MedicalResearch.com Interview with:
Melissa C. Bartick, M.D.
Assistant Professor of Medicine
Department of Medicine, Cambridge Health Alliance, Cambridge
Harvard Medical School, Boston
MedicalResearch.com: What is the background for this study?
Response: There has never been a study that combined maternal and pediatric health outcomes and costs into a single model. My colleague Arnold Reinhold and I had published a pediatric study in 2010, which was widely publicized but needed to be updated. My colleagues and I published a maternal study in 2013. But the two studies had different methodologies, and so the total costs could not be simply added together.
Here, we wanted to get a picture of the impact of breastfeeding in the US public health as whole, by creating a single model that combined maternal and pediatric outcomes. That had never been done before.
MedicalResearch.com: What are the main findings?
Response: The main findings are that the public health outcomes and costs of suboptimal breastfeeding in the US remain significant. Because we are not supporting women to breastfeed for the duration and exclusivity that is recommended by medical authorities, our country has many excess cases of maternal and pediatric disease and death and associated costs. Most of the deaths and costs are from maternal disease. However, some pediatric diseases, such as ear infections and gastrointestinal infections, affect millions of people.
Some results are quite striking. For example only 55 women need to breastfeed optimally (a year for each child) to prevent on case of hypertension, and only 235 need to do so to prevent one heart attack. Only 597 women needed to breastfeed optimally (exclusive breastfeeding for 6 months with continued breastfeeding for 1 year) to prevent one maternal or child death. There are 3,3340 excess deaths annually in the US due to suboptimal breastfeeding, 78% of which are maternal. The biggest causes of excess deaths are heart attacks (986), breast cancer (838), and Sudden Infant Death Syndrome (492).
Medical costs total $3.0 billion and costs of premature death total $14.2 billion.
MedicalResearch.com: What should readers take away from your report?
Response: Breastfeeding is woman’s health issue. It has a much greater effect on women’s health than was previously appreciated.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: There has been a marked decline in infant mortality since 2010 for three of the diseases we studied (Necrotizing Enterocolitis, SIDS, lower respiratory tract infection which corresponds to the time when breastfeeding rates in the US rapidly started to increase. This decrease in mortality outpaces the decrease in overall infant mortality for the same period of time. It would be interesting to study exactly how much of the decrease in this mortality, mathematically, can be attributed to the increase in breastfeeding rates.
MedicalResearch.com: Is there anything else you would like to add?
Response: We know the vast majority of women want to breastfeed. Over 80% of US women initiate breastfeeding, yet other research shows that 60% of US women do not meet their own breastfeeding goals. It’s vitally important to help put policies in place to help women meet their own breastfeeding goals and to help women breastfeed each child for as long as they would like, for at least a year, or even longer if they want to. This would paid family leave, expanding workplace accommodations for nursing mothers, and greater public acceptance for breastfeeding in public. Finally, because breastfeeding is really a woman’s health issue, I hope this study puts an end to the “mommy wars.” Women should be informed and supported in their choices.
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Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs
Authors Melissa C. Bartick ,Eleanor Bimla Schwarz , Brittany D. Green ,Briana J. Jegier ,
Arnold G. Reinhold ,Tarah T. Colaizy , Debra L. Bogen ,Andrew J. Schaefer ,
Alison M. Stuebe
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