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墨西哥婴儿母乳喂养不足的成本。

The costs of inadequate breastfeeding of infants in Mexico.

机构信息

From the Center for Research on Health Systems, National Institute of Public Health (NIPH), Cuernavaca, Mexico (MAC and DC-L); the Center for Research on Infectious Diseases, NIPH (HL-G); and Nutrition and Health Research Center, NIPH (TGdC).

出版信息

Am J Clin Nutr. 2015 Mar;101(3):579-86. doi: 10.3945/ajcn.114.092775. Epub 2015 Jan 7.

Abstract

BACKGROUND

Breastfeeding is vital for child survival, health, and development. Mexico has very low rates of breastfeeding and experienced a severe decrease in the prevalence of exclusive breastfeeding from 21% in 2006 to 14% in 2012.

OBJECTIVE

The objective of the article was to estimate the pediatric costs of inadequate breastfeeding in Mexico associated with the following acute health conditions: respiratory infections, otitis media, gastroenteritis, necrotizing enterocolitis (NEC), and sudden infant death syndrome (SIDS).

DESIGN

The authors estimated the economic costs of inadequate breastfeeding as follows: the sum of direct health care costs for diseases whose risk increases when infants are non-exclusively breastfed <6 mo or are not breastfed from ages 6 to <11 mo, lost future earnings due to premature infant death, and the costs of purchasing infant formula. Incidence cases were retrieved from national surveillance systems, except for NEC and SIDS, which were estimated from the literature. A sensitivity analysis was carried out to provide a range of costs based on different assumptions of the number of incident cases of all infant health outcomes examined. The model applied to the cohort of 1-y-old children born in 2012.

RESULTS

The total annual costs of inadequate breastfeeding in Mexico for the studied cohort ranged from $745.6 million to $2416.5 million, where the costs of infant formula accounted for 11-38% of total costs. A range of 1.1-3.8 million reported cases of disease and from 933 to 5796 infant deaths per year for the diseases under study are attributed to inadequate infant breastfeeding practices; altogether these represent nearly 27% of the absolute number of episodes of such diseases.

CONCLUSIONS

This study provides costs of inadequate breastfeeding that had not been quantified in Mexico. The costs presented in this article provide the minimum amount that the country should invest to achieve better breastfeeding practices.

摘要

背景

母乳喂养对儿童的生存、健康和发展至关重要。墨西哥的母乳喂养率非常低,2006 年至 2012 年期间,纯母乳喂养的比例从 21%急剧下降至 14%。

目的

本文旨在评估墨西哥因母乳喂养不足而导致的以下几种儿科疾病的经济负担:呼吸道感染、中耳炎、肠胃炎、坏死性小肠结肠炎(NEC)和婴儿猝死综合征(SIDS)。

方法

作者通过以下方式来估计因母乳喂养不足导致的经济负担:非纯母乳喂养 <6 个月或 6 至 <11 个月未母乳喂养的婴儿患某些疾病的直接医疗费用总和、因早产死亡而导致的未来收入损失以及购买婴儿配方奶粉的费用。通过国家监测系统获取了发病率数据,除 NEC 和 SIDS 之外,这两种疾病的数据均来自文献。进行了敏感性分析,以根据所有研究婴儿健康结果的发病例数的不同假设提供成本范围。该模型适用于 2012 年出生的 1 岁儿童队列。

结果

在墨西哥,为研究队列中的儿童提供充足的母乳喂养,每年的总成本在 74560 万美元至 241650 万美元之间,其中婴儿配方奶粉的费用占总成本的 11%-38%。每年与婴儿母乳喂养不足相关的疾病报告病例数在 110 万至 380 万例之间,婴儿死亡人数为 933 至 5796 例,这些疾病的发生都归因于婴儿母乳喂养不足;所有这些疾病的绝对病例数约占 27%。

结论

本研究提供了墨西哥母乳喂养不足的成本数据。本文提出的成本为该国实现更好的母乳喂养实践所应投入的最低金额。

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