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First UK study showing investment in breastfeeding could save NHS money
Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK was led by Professor Mary Renfrew and takes a detailed look at the costs of not breastfeeding in the UK.
We know that the majority of women stop breastfeeding before they wanted to; a shocking 90% of women in the first six weeks. This not only causes distress and increases costs for families, it also costs the NHS through more hospital admissions and GP consultations.
Taking just a few of the illnesses where breastfeeding is linked to a reduction in risk, the study found potential savings to the NHS from a moderate increase in breastfeeding of about £40 million each year, although the true cost savings are likely to be much higher. The report found that, even taking a conservative view, investing in improving breastfeeding support would provide a rapid financial return, with higher breastfeeding rates leading to greater savings.
Four categories of diseases were identified with different levels of available evidence. Reliable costs could only be modelled for a few of the conditions where not breastfeeding has been linked to an increased risk, so the costs are likely to be only a proportion of the potential savings.
Summary of the four groups
1) Clear evidence making economic modelling possible:
If 45% of babies were exclusively breastfed for four months, and 75% of babies were breastfed on discharge from neonatal units , each year there would be:
• 5,916 fewer babies in hospital with respiratory illness, and 22,248 fewer GP consultations, saving around £6.7 million
• 3,285 fewer babies in hospital with gastroenteritis and 10,637 fewer GP consultations, saving more than £3.6 million
• 21,045 fewer ear infection GP visits, saving £750,000
• 361 fewer cases of NEC, saving more than £6 million
If half of for first time mothers each year who currently don’t breastfeed were to do so for up to 18 months in their life, there would be:
• 865 fewer cases of breast cancer
• Cost savings to the NHS of over £21 million
• Improved quality of life equating to more than £10 million
2) Where evidence was good but not clear enough for full economic models, the authors considered three conditions to predict the likely impact of increasing breastfeeding rates. They estimate that:
• If the proportion of babies receiving breastmilk rose by 1% this could lead to a small increase in IQ so that, across the whole population, more than £278 million could be gained in economic productivity each year.
• A very modest increase in exclusive breastfeeding rates could lead to at least three fewer cases of Sudden Infant Death Syndrome annually, avoiding the loss of life and profound consequences for families and saving around £4.7 million.
• Increasing breastfeeding rates could lead to around a 5% reduction in childhood obesity, which would save around £1.6million each year.
3) Illnesses where research finds a plausible or likely link with not breastfeeding, but where the evidence is not suitable for reliable modelling. For example, although raised blood pressure and cholesterol levels in childhood are markers of future cardiac disease that are related to not being breastfed, it is not possible to calculate the costs of cardiac disease based on these markers alone.
This category includes diabetes (Type 2 for mothers and mainly Type 1 for children), cardiovascular disease, ovarian cancer, asthma, leukaemia, coeliac disease, and neonatal sepsis. These affect quality of life for many people and are a huge cost to the NHS so even a small reduction would have a considerable economic impact.
4) For these 45 conditions there is some evidence of breastfeeding providing protection, but the authors considered current data unreliable. This list also forms an agenda for future research.
The report makes it clear that, if health services invest in enabling women to breastfeed for as long as they want to, they would achieve a rapid return on investment, reduce illness and improve the quality of life for thousands of families.
NCT is joining UNICEF UK in calling UK Government and policy makers to recognise that:
• Breastfeeding is a major public health issue
• Low breastfeeding rates results in significant costs to the NHS
And respond accordingly by
1 Ensuring public services are fit for purpose, including:
• Breastfeeding to be a priority action for all Health and Wellbeing Boards / Local Health Boards/ Local Health and Social Care Trusts / Local NHS Boards.
• Effective implementation of Baby Friendly Initiative standards in maternity, neonatal, health visiting and children’s centre services.
• Development of pre-registration curriculums across health and early years to support the implementation of evidence practice for breastfeeding across health and early years services.
• Ensure that evidence-based information about the important impact of breastfeeding on the health of mothers and babies is readily available in the public domain including in the schools curriculum.
2 Strengthening legislation to protect breastfeeding, including:
• Full implementation of the International Code of Marketing of Breast-milk Substitutes and subsequent resolutions.
3 Supporting further research into:
• The impact of breastfeeding on health, in particular the extent of the burden of disease associated with low breastfeeding rates.