ECONOMIC BENEFIT OF BREAST-FEEDING INFANTS ENROLLED IN WIC

Objectives To determine whether breast-feeding of infants enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Chi ldren (WIC) is associated with a reduction in Medicaid expenditures du ring the first 6 months of life; if so, to determine whether the reduc tion in Medicaid expenditures represents a positive economic benefit t o society when WIC costs for these infants and their mothers are consi dered. Design Cohorts of exclusively breast-fed and formula-fed infant s were tracked for 6 months to compare WIC costs and Medicaid expendit ures. Subjects The sample consisted of 406 healthy infants who were br east-fed exclusively for at least 3 months and 470 healthy infants who were formula-fed exclusively. The infants, born between August 1, 199 3, and December 31, 1993, were enrolled in NIC and Medicaid. Cost and benefit measures WIC costs included redeemed WIC vouchers for formula and foods for infants and mothers, plus administrative expenses for 6 months, minus manufacturers' rebates for formula. Benefit was determin ed from Medicaid expenditures for health care initiated in tile first 180 days of each infant's life. Statistical and benefit-cost analyses Economic benefit was calculated as net benefit and as benefit-cost rat ios. Regression techniques were used to estimate Medicaid expenditures associated with breast-feeding, adjusted for demographic and prenatal care variables. Results Compared with formula-feeding, breast-feeding each infant enrolled in WIC saved $478 in WIC costs and Medicaid expe nditures during the first 6 months of the infant's life, or $161 after consideration of the formula manufacturer's rebate. A Medicaid cost s aving of $112 per infant was realized by the breast-feeding cohort, an d Medicaid pharmacy reimbursement costs for breast-fed infants were si gnificantly lower-half that of formula-fed infants. Applications The p romotion of breast-feeding among low-income populations through nutrit ion programs such as WIC is an effective cost-containment measure.