International Journal of Technology Assessment in Health Care


Economic evaluation of enhanced staff contact for the promotion of breastfeeding for low birth weight infants

Stephen J. C. Ricea1, Dawn Craiga1, Felicia McCormicka1, Mary J. Renfrewa1 and Anthony F. Williamsa2

a1 University of York

a2 University of London


Objectives: There is evidence that breastmilk feeding reduces mortality and short and long-term morbidity among infants born too soon or too small. The aim of this study was to evaluate the cost-effectiveness of enhanced staff contact for mothers with infants in a neonatal unit with a birth weight of 500–2,500 g from the perspective of the UK National Health Service.

Methods: A decision-tree model linked clinical outcomes with long-term health outcomes. The study population was divided into three weight bands: 500–999 g, 1000–1,749 g, and 1,750–2,500 g. Clinical and resource use data were obtained from literature reviews. The measure of benefit was quality-adjusted life-years. Uncertainty was evaluated using cost-effectiveness acceptability curves and sensitivity analyses.

Results: The intervention was less costly and more effective than the comparator in the base–case analysis for each birth weight group. The results were quite robust to the sensitivity analyses performed.

Conclusions: This is the first economic evaluation in this complex field and offers a model to be developed in future research. The results provide preliminary indications that enhanced staff contact may be cost-effective. However, the limited evidence available, and the limited UK data in particular, suggest that further research is required to provide results with confidence.


The study was funded by a grant from the National Institute for Health Research Health Technology Assessment programme: grant no 06–34/02. This paper does not represent the views of the NIHR or the Department of Health. Input without contributing to the paper: Kate Misso contributed to the design of searches of the literature for evidence and references management; and Lisa Dyson, Sarah E. King, and Elizabeth Stenhouse contributed to the design of the study. Advisory Group: Gene Anderson, Rosie Dodds, Sandra Lang, Shelley Mason, Paula Meier, Josephine Patterson, Mark Sculpher, Sarah O'Sullivan, Amanda Sowden, Louise Wallace. Additional expert input: Nick Embleton, Alan Fenton, Elizabeth Jones, Caroline King, Camilla Kingdon, Paula Sisk, Gillian Weaver: and four anonymous peer reviewers.