Abstract

Background: Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, however, it is not usually estimated from actual cohorts but via simulation studies. Methods: A cohort of 970 children was followed-up for twelve months. Data on mother characteristics, pregnancy, delivery and neonate characteristics were obtained from medical records. The type of neonate feeding at discharge, 2, 4, 6, 9 and 12 months of life was reported by the mothers. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. Health care costs were attributed using public prices and All Patients Refined–Diagnosis Related Groups (APR–DRG) classification. Results: Health care costs in the first year of life were higher in children artificially fed than in those breastfed (1339.5€, 95% confidence interval (CI): 903.0–1775.0 for artificially fed vs. 443.5€, 95% CI: 193.7–694.0 for breastfed). The breakdown of costs also shows differences in primary care consultations (295.7€ for formula fed children vs. 197.9€ for breastfed children), emergency room consultations (260.1€ for artificially fed children vs. 196.2€ for breastfed children) and hospital admissions (791.6€ for artificially fed children vs. 86.9€ for breastfed children). Conclusions: Children artificially fed brought about more health care costs related to infectious diseases than those exclusively breastfed or mixed breastfed. Excess costs were caused in hospital admissions, primary care consultations, emergency room consultations and drug consumption.

Highlights

  • Breastfeeding is one of the most efficacious tools for preventing diseases and for promoting health in both mothers and children [1,2,3,4]

  • According to our results in a cohort of 970 infants, neonates fed with artificial feeding at hospital discharge use more resources of the health care system due to infectious diseases: they have more consultations in primary care and emergency room, more admissions to hospital and produce more health care costs than neonates exclusively or partially breastfed

  • This result is higher than that previously reported by Santacruz-Salas et al in a smaller Spanish cohort [29], they compared exclusive vs. non-exclusive breastfeeding until six months, while we have separated the last group into mixed breastfeeding + artificial feeding and only artificial feeding

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Summary

Introduction

Breastfeeding is one of the most efficacious tools for preventing diseases and for promoting health in both mothers and children [1,2,3,4]. The benefits of breastfeeding on maternal and neonatal health result in lower demand for health services in both primary and specialized care, decreasing the number of hospital admissions and drug treatments [12,13,14,15,16,17]. Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, it is not usually estimated from actual cohorts but via simulation studies. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. The breakdown of costs shows differences in primary care consultations

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