Economic Benefit of Breast-Feeding Infants Enrolled in WIC

    Address correspondence to: Debbie L. Montgomery, MPH, RD, Colorado Department of Public Health and Environment Special Supplemental Nutrition Program for Women, Infants, and Children, FCHS-NS-A4, 4300 Cherry Creek Dr S, Denver, CO 80222.
    D. L. Montgomery is the breast-feeding promotion coordinator with the Colorado Department of Public Health and Environment Special Supplemental Nutrition Program for Women, Infants, and Children, USA.
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    P. L. Splett is a consultant in evaluation and cost-effectiveness analysis with Splett and Associates, St Paul, Minn. At the time of the study, she was an assistant professor in the School of Public Health, University of Minnesota, Minneapolis, USA.
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      Objectives To determine whether breast-feeding of infants enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is associated with a reduction in Medicaid expenditures during the first 6 months of life; if so, to determine whether the reduction in Medicaid expenditures represents a positive economic benefit to society when WIC costs for these infants and their mothers are considered.
      Design Cohorts of exclusively breast-fed and formula-fed infants were tracked for 6 months to compare WIC costs and Medicaid expenditures.
      Subjects The sample consisted of 406 healthy infants who were breast-fed exclusively for at least 3 months and 470 healthy infants who were formula-fed exclusively. The infants, born between August 1, 1993, and December 31, 1993, were enrolled in WIC and Medicaid.
      Cost and benefit measures WIC costs included redeemed WIC vouchers for formula and foods for infants and mothers, plus administrative expenses for 6 months, minus manufacturers' rebates for formula. Benefit was determined from Medicaid expenditures for health care initiated in the first 180 days of each infant's life.
      Statistical and benefit-cost analyses Economic benefit was calculated as net benefit and as benefit-cost ratios. Regression techniques were used to estimate Medicaid expenditures associated with breast-feeding, adjusted for demographic and prenatal care variables.
      Results Compared with formula-feeding, breast-feeding each infant enrolled in WIC saved $478 in WIC costs and Medicaid expenditures during the first 6 months of the infant's life, or $161 after consideration of the formula manufacturer's rebate. A Medicaid cost saving of $112 per infant was realized by the breast-feeding cohort, and Medicaid pharmacy reimbursement costs for breast-fed infants were significantly lower—half that of formula-fed infants.
      Applications The promotion of breast-feeding among low-income populations through nutrition programs such as WIC is an effective cost-containment measure. J Am Diet Assoc. 1997;97:379–385.
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