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

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dc.citation.firstpage100en_US
dc.citation.journalTitleThe Journal of Pediatricsen_US
dc.citation.lastpage105.e2en_US
dc.citation.volumeNumber175en_US
dc.contributor.authorColaizy, Tarah T.en_US
dc.contributor.authorBartick, Melissa C.en_US
dc.contributor.authorJegier, Briana J.en_US
dc.contributor.authorGreen, Brittany D.en_US
dc.contributor.authorReinhold, Arnold G.en_US
dc.contributor.authorSchaefer, Andrew J.en_US
dc.contributor.authorBogen, Debra L.en_US
dc.contributor.authorSchwarz, Eleanor Bimlaen_US
dc.contributor.authorStuebe, Alison M.en_US
dc.date.accessioned2017-08-21T14:34:16Zen_US
dc.date.available2017-08-21T14:34:16Zen_US
dc.date.issued2016en_US
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.en_US
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.en_US
dc.identifier.digitalImpact_of_suboptimal_breastfeedingen_US
dc.identifier.doihttps://doi.org/10.1016/j.jpeds.2016.03.040en_US
dc.identifier.urihttps://hdl.handle.net/1911/97374en_US
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.rightsThis is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier.en_US
dc.subject.keywordeconomic analysisen_US
dc.subject.keywordhuman milken_US
dc.subject.keywordmonte carlo modelingen_US
dc.subject.keywordnecrotizing enterocolitisen_US
dc.titleImpact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infantsen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpost-printen_US
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