The costs of inadequate breastfeeding of infants in Mexico.
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).


METHODS
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.
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).
M Arantxa
MA
Colchero
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).
David
D
Contreras-Loya
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).
Hugo
H
Lopez-Gatell
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).
Teresita
T
González de Cosío
D000328:Adult; D001942:Breast Feeding / Q000191:economics; D002657:Child Development; D015331:Cohort Studies; D017281:Cost of Illness; D020345:Enterocolitis, Necrotizing / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D062665:Epidemiological Monitoring; D005260:Female; D005759:Gastroenteritis / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D017048:Health Care Costs; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D007223:Infant; D041943:Infant Formula / Q000191:economics; D007226:Infant Mortality; D008297:Male; D008800:Mexico / Q000453:epidemiology; D018673:Nutrition Policy; D009749:Nutrition Surveys; D010033:Otitis Media / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D010349:Patient Compliance; D012141:Respiratory Tract Infections / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D013398:Sudden Infant Death / Q000453:epidemiology
Mexico; cost analysis; inadequate breastfeeding; infant morbidity; infant mortality