Economic Benefits and Costs of Human Milk Feedings: A Strategy to Reduce the Risk of Prematurity-Related Morbidities in Very-Low-Birth-Weight Infants

Abstract

Infants born at very low birth weight (VLBW; birth weight <1500 g) are at high risk of mortality and are some of the most expensive patients in the hospital. Additionally, VLBW infants are susceptible to prematurity-related morbidities, including late-onset sepsis, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, and retinopathy of prematurity, which have short- and long-term economic consequences. The incremental cost of these morbidities during the neonatal intensive care unit (NICU) hospitalization is high, ranging from $10,055 (in 2009 US$) for late-onset sepsis to $31,565 for BPD. Human milk has been shown to reduce both the incidence and severity of some of these morbidities and, therefore, has an indirect impact on the cost of the NICU hospitalization. Furthermore, human milk may also directly reduce NICU hospitalization costs, independent of the indirect impact on the incidence and/or severity of these morbidities. Although there is an economic cost to both the mother and institution for providing human milk during the NICU hospitalization, these costs are relatively low. This review describes the total cost of the initial NICU hospitalization, the incremental cost associated with these prematurity-related morbidities, and the incremental benefits and costs of human milk feedings during critical periods of the NICU hospitalization as a strategy to reduce the incidence and severity of these morbidities.

Greater Mortality and Morbidity in Extremely Preterm Infants Fed a Diet Containing Cow Milk Protein Products

“…A recent analysis confirmed that human milk costs are minimal compared with the costs of the major morbidities in very low birth weight infants. 17 The results of this analysis indicate a significant effect on overall mortality as well as sepsis that was not identified in the individual studies previously reported. 4,5 The combined studies demonstrate a dose-related effect of nonhuman milk intake in increasing negative patient outcomes.…”

Mother's breast milk supplemented with donor milk reduces hospital and health service usage costs in low-birthweight infants

“…Among these 'interventions', breast feeding is considered to be the most cost-effective, especially for lowbirthweight (LBW) infants (Stevenson and Cooke, 1998;St John et al, 2000;Phibbs and Schmitt, 2006;Jegier et al, 2010;Johnson et al, 2014). The World Health Organization (WHO) endorses breast feeding as the most efficient nutritional practice for the health and well-being of preterm infants (WHO/UNICEF, 1990, 1992.…”

Effects of a Breast Milk Diet on Enteral Feeding Outcomes of Neonates with Gastrointestinal Disorders

“…While there is literature to support this conclusion in preterm and very low-birthweight neonates, there is a paucity of literature assessing the role of BM diets on outcomes of neonates who do not meet such criteria. 5,[7][8][10][11][12][13][14] The objective of this study was to assess whether a diet of ‡50% BM is associated with an earlier transition off of PN in neonates with specific GI disorders when compared to similar neonates who receive enteral diets <50% BM. Secondary outcomes included hospital LOS and days to achievement of full enteral feeds.…”