Infant Feeding in Leicester City - East Midlands Public Health ...

34model has been applied specifically to peer support interventions it is noted that it could usefully be appliedto other interventions designed to increase breastfeeding initiation and prevalence. The model uses a“what if” approach where by the potential cost savings are calculated based on the relationship betweenbreastfeeding and health outcomes reported in the academic literature. Health outcomes are used wherebreastfeeding has been shown to provide significant benefits. As a result NICE have adopted a threshold of£20,000 to £30,000 per QALY (Quality Adjusted Life Year) gained for breastfeeding interventions to beconsidered cost effective. This measure takes into account both the actual cost savings to the NHS andplaces a value upon the improvement in individual quality of life gained through avoiding illness. This figureis estimated to represent achieving an increase of 15 percentage points in breastfeeding initiation rates.Battersby et.al(46) reviewed the cost effectiveness of a breastfeeding peer support intervention in Sheffield(UK) where women who have successfully breastfed are trained to offer support and encouragement tonew mothers. This intervention resulted in a significant increase in breastfeeding initiation as comparedwith previous rates in the same area from 22% to 49%. An assessment of the cost-effectiveness wasperformed and showed that the potential savings to the NHS by reducing the incidence of admission tohospital, gastroenteritis, respiratory infections and otitis media per year alone were enough to roughly equalthe cost of the intervention. When other potential savings are taken in to account, the authors contend thatthe implementation of peer support initiatives is financially valuable.A review and analysis of the economic benefits of breastfeeding in the USA(47) also discusses the impactof increasing breastfeeding in terms of potential cost savings from reducing the incidence of otitis media,gastroenteritis and necrotizing enterocolitis. The potential cost savings were estimated based on publisheddata and included prevention of premature death, medical costs and indirect costs such as parental loss ofearnings. The review concludes that an estimated saving of $3.6 billion per year could be made ifbreastfeeding was increased from current levels (64% initiation and 29% at 6 months) to the ratesrecommended by the U.S. Surgeon General (75% and 50% respectively).A systematic review by the Cochrane Collaboration(48) looking at support for breastfeeding mothersexamined 34 studies from 14 countries and found that both professional and lay or peer support wereeffective for increasing both breastfeeding initiation rates and duration of exclusive or any breastfeeding.The effect of support on overall breastfeeding was found to be greatest in areas where initial rates ofbreastfeeding were between 40% and 80% and a greater effect was found in increasing exclusivebreastfeeding than any breastfeeding up to five months. Although no assessment was made in this reviewof cost-effectiveness it may be concluded in view of the NICE guidance that interventions which increasebreastfeeding are likely to reduce poor outcomes and therefore reduce costs. This is also true for a second