The Institutional Cost of Acquiring 100 mL of Human Milk for Very Low Birth Weight Infants in the Neonatal Intensive Care Unit
The Institutional Cost of Acquiring 100 mL of Human Milk for Very Low Birth Weight Infants in the Neonatal Intensive Care Unit
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DOI：
10.1177/0890334413491629
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发表时间：
2013-08-01
影响因子：
2.6
通讯作者：
Meier, Paula
中科院分区：
文献类型：
--
作者：
Jegier, Briana J.;Johnson, Tricia J.;Meier, Paula
背景：与供体母乳（DHM）或商业配方奶（CF）相比，来自亲生母亲的母乳（HM）可减少极低出生体重（VLBW；出生体重< 1500 g）婴儿在新生儿重症监护病房（NICU）住院期间和住院后的疾病负担和相关护理费用。然而，与DHM和CF相比，人们对从生母处获得HM的制度成本知之甚少。目的：本研究旨在确定NICU住院期间VLBW婴儿喂养获得HM的机构成本。方法：本研究分析了来自一项评估VLBW婴儿HM喂养的健康结果和成本的前瞻性队列研究的157例产妇抽吸记录。使用标准成本分析技术对吸乳器租赁费、一次性吸乳器套件购买和用于储存表达的HM的一次性食品级容器的成本进行评估。结果：获得100毫升HM的中位成本从每天抽700毫升的母亲0.51美元到每天抽< 100毫升的母亲7.93美元不等。与DHM（14.84美元/100毫升）和CF（3.18美元/100毫升）相比，每天抽100毫升母乳的母亲获得母乳的成本更低。对于每天抽吸100毫升母乳的母亲，HM比DHM或CF成本更低的确切抽吸日期分别为4至7天和6至19天。结论：当母亲每天提供100 mL母乳并持续足够天数（范围，4-19）时，来自亲生母亲的母乳比DHM和CF的获得成本更低。新生儿重症监护病房应优先考虑资源，以确保母亲达到每日母乳量。
Background: Human milk from the biologic mother (HM) reduces disease burden and associated costs of care during and after neonatal intensive care unit (NICU) hospitalization for very low birth weight (VLBW; birth weight < 1500 g) infants, when compared to feedings of donor human milk (DHM) or commercial formula (CF). However, compared to DHM and CF, little is known about the institutional cost to acquire HM from the biologic mother.Objective: This study aimed to determine the institutional cost of acquiring HM for VLBW infant feedings during the NICU hospitalization.Methods: This analysis examined 157 maternal pumping records from a prospective cohort study evaluating health outcomes and cost of HM feedings for VLBW infants. The costs for the breast pump rental fee, 1-time pump kit purchase, and disposable food-grade containers for storing expressed HM were evaluated using standard cost analysis techniques.Results: The median cost of acquiring 100 mL of HM varied from $0.51 when mothers pumped 700 mL daily to $7.93 for those who pumped < 100 mL daily. Mothers who pumped 100 mL daily had lower acquisition cost compared to both DHM ($14.84/100 mL) and CF ($3.18/100 mL). For mothers who pumped > 100 mL daily, the exact day of pumping where the cost of HM was less expensive than DHM or CF was 4 to 7 days and 6 to 19 days, respectively.Conclusion: Human milk from the biologic mother has lower acquisition cost than DHM and CF when mothers provided 100 mL daily and pumped for a sufficient number of days (range, 4-19). Neonatal intensive care units should prioritize resources to ensure that mothers achieve this daily milk volume.