The burden of suboptimal breastfeeding in Mexico: Maternal health outcomes and costs

Matern Child Nutr. 2019 Jan;15(1):e12661. doi: 10.1111/mcn.12661. Epub 2018 Aug 23.

Abstract

Longer duration of breastfeeding is associated with a lower risk of type 2 diabetes, breast and ovarian cancer, myocardial infarction, and hypertension diseases in women. Mexico has one of the lowest breastfeeding rates worldwide; therefore, estimating the disease and economic burden of such rates is needed to influence public policy. We considered suboptimal breastfeeding when fewer than 95% of parous women breastfeed for less than 24 months per child, according to the World Health Organization recommendations. We quantified the lifetime excess cases of maternal health outcomes, premature death, disability-adjusted life years, direct costs, and indirect costs attributable to suboptimal breastfeeding practices from Mexico in 2012. We used a static microsimulation model for a hypothetical cohort of 100,000 Mexican women to estimate the lifetime economic cost and disease burden of type 2 diabetes, breast and ovarian cancer, myocardial infarction, and hypertension in mothers, due to suboptimal breastfeeding, compared with an optimal scenario of 95% of parous women breastfeeding for 24 months. We expressed cost in 2016 USD. We used a 3% discount rate and tested in sensitivity analysis 0% and 5% discount rates. We found that the 2012 suboptimal scenario was associated with 5,344 more cases of all analysed diseases, 1,681 additional premature deaths, 66,873 disability-adjusted life years, and 561.94 million USD for direct and indirect costs over the lifetime of a cohort of 1,116 million Mexican women. Findings suggest that investments in strategies to enable more women to optimally breastfeed could result in important health and cost savings.

Keywords: Mexico; burden of disease; economic costs; maternal health; microsimulation; suboptimal breastfeeding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding / statistics & numerical data*
  • Cohort Studies
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Maternal Health* / economics
  • Maternal Health* / ethnology
  • Maternal Health* / statistics & numerical data
  • Mexico / ethnology
  • Mothers
  • Neoplasms
  • Quality-Adjusted Life Years