Cut Healthcare Costs By Breastfeeding

1994-1995 RESEARCH

Kaiser Permanente, one of the United States' largest and most successful HMOs (Health Maintenance Organizations) recently conducted internal research to determine the value of providing a lactation support program for their members in the North Carolina region. The following study is a re-print of their findings. (All funds are in U.S. dollars).

The bottom line is this:

Piggybank Infants who were breastfed for a minimum of 6 months experienced $1,435.00 less health care claims than formula fed infants.


"Healthy people 2000" goals for breastfeeding in the United States include "Increase to at least 75% the proportion of mothers who breast-feed their babies in the early post-partum period and to at least 50% the proportion who continue breast-feeding unti l their babies are five to six months old." There is no reference to ethnic or socio-economic subgroups, but instead, the goals state that the nation as a whole can benefit from breastfeeding. Overcoming barriers to breastfeeding will require "public an d professional education and improving support from health care providers."

The savings of breastfeeding a baby for the first 6 months are just now being researched. Previous studies show unequivocally that breastfeeding decreases the incidence of the following:

    * gastrointestinal and urinary tract infections

    * lower respiratory tract illnesses

    * otitis media

    * bacterernia and meningitis

Breastfeeding has also been shown to lower infant mortality and reduce the frequency of certain chronic diseases later in life (i.e., insulin dependent diabetes, Crohns' Disease, ulcerative colitis and certain lymphomas). Among the benefits occurring to a mother who breastfeeds for 4-6 months are a lower risk of both breast and uterine cancer. It is logical to conclude that an increase in breastfeeding rates can save lives and can have a significant impact on our national health care budget. In other w ords, breast-feeding can be thought of as a low cost health improver.

In recent years, the incidence of breastfeeding has dropped from high of 62% in the mid '80's to a recent level of 57%. Research points to a variety of factors that may have a negative influence on breastfeeding rates. These include:

    * Increase in early discharge of new mothers from hospitals (hospitals are the new mothers' primary source of breastfeeding information)

    * Lack of follow up support from health care providers for lactation difficulties

    * Lack of consistent breastfeeding information from hospitals, medical offices and health care providers

    * More women in the workforce

    * Lack of "breast-feeding friendly" workplaces

    * Aggressive direct marketing of infant formula

Breastfeeding Support Program Objectives

    * To organize, deliver, manage and evaluate a program of educational/clinical lactation services that is fully integrated into the continuum of prenatal, intrapartum and postpartum care.

    * To provide lactation education/consultation by Board Certified Lactation Consultants during the prenatal, intrapartum and postpartum period.

    * To meet the equipment needs of members for rental and all breastfeeding products during the perinatal period.

    * To meet organizational goals of increased member satisfaction, decrease health care costs and increase provider satisfaction.

    * To educate Kaiser Permanente providers and staff who are in contact with breastfeeding families on how to manage clinical lactation problems.

    * To develop policies that support breastfeeding in the workplace. Provide on-site in the medical office a "Nursing" room for members and Kaiser employees to utilize for breastfeeding and pumping away from public view.

    * To address employer groups requests for information about worksite support for breastfeeding employees.

Anticipated Outcomes

    * TO LOWER MEDICAL CARE COSTS otherwise incurred through hospital admissions and frequent office visits due to results of improper breastfeeding or breastfeeding failure.

    * TO MEET CURRENT MEMBER DEMAND for lactation services and accommodate future growth (perinatal services are a valued and established marketing tool for engendering client loyalty among major health care organizations.)

    * TO MEET COMMUNITY STANDARDS and marketplace value in health care services.

    * TO OPTIMIZE LONG-TERM HEALTH of infants and women due to the health benefits of breastfeeding.

    * TO SUPPORT PROVIDERS in the care & management of breastfeeding mother/baby dyad.

    * TO INCREASE BREASTFEEDING WORKING EMPLOYEES' SATISFACTION and morale by implementing on-site breastpump room and support breastfeeding policies.

    * TO INCREASE MEMBER SATISFACTION by providing high quality care in the support and promotion of a mother's desire to breastfeed.


(North Carolina REGION, 1993)

Method of feeding at hospital discharge38%62%
Method of feeding at 6 mo74%26%
Avg # of office visits in first yr (includes 5 well-baby visits)$1162 per infant$714 per infant
Cost savings =$448 per infant/year

*Random chart review of 270 current members, WRMO & NBMO in 1992 and 1993

The most common reasons breast and bottle fed infants were brought in other than well baby visits were for the following:

    * otitis media

    * respiratory tract infections

    * viral infections

    * gastroenteritis

Both groups of infants were hospitalized in the first 6 months of 1993 for the following reasons regional)

    * respiratory tract infections-64%

    * urinary tract/gastrointestinal infections-34%

    * viral, perinatal, sepsis infections-23%

    * otitis-14%


Additional cost of bottle fed baby over cost of breastfed baby in the first year of life:


Current Experience10% Fewer bottle fed babies20% Fewer bottle fed babies
Total deliveries in 19932,1402,1402,140
Estimated percentage bottle fed74%64%54%
Total additional cost bottle fed$2,272,466$1,965,376$1,658,286

Estimated Potential Savings

1993 Deliveries10% fewer bottle fed babies20% Fewer bottle fed babies


Savings Categories

Additional Office Visits$ 448.00

Prescription Drugs 84.00

Hospitalizations 903.00



200 Bottle fed babies70 Breastfed babies
64 Discharges9 Discharges
$4,718 per discharge$4,718 Per discharge

Source: Kaiser Permanente; internal research to determine benefits of sponsoring an official lactation program.



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