Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-28T20:06:41.268Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  15 April 2010

Stephen J. C. Rice
Affiliation:
University of York
Dawn Craig
Affiliation:
University of York
Felicia McCormick
Affiliation:
University of York
Mary J. Renfrew
Affiliation:
University of York
Anthony F. Williams
Affiliation:
University of London

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.

Type
ASSESSMENTS
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. BLISS. Breastfeeding or expressing for a sick or premature baby. An overview of 500 women's experiences. London: BLISS; 2008.Google Scholar
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).Google Scholar
3. Breastmilk Banking Working Group. Report submitted to the Department of Health. Unpublished. London: Department of Health; 2005.Google Scholar
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.CrossRefGoogle Scholar
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).Google Scholar
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.Google Scholar
7. Department of Health. Reference costs 2006–2007. London: Department of Health; 2008 (accessed April 9, 2008).Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
10. Guthrie, S, Gordon, P, Thomas, V, et al. Necrotizing enterocolitis among neonates in the United States. J Perinatol. 2003;23:278285.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
12. HM Government. PSA Agreement 12: Improve the health and wellbeing of children and young people. London: The Stationery Office; 2007.Google Scholar
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).Google Scholar
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.Google Scholar
15. Joint United Nations Programme on HIV/AIDS. 2008 report on the global AIDS epidemic. Geneva: UNAIDS; 2008.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
18. Lucas, A, Cole, T. Breast milk and neonatal necrotising enterocolitis. Lancet. 1990;336:15191523.CrossRefGoogle ScholarPubMed
19. Luck, S, Sharland, M. Postnatal cytomegalovirus: Innocent bystander or hidden problem? Arch Dis Child Fetal Neonatal Ed. 2009;94:F58F64.CrossRefGoogle ScholarPubMed
20. National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. London: NICE; (accessed August 5, 2008).Google Scholar
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.CrossRefGoogle ScholarPubMed
22. Pineda, R. Breastfeeding practices in the neonatal intensive care unit before and after an intervention plan. Gainesville: University of Florida; 2006. p 99.Google Scholar
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.CrossRefGoogle Scholar
24. Redshaw, M, Hamilton, K. Networks, admissions and transfers: The perspectives of networks, neonatal units and parents. Oxford: National Perinatal Epidemiology Unit; 2006.Google Scholar
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.CrossRefGoogle ScholarPubMed
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].Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
32. Trotter, C, Edmunds, W. Modelling cost effectiveness of meningococcal serogroup C conjugate vaccination campaign in England and Wales. BMJ. 2002;324:809.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
35. World Health Organization. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003.Google Scholar
Supplementary material: File

Rice et al. supplementary material

Tables and figure

Download Rice et al. supplementary material(File)
File 23.4 KB