A recent study(pediatrics.aappublications.org) in Pediatrics estimates that if 90 percent of American mothers complied with recommendations to breastfeed exclusively for the first 6 months of a child's life, the United States would save $13 billion per year and prevent more than 900 infant deaths.
The authors of the Pediatrics study note that it is the first peer-reviewed cost analysis on breastfeeding in the United States in more than 10 years and the only one to date that examined as many as 10 diseases.
A 2001 study by the U.S. Department of Agriculture(www.ers.usda.gov), or USDA, estimated that $3.6 billion could be saved if breastfeeding rates increased to the more modest goals established by HHS' Healthy People 2010 initiative, which calls for 75 percent of mothers to breastfeed in the early postpartum period, 50 percent at six months postpartum (not necessarily exclusively) and 25 percent at one year after an infant's birth.
By 2006, the nation was close to those goals, with 73.9 percent of mothers breastfeeding their newborns, 43.4 percent breastfeeding at six months postpartum and 22.7 percent breastfeeding at one year, according to a CDC survey(www.cdc.gov). The survey indicated that 13.6 percent of mothers were breastfeeding exclusively at six months.
The 2001 USDA study examined the economic impact of breastfeeding for three diseases: necrotizing enterocolitis, otitis media (i.e., acute otitis media, or AOM; recurrent AOM; otitis media with effusion, or OME; and chronic OME) and gastroenteritis. The just-published Pediatrics study used a similar model but went further, examining nearly all pediatric diseases for which the Agency for Healthcare Research and Quality, or AHRQ, had reported risk ratios that favored breastfeeding in a 2007 evidence report(www.ahrq.gov):
- necrotizing enterocolitis,
- otitis media,
- hospitalization for lower respiratory tract infections,
- atopic dermatitis,
- sudden infant death syndrome,
- childhood asthma,
- childhood leukemia,
- type 1 diabetes mellitus and
- childhood obesity.
The Pediatrics study authors, who excluded type 2 diabetes from consideration because of insufficient data, used government estimates of the direct and indirect costs for each disease, as well as the cost of premature death from necrotizing enterocolitis, sudden infant death syndrome, lower respiratory tract infections, asthma, leukemia and type 1 diabetes, in conducting their analysis.
In addition to their estimates of $13 billion in savings and more than 900 infant deaths prevented based on the scenario in which 90 percent of mothers breastfed exclusively for six months, the authors estimated $10.5 billion could be saved and more than 700 deaths could be prevented if 80 percent of mothers breastfed their infants exclusively for the first 6 months of life.
"By allowing breastfeeding rates to continue at their current levels, rather than implementing supports to help more families follow medically recommended guidelines, the United States incurs billions of dollars in excess costs and hundreds of preventable infant deaths," the authors wrote in Pediatrics. "Action to improve breastfeeding rates, duration and exclusivity, including creation of a national infrastructure to support breastfeeding, could be cost-effective."
The AAFP, the American Academy of Pediatrics, the U.S. surgeon general and the World Health Organization all advocate that mothers breastfeed their infants exclusively for the first 6 months of life. The Academy's policy on breastfeeding further states that, "Family physicians should have the knowledge to promote, protect and support breastfeeding."
A draft of HHS' Healthy People 2020 initiative(www.healthypeople.gov) retains the objective to increase the proportion of mothers who breastfeed their babies at various stages and adds an objective to decrease the percentage of breastfed newborns who receive formula supplementation during the first 2 days of life.