Economics of home vs. hospital breastfeeding support for newborns

Aim. This paper presents the findings of research comparing the incremental costs associated with the provision of home‐based vs. hospital‐based support for breastfeeding by nurse lactation consultants for term and near‐term neonates during the first week of life. Background. A consequence of both consumer demands and increasing health resource constraints is that alternative care delivery models for safe, efficacious and cost‐effective breastfeeding programmes have steadily evolved. To date, the economic impact of the setting (home or hospital) where lactation support is delivered has received little research attention. Methods. Mother–infant dyads were stratified by gestational age as term (>37 weeks gestational age; n = 101) or near term (35–37 weeks gestational age; n = 37) and randomized to standard hospital care and postpartum follow‐up (standard care), or to standard hospital care plus home support from certified nurse lactation consultants (experimental). Data collection occurred at study entry, hospital discharge and at a seventh day postpartum follow‐up session. Costs to the family (out‐of‐pocket and time costs) and to the healthcare system (during hospitalization and after hospital discharge) were measured. Total societal costs were defined as the sum of both family and healthcare system costs. Results. Compared with standard hospital‐based care, home support by nurse lactation consultants showed no statistically significant differences in either time costs to the family or total societal costs. Term infants who received home support had statistically significantly greater postdischarge system costs (P