title: [Economic analysis of specialised and intensive promotion of breastfeeding in neonatal units in Spain].
abstract: BACKGROUND
  Although breastfeeding (BF) is the ideal food for newborns because it covers their growing needs and provides active immunity against various diseases, it is often replaced by artificial feeding. We estimated the cost-effectiveness of increased promotion of BF in neonatal units with intensive intervention with specialised nurses or midwives dedicated to this purpose.
  
  
  METHODS
  An analysis of cost-effectiveness, using a decision analysis model which included data on a specialised intervention for the promotion of BF, its effectiveness in the short-term (sepsis, necrotizing enterocolitis) and long-term (disabled due to neurodevelopmental impairment) of the different types of milk consumed, as well as the mortality, costs and benefits of these. Data was also obtained from current medical literature, studies and Spanish sources. The analysis was limited to three subgroups of low birthweights (500-999g, 1000-1749g, 1750-2500g).
  
  
  RESULTS
  In the deterministic analysis, the intervention was "dominant" for the three subgroups of infants, which meant it was more effective and with lower costs, than no intervention. The Monte Carlo probabilistic analysis confirmed the robustness of the result with probabilities of dominance of 100%, 100% and 99.9% for the three subgroups of weights, respectively. The intervention would be cost-effective with costs of puerperal intervention of € 70,504, € 14,742 and € 7,106, respectively. These costs would be well above the estimated maximum (€ 12.51).
  
  
  CONCLUSIONS
  According to this model, the promotion of breastfeeding through an intensive promotion and with specialised nurses or midwives dedicated to this purpose, may be cost-effective in the case of puerperal women with low birth weight neonates (500-2500g).
authors.affiliation: Health Value, Madrid, España. drubiorodriguez@Healthvalue.Org
authors.forename: D
authors.initials: D
authors.lastname: Rubio-Rodríguez
mesh_terms: D001942:Breast Feeding / Q000191:economics*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D006293:Health Promotion / Q000191:economics* / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D009725:Nurseries, Hospital; D013030:Spain