Cost analysis of maternal disease associated with suboptimal breastfeeding

Melissa C. Bartick, Alison M. Stuebe, Eleanor Schwarz, Christine Luongo, Arnold G. Reinhold, E. Michael Foster

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

OBJECTIVE:: To estimate the U.S. maternal health burden from current breastfeeding rates both in terms of premature death as well as economic costs. METHODS:: Using literature on associations between lactation and maternal health, we modeled the health outcomes and costs expected for a U.S. cohort of 15-year-old females followed to age 70 years. In 2002, this cohort included 1.88 million individuals. Using Monte Carlo simulations, we compared the outcomes expected if 90% of mothers were able to breastfeed for at least 1 year after each birth with outcomes under the current 1-year breastfeeding rate of 23%. We modeled cases of breast cancer, premenopausal ovarian cancer, hypertension, type 2 diabetes mellitus, and myocardial infarction considering direct costs, indirect costs, and cost of premature death (before age 70 years) expressed in 2011 dollars. RESULTS:: If observed associations between breastfeeding duration and maternal health are causal, we estimate that current breastfeeding rates result in 4,981 excess cases of breast cancer, 53,847 cases of hypertension, and 13,946 cases of myocardial infarction compared with a cohort of 1.88 million U.S. women who optimally breastfed. Using a 3% discount rate, suboptimal breastfeeding incurs a total of $17.4 billion in cost to society resulting from premature death (95% confidence interval [CI] $4.38-24.68 billion), $733.7 million in direct costs (95% CI $612.9-859.7 million), and $126.1 million indirect morbidity costs (95% CI $99.00-153.22 million). We found a nonsignificant difference in number of deaths before age 70 years under current breastfeeding rates (4,396 additional premature deaths, 95% CI -810-7,918). CONCLUSIONS:: Suboptimal breastfeeding may increase U.S. maternal morbidity and health care costs. Thus, investigating whether the observed associations between suboptimal breastfeeding and adverse maternal health outcomes are causal should be a research priority.

Original languageEnglish (US)
Pages (from-to)111-119
Number of pages9
JournalObstetrics and Gynecology
Volume122
Issue number1
DOIs
StatePublished - Jul 1 2013
Externally publishedYes

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Breast Feeding
Mothers
Costs and Cost Analysis
Premature Mortality
Confidence Intervals
Health Care Costs
Myocardial Infarction
Breast Neoplasms
Hypertension
Morbidity
Lactation
Ovarian Neoplasms
Type 2 Diabetes Mellitus
Economics
Maternal Health
Parturition
Research

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Bartick, M. C., Stuebe, A. M., Schwarz, E., Luongo, C., Reinhold, A. G., & Foster, E. M. (2013). Cost analysis of maternal disease associated with suboptimal breastfeeding. Obstetrics and Gynecology, 122(1), 111-119. https://doi.org/10.1097/AOG.0b013e318297a047

Cost analysis of maternal disease associated with suboptimal breastfeeding. / Bartick, Melissa C.; Stuebe, Alison M.; Schwarz, Eleanor; Luongo, Christine; Reinhold, Arnold G.; Foster, E. Michael.

In: Obstetrics and Gynecology, Vol. 122, No. 1, 01.07.2013, p. 111-119.

Research output: Contribution to journalArticle

Bartick, MC, Stuebe, AM, Schwarz, E, Luongo, C, Reinhold, AG & Foster, EM 2013, 'Cost analysis of maternal disease associated with suboptimal breastfeeding', Obstetrics and Gynecology, vol. 122, no. 1, pp. 111-119. https://doi.org/10.1097/AOG.0b013e318297a047
Bartick, Melissa C. ; Stuebe, Alison M. ; Schwarz, Eleanor ; Luongo, Christine ; Reinhold, Arnold G. ; Foster, E. Michael. / Cost analysis of maternal disease associated with suboptimal breastfeeding. In: Obstetrics and Gynecology. 2013 ; Vol. 122, No. 1. pp. 111-119.
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