Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

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dc.citation.firstpage100
dc.citation.journalTitleThe Journal of Pediatrics
dc.citation.lastpage105.e2
dc.citation.volumeNumber175
dc.contributor.authorColaizy, Tarah T.
dc.contributor.authorBartick, Melissa C.
dc.contributor.authorJegier, Briana J.
dc.contributor.authorGreen, Brittany D.
dc.contributor.authorReinhold, Arnold G.
dc.contributor.authorSchaefer, Andrew J.
dc.contributor.authorBogen, Debra L.
dc.contributor.authorSchwarz, Eleanor Bimla
dc.contributor.authorStuebe, Alison M.
dc.date.accessioned2017-08-21T14:34:16Z
dc.date.available2017-08-21T14:34:16Z
dc.date.issued2016
dc.description.abstractObjective: To estimate risk of necrotizing enterocolitis (NEC) for extremely low birth weight (ELBW) infants as a function of preterm formula (PF) and maternal milk intake and calculate the impact of suboptimal feeding on the incidence and costs of NEC. Study design: We used aORs derived from the Glutamine Trial to perform Monte Carlo simulation of a cohort of ELBW infants under current suboptimal feeding practices, compared with a theoretical cohort in which 90% of infants received at least 98% human milk. Results: NEC incidence among infants receiving ≥98% human milk was 1.3%; 11.1% among infants fed only PF; and 8.2% among infants fed a mixed diet (P = .002). In adjusted models, compared with infants fed predominantly human milk, we found an increased risk of NEC associated with exclusive PF (aOR = 12.1, 95% CI 1.5, 94.2), or a mixed diet (aOR 8.7, 95% CI 1.2-65.2). In Monte Carlo simulation, current feeding of ELBW infants was associated with 928 excess NEC cases and 121 excess deaths annually, compared with a model in which 90% of infants received ≥98% human milk. These models estimated an annual cost of suboptimal feeding of ELBW infants of $27.1 million (CI $24 million, $30.4 million) in direct medical costs, $563 655 (CI $476 191, $599 069) in indirect nonmedical costs, and $1.5 billion (CI $1.3 billion, $1.6 billion) in cost attributable to premature death. Conclusions: Among ELBW infants, not being fed predominantly human milk is associated with an increased risk of NEC. Efforts to support milk production by mothers of ELBW infants may prevent infant deaths and reduce costs.
dc.identifier.citationColaizy, Tarah T., Bartick, Melissa C., Jegier, Briana J., et al.. "Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants." <i>The Journal of Pediatrics,</i> 175, (2016) Elsevier: 100-105.e2. https://doi.org/10.1016/j.jpeds.2016.03.040.
dc.identifier.digitalImpact_of_suboptimal_breastfeeding
dc.identifier.doihttps://doi.org/10.1016/j.jpeds.2016.03.040
dc.identifier.urihttps://hdl.handle.net/1911/97374
dc.language.isoeng
dc.publisherElsevier
dc.rightsThis is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier.
dc.subject.keywordeconomic analysis
dc.subject.keywordhuman milk
dc.subject.keywordmonte carlo modeling
dc.subject.keywordnecrotizing enterocolitis
dc.titleImpact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants
dc.typeJournal article
dc.type.dcmiText
dc.type.publicationpost-print
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