal and pediatric health costs using a combined approach.

Methods: This study performed Monte Carlo simulations on a hypothetical cohort of US mothers who gave birth to infants in 2010 and followed mothers through age 70 years. The model compared rates of 5 maternal and 10 pediatric health conditions using two scenarios: (a) current rates of BMF and (b) a theoretical scenario where  90% of infants were fed according to standard medical recommendations (i.e., exclusively BMF for 6 months, with continued BMF for at least one year). Incidence and prevalence rates for health conditions and associated health costs (US 2012 dollars) were obtained from current literature.  

Results:  For pediatric conditions, there were 979 (95% CI 969-987) excess pediatric deaths and $13.1 billion (95% CI $12.0-14.1 billion) excess costs, 4.9% of which were direct healthcare costs, and 7.5% were indirect morbidity costs. Preliminary results for maternal breast and ovarian cancer indicate that there were 4,914 excess cases and 914 excess deaths. Results for the remaining maternal conditions and associated costs are in progress.

Conclusions: This is the first and most comprehensive, robust cost analysis to date of maternal and pediatric conditions. These results suggest that there is the potential for significant return on investment for initiatives and policies that enable greater BMF duration and exclusivity.

Learning Areas:

Advocacy for health and health education
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related public policy

Learning Objectives:
Compare the cost of maternal and pediatric health conditions under optimal and suboptimal breast milk feeding conditions Compare the incidence of maternal and pediatric health conditions under optimal and suboptimal breast milk feeding conditions Compare the deaths from maternal and pediatric health conditions under optimal and suboptimal breast milk feeding conditions

Keyword(s): Breastfeeding, Economic Analysis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a clinician and researcher for over a decade in breastfeeding and maternal-child health. I have written many peer-reviewed articles on breastfeeding including several on the economic impacts of breastfeeding. My research has been published in leading journals such as Pediatrics. I have served as the PI on numerous grants. I am the immediate past chair of the breastfeeding forum.
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.

Back to: 4401.2: Supporting equity in breastfeeding through policy