Cost Benefits Of Breastfeeding

Asked at a Blue Cross/Blue Shield health care cost containment in Minot, North Dakota: “What helps reduce the incidence of ear and respiratory infections, intestinal disease, pneumonia, meningitis, Crohn’s disease, colitis, diabetes, childhood cancers, allergies, constipation, urinary tract infections, tooth decay and obesity? It also increases intelligence and reduces the incidence of breast cancer for the mother.”

No one knew the answer was breastfeeding…

Today I would add that breastfeeding reduces ovarian and cervical cancer, juvenile rheumatoid arthritis, bacterial and viral infections of all types and increases visual acuity, optimal neurological and social and oral development, as well as saves money for health care providers and families.

Cost Benefits of Breastfeeding

Medical costs for breastfed infants were ~$200 less per child for the first 12 months of life than those for formula-fed infants; extrapolating this to the Healthy People 2000 goal of 50% of infants breastfed could save this HMO up to $140,000 annually. This study included office visits, drug prescriptions and hospitalizations (Hoey and Ware, 1997).

Infant diarrhea in non-breastfed infants costs $291.3 million in annual health care costs. Respiratory syncytial virus (RSV) costs $225 million in annual health care costs. Insulin-dependent diabetes mellitus costs from $9.6 to $124.8 million in annual health care costs.

Otitis media costs $660 million in annual health care costs.

Total annual cost of not breastfeeding: $1.186 to $1.301 billion

Additionally, formula provided by WIC program to non-breastfeeding mothers costs $2,665,715 annually. (Riordan, 1997)

Increasing breastfeeding in Australia could add A$3.4 billion to the national food output (equal to an extra 0.7% of the GNP). (Smith, 1997)

Reduction in childhood cancer saves $10 million
Reduction in childhood diarrhea $100 million
Reduction in ear infections $500 million
Reduction in tympanosomies $500 million
Reduction in juvenile onset diabetes $2.6 billion
Reduction in hospitalization for RSV $225 million

total conservative estimate of cost savings nationally for 1 year: $4.18 billion (Lee, 1997)

Cost savings in disease: $3.689 billion
Cost savings in health expenditures: $3.96 billion
Cost savings in household expenses: $2.835 billion
Breastfeeding Support costs (1 LC/1000; additional training; direct support): $360 million

Cost/benefit ratio of 0.7—over $1 billion would be saved by providing Lactation Consultant Support (Labbok, 1995)

Annual reduction in Maternal Medicals at delivery (Philadelphia-based): $91,650. Annual reduction in premenopausal cancer: $202 million. Annual reduction in domestic violence: $42.5 million. (Lee, 1997)

Overall estimated savings of $459–$808 per family enrolled in four social service programs: Medi-Cal, WIC, AFDC, Food Stamps. (Tuttle and Dewey 1996)

Overall estimated savings of $112 for the first six months of life per infant enrolled in Medicaid; pharmacy coasts were one-half the amount of formulafed infants—infants were breastfed exclusively for a minimum of three months. (Montgomery and Splett 1997)

Overall a minimum of A$115 million could be saved/year in Australia by increasing breastfeeding rates to 80% at three months calculating savings only in otitis media, IDDM, gastrointestinal illness and eczema. (Drane 1997)

The Mother

Short-Term Benefits

Pitocin, usually administered to newly postpartum mothers to prevent hemorrhage, costs about $4.49/patient for supplies: ($0.84 18 French angiocath; $1.40 IV tubing; $0.76 saline IV fluid; $0.30 one ampule pitocin; $1.10 syringe). Babies breastfed immediately postpartum make this process unnecessary, saving $4.49/patient x ?? patients/year =

Long-Term Benefits

Breast Cancer: Treatment of breast cancer is approximately $30,000 annually/ patient. Breastfeeding reduces the incidence of breast cancer. (Lee 1997)

Diabetes: Breastfeeding reduces a diabetic mother’s need for insulin and a two-fold reduction or delay in the onset of subsequent diabetes for a gestational diabetic. Treatment of diabetes takes one of every $7 of health care dollars, and costs the US $130 billion annually. This is for direct treatment and does not factor in the high incidence of kidney disease, peripheral vascular disease and blindness which accompany diabetes.

Emotional Stability: Oxytocin, a hormone released each time a mother breastfeeds, decreases blood pressure, stress hormone level and calms the mother. A 38-fold difference in the frequency of domestic violence and sexual abuse was found between the group that breastfed and the group which did not. (Acheston 1995)

Infertility: Breastfed women were 25% less likely to have hyperprolactinemia, galactorrhea and menstrual disturbances according to Dr. Shafig Rahimova. He also feels that males not breastfed are at greater risk of developing genito-urinary difficulties.

Ovarian and Endometrial Cancer: A WHO Collaborative Study found the relative risk of endometrial cancer decreased significantly with increased duration of breastfeeding; women whose lifetime lactation was 72 months or greater had the greatest protection. Those breastfeeding for less than one year did not accrue this benefit. (Rosenblatt, 1995)

Lactation has a preventative effect on ovarian cancer; the ACS estimates 26,888 new cases of ovarian cancer will be diagnosed this year. For every 1.6 women who did not lactate, only one woman who did developed ovarian cancer. (Gwinn, 1990)

Osteoporosis: Lactating protects women against osteoporosis; not breastfeeding is a risk factor in its development. Bone mineral density decreases during lactation but after weaning showed higher bone mineral density than those who did not breastfeed. A mother’s bone mineral density increases with each child breastfed; lumbar spine density increased 1.5% per child breastfed. Thus a decrease in the risk of a fracture of the hip, vertebrae, humerus or pelvis. (Kalwart and Specker 1995; Hreschyshyn 1988)

In 1983 osteoporosis and osteoporotic fractures cost an estimated $6.1 billion; an adult white woman who lives to the age of 80 has a 15% lifetime risk of a hip fracture. (Cummings 1985)

Rheumatoid Arthritis: In Norway, 63,090 women with rheumatoid arthritis were followed for 28 years. The total time of lactation was associated with reduced mortality; the protective effects of breastfeeding appear dose related. (Brun 1995)

Weight Loss: During the first year postpartum, lactating women lose an average of 2 kg more than nonbreastfeeding women, with no return of weight once weaning occurs. The impact of overweight impacts health by increasing chances of cardiovascular disease and diabetes. (Dewey 1993)

The Baby

Short-Term (Up to One Year)

Allergies: Allergy protection is one of the most frequently cited reasons mothers choose to breastfeed. Premature infants are also protected from allergies; breastfed preemies had less than one-third of the allergies, particularly atopic disease, in the first 18 months of life. (Lucas 1990)

There has not been a documented case of anaphylaxis to human milk. (Baylor, 1991; Ellis 1991)

Estimated treatment cost of allergy diagnosis and treatment is $400; acute reaction treatment costs about $80-100 per episode. (Hoey at 1996 ILCA Conference)

Anemia: Piscante 1995 reports that “none of the infants who were exclusively breastfed for 7 months or more…were anemic.”