Infant Feeding Mode Predicts the Costs of Healthcare Services in One Region of Canada: a Data Linkage Study

Background Few studies have examined the association between infant feeding mode (IFM) and costs related to healthcare service use (HSU) in Canada. The aim of this study is to evaluate differences in HSU and its associated costs by IFM, in an infant’s first year of life in one region of Newfoundland and Labrador, Canada.Methods Data from a prospective cohort study were linked to administrative databases to examine HSU during an infant’s first year of life. The cohort study collected information on peri- and postnatal variables, including IFM during three stages that covered pregnancy through the first year postnatally. Consenting mothers provided their infants health insurance number for a data linkage to examine HSU by the infant. Outcomes included: hospital admissions, emergency room, family doctor and specialist visits. IFM was categorized as exclusively breastfed, mixed fed and exclusively formula fed. Descriptive statistics and multivariate analysis were performed to examine the relationship between IFM, maternal and child characteristics and costs associated with HSU.Results The sample included 160 mother infant dyads who consented to the data linkage. Mothers were Caucasian (95.6%), 26 years or older (95%), partnered (97.5%), living in a household with income greater than $30,000 CAN (98.1%) with a post-secondary education (97.5%). At one month 67% were exclusively breastfeeding, 20% were mixed feeding, and 13% were exclusively formula feeding. Overall $315,235 was spent on healthcare service use for the sample of healthy full-term infants during their first year of life. Generalized linear modelling was performed to assess the effect of IFM on costs associated with HSU adjusting for confounders. When compared to exclusive breastfeeding, exclusive formula and mixed feeding were found to be significant predictors of the total costs associated with HSU during the first year of life (p <0.05), driven by costs of hospital admissions.Conclusions Due to the human and economic burden associated with not breastfeeding, policies and programs that support and encourage breastfeeding should be a priority for governments and regional health authorities.