Skip to main content
×
Home

Economic evaluation of enhanced staff contact for the promotion of breastfeeding for low birth weight infants

  • Stephen J. C. Rice (a1), Dawn Craig (a1), Felicia McCormick (a1), Mary J. Renfrew (a1) and Anthony F. Williams (a2)...
Abstract

Objectives: There is evidence that breastmilk feeding reduces mortality and short and long-term morbidity among infants born too soon or too small. The aim of this study was to evaluate the cost-effectiveness of enhanced staff contact for mothers with infants in a neonatal unit with a birth weight of 500–2,500 g from the perspective of the UK National Health Service.

Methods: A decision-tree model linked clinical outcomes with long-term health outcomes. The study population was divided into three weight bands: 500–999 g, 1000–1,749 g, and 1,750–2,500 g. Clinical and resource use data were obtained from literature reviews. The measure of benefit was quality-adjusted life-years. Uncertainty was evaluated using cost-effectiveness acceptability curves and sensitivity analyses.

Results: The intervention was less costly and more effective than the comparator in the base–case analysis for each birth weight group. The results were quite robust to the sensitivity analyses performed.

Conclusions: This is the first economic evaluation in this complex field and offers a model to be developed in future research. The results provide preliminary indications that enhanced staff contact may be cost-effective. However, the limited evidence available, and the limited UK data in particular, suggest that further research is required to provide results with confidence.

Copyright
References
Hide All
1. BLISS. Breastfeeding or expressing for a sick or premature baby. An overview of 500 women's experiences. London: BLISS; 2008.
2. Bolling K, Grant C, Hamlyn B, Thornton A; & BMRB Social Research. Infant feeding survey 2005: A survey conducted on behalf of the Information Centre for Health and Social Care and the UK Health Departments. London: The Information Centre; 2007 (accessed January 29, 2008).
3. Breastmilk Banking Working Group. Report submitted to the Department of Health. Unpublished. London: Department of Health; 2005.
4. Colbourn T, Asseburg C, Bojke L, et al. Prenatal screening and treatment strategies to prevent group B streptococcal and other bacterial infections in early infancy: Cost effectiveness and expected value of information analyses. Health Technol Assess. 2007;11:1226.
5. Curtis L, Netten A. Unit costs of health and social care 2006. Kent: Personal Social Services Research Unit, University of Kent; 2006 (accessed April 8, 2008).
6. Department of Health. Implementation plan for reducing health inequalities in infant mortality: A good practice guide. London; Department of Health, Health Inequalities Unit; 2007.
7. Department of Health. Reference costs 2006–2007. London: Department of Health; 2008 (accessed April 9, 2008).
8. Fanaroff A, Korones S, Wright L, et al. Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. Pediatr Infect Dis J. 1998;17:593598.
9. Gonzalez KA, Meinzen-Derr J, Burke BL, et al. Evaluation of a lactation support service in a children's hospital neonatal intensive care unit. J Hum Lact. 2003;19:286292.
10. Guthrie S, Gordon P, Thomas V, et al. Necrotizing enterocolitis among neonates in the United States. J Perinatol. 2003;23:278285.
11. Hintz S, Kendrick D, Stoll B, et al. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics. 2005;115:696703.
12. HM Government. PSA Agreement 12: Improve the health and wellbeing of children and young people. London: The Stationery Office; 2007.
13. Information and Statistics Division & NHS Scotland. Small babies in Scotland: A ten year overview 1987–1996. Scotland: Information and Statistics Division & NHS Scotland; 1998 (accessed March 13, 2008).
14. Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep). 2007;153:1186.
15. Joint United Nations Programme on HIV/AIDS. 2008 report on the global AIDS epidemic. Geneva: UNAIDS; 2008.
16. Larroque B, Ancel P, Marret S, et al. Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): A longitudinal cohort study. Lancet. 2008;371:813820.
17. Liu WF, Laudert S, Perkins B, et al. The development of potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol. 2007;27 (Suppl 2):S48S74.
18. Lucas A, Cole T. Breast milk and neonatal necrotising enterocolitis. Lancet. 1990;336:15191523.
19. Luck S, Sharland M. Postnatal cytomegalovirus: Innocent bystander or hidden problem? Arch Dis Child Fetal Neonatal Ed. 2009;94:F58F64.
20. National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. London: NICE; (accessed August 5, 2008).
21. Oostenbrink R, Moll H, Essink-Bot M. The EQ-5D and the Health Utilities Index for permanent sequelae after meningitis: A head-to-head comparison. J Clin Epidemiol. 2002;55:791799.
22. Pineda R. Breastfeeding practices in the neonatal intensive care unit before and after an intervention plan. Gainesville: University of Florida; 2006. p 99.
23. Quigley M, Cumberland P, Cowden J, Rodrigues L. How protective is breastfeeding against diarrhoeal disease in infants in 1990 England? A case-control study. Arch Dis Child. 2005;91:245250.
24. Redshaw M, Hamilton K. Networks, admissions and transfers: The perspectives of networks, neonatal units and parents. Oxford: National Perinatal Epidemiology Unit; 2006.
25. Renfrew M, Craig D, Dyson L, et al. Breastfeeding promotion for infants in neonatal units: A systematic review and economic analysis. Health Technol Assess. 2009;13:1146.
26. Renfrew M, Dyson L, McCormick F et al. , Breastfeeding promotion for infants in neonatal units: A systematic review. Child Care Health Dev. [Epub ahead of print].
27. Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers’ own milk in the feeding of extremely premature infants. Pediatrics. 2005;116:400406.
28. Sisk P, Lovelady C, Dillard R, Gruber K. Lactation counseling for mothers of very low birth weight infants: Effect on maternal anxiety and infant intake of human milk. Pediatrics. 2006;117:e67e75.
29. Stoll B, Hansen N, Adams-Chapman I, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA. 2004;292:23572365.
30. Stoll B, Hansen N, Fanaroff A, et al. Late-onset sepsis in very low birth weight neonates: The experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110:285291.
31. Townsend C, Cortina-Borja M, Peckham C, et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS. 2008;22:973981.
32. Trotter C, Edmunds W. Modelling cost effectiveness of meningococcal serogroup C conjugate vaccination campaign in England and Wales. BMJ. 2002;324:809.
33. Vohr B, Poindexter B, Dusick A, et al. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics. 2006;118:e115e123.
34. Vohr B, Poindexter B, Dusick A, et al. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics. 2007;120:e953e959.
35. World Health Organization. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
UNKNOWN
Supplementary Materials

Rice et al. supplementary material
Tables and figure

 Unknown (23 KB)
23 KB

Metrics

Full text views

Total number of HTML views: 5
Total number of PDF views: 26 *
Loading metrics...

Abstract views

Total abstract views: 439 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th November 2017. This data will be updated every 24 hours.