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Mothers' milk has adapted through evolution to meet the needs of the healthy newborn infant, by supporting its survival, growth and development. Mother’s milk is unique in providing all of the components an infant needs: macronutrients, micronutrients, developmental factors, bacteria that become part of the gut microflora and even stem cells.
Although scientists have already found thousands of human milk components, new ones are continuously being discovered. These components, their complex interactions, and their bioactive role in infants are unique to human milk, making it irreproducible. That is why breastfeeding has such a powerful impact on infant health, compared to formula feeding.
Human milk also lowers the rate of some of the most serious complications in newborns, and significantly improves an infant’s short-term and long-term health.1
Better health and an improved quality of life also lead to economicadvantages through lowered hospital and healthcare costs and higher productivity.2
It is well known and accepted by researchers and medical practitioners that breastfeeding provides infants and mothers with maximum benefits which last a lifetime. Compared to formula-fed infants, infants who receive human milk experience significant nutritional advantages, lower risk of infection and chronic disease, and improved gastrointestinal maturation and neurodevelopment.
"Mother's milk is food, medicine and signal"
Katie Hinde, TED talk
Mothers who breastfeed also benefit significantly from reduced risk of breast and ovarian cancer.
"Every year, breastfeeding could save the lives of 823,000 children below fixe years old, and 20,000 mothers."1
Preterm infants
Among infants that are born too early or too small, feeding human milk reduces the risk for some of the most devastating complications, which are often chronic or lead to rehospitalisation, lifelong disabilities, deficits in life quality and even early death. A detailed analysis of the health and economic benefits of human milk for preterm infants can be found here.5
"If human milk was considered a medicine, its cost-effectiveness would not be doubted."
James Mahon Economist, YHEC
Considering the lifelong health benefits of human milk, it becomes clear that breastfeeding must also provide an enormous economic value. This value reaches far beyond individual infants, their families, or single hospitals. Increased breastfeeding positively affects the entire healthcare system by providing direct and indirect cost savings, and it benefits society by improving productivity and overall quality of life.
Suboptimal breastfeeding rates in the US are associated with USD 3 billion in direct medical costs, USD 1.3 billion for non-medical costs and USD 14.2 billion for premature maternal and child death costs.9
The improved cognitive development through feeding all infants breast milk for the first 6 months of life would lead to a worldwide increase of USD 302 billion (EUR 260 billion) in gross national products.2
Increasing breastfeeding rates for the first 6 months of life by 10% would translate into savings of USD 351.6 million (EUR 303.1 million) in childhood disorder treatments in the US, UK, urban China and Brazil.2
The health benefits of human milk feeding are even greater for preterm and low birthweight infants, and the economic benefits are proportional to that.
Preterm and low birthweight infants
The York Health Economic consortium conducted a meta-study of all published clinical outcomes and associated costs for premature infants in the UK10 and Germany. They modelled the cost savings and the increase in productivity from feeding a preterm infant human milk instead of formula, and applied this model to the English and German healthcare systems and economies. The entire detailed analysis can be found here.5
"Preterm birth accounts for almost half (47%) of the costs for all infant hospitalisations in the USA."10
The results are clear: On average, in England and Germany every preterm infant who receives human milk instead of formula contributes direct healthcare cost savings of EUR 1 356.54 (USD 1 573) and increases national productivity by EUR 3 425 (USD 3 973).5
For Germany, and England and Wales, the combined economic benefits are powerful:
In the United States, Johnson et al. published a series of health and economic analyses of very low birth weight (VLBW) infants. They measured the direct healthcare costs that could be saved at the Rush University Medical Center (USA) by increasing human milk from a low dose to a high dose:
For every VLBW infant, the increase in human milk dose from below 25 ml/kg/day to over 50 ml/kg/day saved USD 31 514 (EUR 27 167) by reducing the incidence of sepsis.11
For Necrotising Enterocolitis (NEC), published hospital costs were USD 8 167 (EUR 7 041) higher for formula-fed infants than for infants receiving human milk.12
The average costs of a case of Bronchopulmonary Dysplasia (BPD) is USD 41 929 (EUR 36 146) in the US. A reduction by 63% in odds of BPD can be achieved by feeding 100% own mothers milk to VLBW infants. This results in an average cost reduction of USD 7 925 for each VLBW infant that receives 100% own mother's milk instead of no own mother's milk.7
Ultimately, these benefits make every individual a stakeholder in breastfeeding. Insurers, governments and society should support mothers and healthcare professionals in their effort to provide breastmilk to all infants.
Disclaimer
To convert the economic numbers from the original references' currency, the following conversion rate was used: 1.00 EUR = 1.16 USD (November 6, 2017)
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