Friday, September 21, 2007

How Gordon Brown could save billions of pounds by protecting mothers and babies

Gordon Brown could save the UK economy billions of pounds by showing political leadership in the area of infant feeding. That’s the indication from a study in the United States, UK Government surveys and other information. Yet this fact is ignored in the draft Regulatory Impact Assessment produced by the Food Standards Agency as part of the consultation on revising formula marketing regulations. We are calling for the FSA to do a few sums.

According to the UK Government’s national infant feeding survey (page 221), 90% of mothers who stopped breastfeeding by 6 months said they had wanted to breastfeed for longer. If obstacles were removed and better support given, then we could expect them to have their wish. Breastfeeding rates are higher in almost all European countries, markedly so in Scandinavia where the aggressive marketing of formula that occurs in the UK is absent. In Brazil breastfeeding rates have recovered from median duration of less than 3 months to ten months because of government action.

According to the UK Department of Health, breastfed infants are less likely to develop gastric, respiratory and urinary tract infections, obesity in later childhood, juvenile-onset insulin-dependent diabetes and atopic disease.

And as I have been hearing at the International Milk Bank Conference in Chester these past two days, premature infants receiving breastmilk (either from their mother or donor milk from a bank, should they be fortunate to have that opportunity in our current postcode lottery of coverage) are less likely to develop Necrotising Enterocolitis and less likely to die from it if they do develop it.

This reduction in illness and death equates not only to less suffering, but savings for the economy.

A paper cited by the UNICEF Baby Friendly Hospital training for policy makers (Powerpoint presentation) states the following:

---Extract begins
This preliminary analysis of breastfeeding and formula feeding indicates that a minimum of $3.6 billion would be saved if the prevalence of exclusive breastfeeding increased from current rates (64 percent in-hospital, 29 percent at 6 months) to those recommended by the Surgeon General (75 and 50 percent, respectively).

This figure reflects approximately $3.1 billion attributable to preventing premature deaths, and an additional $0.5 billion annual savings associated with reducing traditional medical expenditures (for example, office or hospital visits, laboratory tests, etc.) and indirect costs such as forgone earnings of parents, among others.

This figure probably underestimates the total savings likely. This figure represents only cost savings due to reduced costs to treat three childhood illness; it excludes the cost of purchases for over-the-counter medications for treatment of OM and gastroenteritis symptoms, physician charges related to the treatment of NEC, and cost savings due to reductions in long-term morbidity.
---extract ends

Ref: Weimer. The economic benefits of breastfeeding: A review and analysis, Food Assistance & Nutrition Research Report No. 13. Wash.D.C., USDA, 2001.

As it says, this is probably an underestimate because only the costs of treating three illnesses in the first year are considered. As infants who are not breastfed are more likely to be sick in the longer term, these treatment costs could also be reduced.

Another factor missing from the equation is the treatment costs due to companies not providing preparation instructions in line with Food Standards Agency and World Health Organisation guidance for parents. Powdered infant formula is not sterile, but only one company in the UK warns parents of this fact (Hipp) and it directly contradicts the expert advice on how to reduce the risks of possible contamination. If companies were forced to provide correct information to parents who use formula, as we are demanding, then there could be a reduction in illness attributable to intrinsic contamination of powdered formula with Enterobacter Sakazakii, Salmonella and other pathogens, which is worryingly common (Enterobacter Sakazakii contamination was found in 14% of tins in a survey referenced by the US Food and Drug Administration). Fortunately the steps required to reduce the risks are simple. Unfortunately the industry is loathe to say anything about the risks associated with formula feeding and so does not communicate this. See:

If we scale the U$3.6 billion possible savings cited in the US study by the differences in population to gain a crude indication of possible savings for the UK, we arrive at a figure of £360 million for each year of breastfeeding rates at a higher level. A more accurate figure could be arrived at by comparing the assumptions in the paper with the UK situation.

Gordon Brown built his political reputation through being a ‘prudent’ Chancellor of Exchequer. Let us hope he will demand the Food Standards Agency conduct a proper cost-benefit analysis of bringing World Health Assembly marketing requirements into UK law so the enormous potential financial benefit is offset against any fears the government may have to spend a bit of money on lawyers to see off any challenge from the baby food industry wanting to continue aggressive marketing.

1 comment:

Anonymous said...

Excellent article highlighting the cost savings in healthcare if the government acted more positively in providing better indepth factual education on breastfeeding, human milk and refraining from continuing to deny the public information on the very real health risks of formula feeding.
Why on earth did the the Secretary of State for Health Alan Johnson neglect to include the importance of breastfeeding / human milk in his House of Commons speech on the 12th Sept, The Healthy Society, when a good percentage of his speech related to infant health and mortality, at a time when scientific research has proven time and time again that breastfeeding and use of ebm as opposed to formula reduces health inequalities with benefits extending from birth to adulthood. His omittance is pathetic considering he cites “the NHS should promote good health rather than only the treatment of bad”.