Stuebe Alison M, Jegier Briana J, Schwarz Eleanor Bimla, Green Brittany D, Reinhold Arnold G, Colaizy Tarah T, Bogen Debra L, Schaefer Andrew J, Jegier Jamus T, Green Noah S, Bartick Melissa C
1 Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
2 Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
Breastfeed Med. 2017 Dec;12(10):645-658. doi: 10.1089/bfm.2017.0083. Epub 2017 Sep 14.
We sought to determine the impact of changes in breastfeeding rates on population health.
We used a Monte Carlo simulation model to estimate the population-level changes in disease burden associated with marginal changes in rates of any breastfeeding at each month from birth to 12 months of life, and in rates of exclusive breastfeeding from birth to 6 months of life. We used these marginal estimates to construct an interactive online calculator (available at www.usbreastfeeding.org/saving-calc ). The Institutional Review Board of the Cambridge Health Alliance exempted the study.
Using our interactive online calculator, we found that a 5% point increase in breastfeeding rates was associated with statistically significant differences in child infectious morbidity for the U.S. population, including otitis media (101,952 cases, 95% confidence interval [CI] 77,929-131,894 cases) and gastrointestinal infection (236,073 cases, 95% CI 190,643-290,278 cases). Associated medical cost differences were $31,784,763 (95% CI $24,295,235-$41,119,548) for otitis media and $12,588,848 ($10,166,203-$15,479,352) for gastrointestinal infection. The state-level impact of attaining Healthy People 2020 goals varied by population size and current breastfeeding rates.
Modest increases in breastfeeding rates substantially impact healthcare costs in the first year of life.
我们试图确定母乳喂养率的变化对人群健康的影响。
我们使用蒙特卡洛模拟模型来估计从出生到12个月龄期间任何母乳喂养率的微小变化以及从出生到6个月龄期间纯母乳喂养率的微小变化所导致的疾病负担的人群水平变化。我们利用这些边际估计值构建了一个交互式在线计算器（可在www.usbreastfeeding.org/saving-calc上获取）。剑桥健康联盟机构审查委员会豁免了该研究。
使用我们的交互式在线计算器，我们发现母乳喂养率提高5个百分点与美国人群儿童感染性发病率的统计学显著差异相关，包括中耳炎（101,952例，95%置信区间[CI]77,929 - 131,894例）和胃肠道感染（236,073例，95%CI 190,643 - 290,278例）。中耳炎相关的医疗费用差异为31,784,763美元（95%CI 24,295,235 - 41,119,548美元），胃肠道感染为12,588,848美元（10,166,203 - 15,479,352美元）。实现《健康人民2020》目标对各州的影响因人口规模和当前母乳喂养率而异。
母乳喂养率适度提高对生命第一年的医疗保健成本有重大影响。
