Thursday, 7 October 2010

The Economics of Breastfeeding

This afternoon saw seven members of the Haringey Breastfeeding Campaign, me included, having a meeting with Sheena Carr, senior public health strategist, and Claire Wright, head of children’s strategy for Haringey. The borough are currently seeking views and doing research on breastfeeding rates and support, with a view to presenting this to NHS Haringey in November.

One of our concerns as breastfeeding mums is that there is NO budget in the borough for breastfeeding. It’s not a case of defending the budget from cuts – there isn’t one to cut.

This is something I questioned at the meeting. Ayala Ochert (who infamously dared to bare her bosom in St Ann’s library, creating somewhat of a media storm a couple of weeks back) has been crunching the figures, and worked out how much the borough could save by supporting breastfeeding.

A recent study[1] in the United States found that if 90% of mothers followed the recommendation to exclusively breastfeed for 6 months then the country would save more than $13 billion per year and prevent more than 900 deaths.

If one were to extrapolate to this to the population of Haringey[2], then it would amount to a saving of more than $9.5 million per year (£6 million).

The study looked at 10 childhood diseases so in fact the savings and deaths prevented would actually be higher. It did not include deaths prevented from breast cancer, for example. If women in the UK breastfed for an extra 6 months on average then 1000 cases of breast cancer, and hundreds of deaths, could be prevented each year[3].

The US survey found that 13.6% of mothers were exclusively breastfeeding at 6 months. Extrapolating to Haringey amount, this would amount to £78,534 per one percent increase in exclusive breastfeeding rates.

As I put it at the meeting, the borough therefore cannot afford NOT to fund breastfeeding – and the first thing our group would like to see the money for would be a midwife who specialised in breastfeeding. (You will recall, this is what the borough had until the post was cut…during national breastfeeding week).

I got the sense that Sheena Carr and Claire Wright ‘got it’; they know how important breastfeeding is but that they feel that their hands are tied. Also, because the PCT will soon cease to exist, and because GPs will be put in charge of commissioning, there is a real sense of ‘wait and see – we’re all in the dark.’

As one of the mothers at the meeting pointed out, however, that just isn’t good enough. Since the specialist midwife was cut in June, hundreds of mothers and babies will have fallen though the net when it comes to breastfeeding. Fact.

Some of the mothers recounted horror stories of being publicly humiliated by midwifes who were anti-breastfeeding. One recalled how her son had been fed formula, against her wishes, and that the baby ended up with constipation so bad that he bled when he finally managed to excrete.

Another woman told of how she had needed surgery when her daughter was still young, but had been told by the Whittington hospital that they couldn’t allow her daughter, who she was still breastfeeding, to come into hospital with her, and so she would either have to quit breastfeeding or delay surgery. She chose to delay surgery, causing her much physical pain. “That’s a struggle no one should have to go though,” she commented.

We discussed the Unicef ‘Baby-Friendly Status’ which the borough is starting to move towards (it will take about five years, incredibly). I asked how it would work seeing as there are no hospitals in Haringey, and the borough’s babies are largely born in Islington, Barnet or Camden (unless they're born at home - and we know how rare home births still are). The answer was pretty vague, and we are concerned that some elements of gaining ‘Baby-Friendly Status’ are simply box-ticking exercises. For example, the Whittington has now got a certificate to say that it is committed to going ‘Baby-Friendly’…yet the above experience of the breastfeeding mum shows that the hospital having a certificate to wave about didn’t improve her experience in any way. Other anecdotes, many of them shocking, seemed to back this up.

What will happen when the council takes over much of the work of the PCT, or the GPs decide what the priorities should be for local healthcare? My guess is that we have even more of a battle on our hands, but that despite being sleep-deprived, our group will not be giving up easily.

1. The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis, Bartick and Reinhold, Paediatrics 2010
2. Based on US population of 307,006,550 and Haringey population of 226,200

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