NDLI: The costs of suboptimal breastfeeding in Ontario, Canada, and potential healthcare resource impacts from improving rates: a pediatric health system costing analysis

Content Provider	Springer Nature : BioMed Central
Author	Onah, Nnachebe Michael Hoy, Sandra Slofstra, Kathleen
Abstract	Background Human milk from the breast is the healthiest option for infants. Other sources of nutrition pose some risk to child, maternal, and environmental health. There are significant costs to suboptimal rates of breastfeeding for children, families and society. Over 92% of mothers in Ontario, Canada initiate breastfeeding, yet exclusivity and duration rates decline over time. This study estimates potential pediatric healthcare cost savings from increased exclusive breastfeeding. Methods We conducted a cost-effectiveness analysis to compare healthcare savings from enhanced breastfeeding rates against current practices by estimating pediatric healthcare costs associated with suboptimal breastfeeding and potential savings from improved rates. Savings are calculated from reduced incidence of childhood illnesses associated with breastfeeding, including lower respiratory tract infections (LRTI), gastrointestinal infections (GII), acute otitis media (AOM), acute lymphoblastic leukemia (ALL), necrotizing enterocolitis (NEC), childhood obesity, and asthma. Cost data were drawn from Canadian healthcare sources, supplemented with data from the UK and other international studies. We used initiation and exclusive breastfeeding rates at hospital discharge and six months postpartum. The study assumes that the incidence of preventable conditions like LRTI, GII, and AOM is directly related to breastfeeding rates at these time points. A six-month threshold for exclusive breastfeeding, recommended by the World Health Organization, was selected for analysis. Partial breastfeeding rates were not separately modeled due to data limitations. Results Improving exclusive breastfeeding (EBF) rates at six months to match rates at hospital discharged and initiation rates could result in 47,114–91,457 fewer cases of LRTI, GII, and AOM, prevent 3,685–7,096 hospitalizations, and reduce 22,043–47,621 outpatient visits. Increased EBF rates could prevent cases of NEC (37–67), ALL (3–6), childhood obesity (1,199–2,661), and asthma (970–2,111). Suboptimal breastfeeding at 6 months for infants born in Ontario in 2019 cost the healthcare system US $72.2 million annually for treating four childhood illnesses and US $61.0 million for long-term conditions (ALL, obesity, and asthma). Increasing breastfeeding rates could save US $32–63 million in annual treatment costs and US $23.6–51.6 million in long-term healthcare costs. Conclusions Suboptimal breastfeeding rates impose a burden on the health of families and Ontario’s healthcare system. Supporting breastfeeding through evidence-based interventions could reduce this burden through lowering pediatric healthcare demands.
Related Links	https://internationalbreastfeedingjournal.biomedcentral.com/counter/pdf/10.1186/s13006-025-00702-y.pdf
Ending Page	16
Page Count	16
Starting Page	1
File Format	HTM / HTML
ISSN	17464358
DOI	10.1186/s13006-025-00702-y
Journal	International Breastfeeding Journal
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2025-02-22
Access Restriction	Open
Subject Keyword	Maternal and Child Health Suboptimal breastfeeding rates Canadian healthcare cost analysis
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology Pediatrics, Perinatology and Child Health
Journal Impact Factor	2.9/2023
5-Year Journal Impact Factor	3.6/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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