title: The initial maternal cost of providing 100 mL of human milk for very low birth weight infants in the neonatal intensive care unit.
abstract: OBJECTIVE
  Human milk (HM) feeding is associated with lower incidence and severity of costly prematurity-specific morbidities compared to formula feeding in very low birth weight (VLBW; <1,500 g) infants. However, the costs of providing HM are not routinely reimbursed by payers and can be a significant barrier for mothers. This study determined the initial maternal cost of providing 100 mL of HM for VLBW infants during the early neonatal intensive care unit (NICU) stay.
  
  
  METHODS
  This secondary analysis examined data from 111 mothers who provided HM for their VLBW infants during the early NICU stay. These data were collected during a multisite, randomized clinical trial where milk output and time spent pumping were recorded for every pumping session (n = 13,273). The cost analysis examined the cost of the breast pump rental, pump kit, and maternal opportunity cost (an estimate of the cost of maternal time).
  
  
  RESULTS
  Mean daily milk output and time spent pumping were 558.2 mL (SD = 320.7; range = 0-2,024) and 98.7 minutes (SD = 38.6; range = 0-295), respectively. The mean cost of providing 100 mL of HM varied from $2.60 to $6.18 when maternal opportunity cost was included and from $0.95 to $1.55 when it was excluded. The cost per 100 mL of HM declined with every additional day of pumping and was most sensitive to the costs of the breast pump rental and pump kit.
  
  
  CONCLUSIONS
  These findings indicate that HM is reasonably inexpensive to provide and that the maternal cost of providing milk is mitigated by increasing milk output over the early NICU stay.
authors.affiliation: Department of Women, Children and Family Nursing, Rush University Medical Center, Chicago, Illinois 60612, USA. briana_j_jegier@rush.edu
authors.forename: Briana J
authors.initials: BJ
authors.lastname: Jegier
authors.forename: Paula
authors.initials: P
authors.lastname: Meier
authors.forename: Janet L
authors.initials: JL
authors.lastname: Engstrom
authors.forename: Timothy
authors.initials: T
authors.lastname: McBride
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D041943:Infant Formula / Q000191:economics; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D007774:Lactation / Q000502:physiology*; D008297:Male; D017784:Milk Banks / Q000191:economics; D008895:Milk, Human / Q000378:metabolism*; D009035:Mothers / Q000523:psychology; D013396:Suction / Q000191:economics / Q000295:instrumentation