by Anne Eglash MD, IBCLC, FABM
Do you ever wonder how much healthier your community would be if the breastfeeding rates increased? Well, now you have access to hard data to answer such questions. A group of researchers developed a free online tool that allows anyone to calculate the change in national or state population health parameters due to a rise or fall in breastfeeding rates.
The calculator measures the impact of breastfeeding rates on pediatric disease, including acute lymphoblastic leukemia, acute otitis media, Crohn’s disease, ulcerative colitis, gastrointestinal infection, hospitalization for lower respiratory tract infection, obesity in non-Hispanic whites to age 4, necrotizing enterocolitis, and Sudden Infant Death Syndrome. It also measures changes in the incidence of maternal disease, including breast cancer, pre-menopausal ovarian cancer, type 2 diabetes mellitus, hypertension, and myocardial infarction.
In addition to changes in disease rates, it calculates the changes in the number of maternal and infant deaths, total medical costs, and societal costs related to breastfeeding rates.
I played around with the calculator for the United States. The calculator tells me that we had a 3-month exclusive breastfeeding rate of 46.6% in 2014.
Based on this calculator, what do you think would have happened if our 3-month exclusive breastfeeding rate in 2014 had a slight rise to 51.6% (only 5% increase), with all other rates staying the same? Choose 2 correct answers:
- The USA would have saved approximately $80.7 million per year in medical costs.
- The USA would have saved $40.2 million per year in medical costs.
- The USA would have saved $20.2 million per year in medical costs.
- The USA would have seen 8 fewer maternal deaths.
- The USA would have seen 12 fewer maternal deaths.
- The USA would have seen 15 fewer maternal deaths.
See the Answer
Answers: B and D
Breastfeed Med. 2017 Dec;12(10):645-658. doi: 10.1089/bfm.2017.0083. Epub 2017 Sep 14.
An Online Calculator to Estimate the Impact of Changes in Breastfeeding Rates on Population Health and Costs.
Stuebe AM, Jegier BJ, Schwarz EB, Green BD, Reinhold AG, Colaizy TT, Bogen DL, Schaefer AJ, Jegier JT, Green NS, Bartick MC
OBJECTIVE:
We sought to determine the impact of changes in breastfeeding rates on population health.
MATERIALS AND METHODS:
We used a Monte Carlo simulation model to estimate the population-level changes in disease burden associated with marginal changes in rates of any breastfeeding at each month from birth to 12 months of life, and in rates of exclusive breastfeeding from birth to 6 months of life. We used these marginal estimates to construct an interactive online calculator (available at www.usbreastfeeding.org/saving-calc ). The Institutional Review Board of the Cambridge Health Alliance exempted the study.
RESULTS:
Using our interactive online calculator, we found that a 5% point increase in breastfeeding rates was associated with statistically significant differences in child infectious morbidity for the U.S. population, including otitis media (101,952 cases, 95% confidence interval [CI] 77,929-131,894 cases) and gastrointestinal infection (236,073 cases, 95% CI 190,643-290,278 cases). Associated medical cost differences were $31,784,763 (95% CI $24,295,235-$41,119,548) for otitis media and $12,588,848 ($10,166,203-$15,479,352) for gastrointestinal infection. The state-level impact of attaining Healthy People 2020 goals varied by population size and current breastfeeding rates.
CONCLUSION:
Modest increases in breastfeeding rates substantially impact healthcare costs in the first year of life.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
This free online calculator is a useful tool to measure the cost effectiveness of funding breastfeeding programs, such as efforts to educate medical staff or strategies to support breastfeeding dyads after hospital discharge. The authors of this work point out that there are several documented interventions that have proven to modestly increase breastfeeding rates at different points in time, a good example being Baby Friendly Hospital certification. Now we can demonstrate to grantors and other funding sources how investment in these interventions can directly impact maternal child health.
This calculator is available at http://www.usbreastfeeding.org/p/cm/ld/fid=438, or go to www.usbreastfeeding.org and search ‘calculator’.