The Economic Impact of Donor Milk in the Neonatal Intensive Care Unit

To assess the cost-effectiveness of mother's own milk supplemented with donor milk vs mother's own milk supplemented with formula for infants of very low birth weight in the neonatal intensive care unit (NICU). A retrospective analysis of 319 infants with very low birth weight born before...

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Bibliographic Details
Published in:The Journal of pediatrics 2020-09, Vol.224, p.57-65.e4
Main Authors: Johnson, Tricia J., Berenz, Andrew, Wicks, Jennifer, Esquerra-Zwiers, Anita, Sulo, Kelly S., Gross, Megan E., Szotek, Jennifer, Meier, Paula, Patel, Aloka L.
Format: Article
Language:English
Subjects:
Breast Feeding - economics
Cost-Benefit Analysis
cost-effectiveness
donor milk program
healthcare costs
hospital costs
Humans
Infant Formula - economics
Infant, Newborn
Infant, Premature, Diseases - prevention & control
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal - economics
Milk Banks - economics
Milk, Human
mother's own milk
necrotizing enterocolitis
Retrospective Studies
very low birth weight
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Summary:To assess the cost-effectiveness of mother's own milk supplemented with donor milk vs mother's own milk supplemented with formula for infants of very low birth weight in the neonatal intensive care unit (NICU). A retrospective analysis of 319 infants with very low birth weight born before (January 2011-December 2012, mother's own milk + formula, n = 150) and after (April 2013-March 2015, mother's own milk + donor milk, n = 169) a donor milk program was implemented in the NICU. Data were retrieved from a prospectively collected research database, the hospital's electronic medical record, and the hospital's cost accounting system. Costs included feedings and other NICU costs incurred by the hospital. A generalized linear regression model was constructed to evaluate the impact of feeding era on NICU total costs, controlling for neonatal and sociodemographic risk factors and morbidities. An incremental cost-effectiveness ratio was calculated for each morbidity that differed significantly between feeding eras. Infants receiving mother's own milk + donor milk had a lower incidence of necrotizing enterocolitis (NEC) than infants receiving mother's own milk + formula (1.8% vs 6.0%, P = .048). Total (hospital + feeding) median costs (2016 USD) were $169 555 for mother's own milk + donor milk and $185 740 for mother's own milk + formula (P = .331), with median feeding costs of $1317 and $936, respectively (P 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2020.04.044