Jae H. Kim

Costs of Necrotizing Enterocolitis and Cost-Effectiveness of Exclusively Human Milk-Based Products in Feeding Extremely Premature Infants

OBJECTIVE This study evaluated the cost-effectiveness of a 100% human milk-based diet composed of mothers milk fortified with a donor human milk-based human milk fortifier (HMF) versus mothers milk fortified with bovine milk-based HMF to initiate enteral nutrition among extremely premature infants in the neonatal intensive care unit (NICU). METHODS A net expected costs calculator was developed to compare the total NICU costs among extremely premature infants who were fed either a bovine milk-based HMF-fortified diet or a 100% human milk-based diet, based on the previously observed risks of overall necrotizing enterocolitis (NEC) and surgical NEC in a randomized controlled study that compared outcomes of these two feeding strategies among 207 very low birth weight infants. The average NICU costs for an extremely premature infant without NEC and the incremental costs due to medical and surgical NEC were derived from a separate analysis of hospital discharges in the state of California in 2007. The sensitivity of cost-effectiveness results to the risks and costs of NEC and to prices of milk supplements was studied. RESULTS The adjusted incremental costs of medical NEC and surgical NEC over and above the average costs incurred for extremely premature infants without NEC, in 2011 US

Human milk macronutrient analysis using point-of-care near-infrared spectrophotometry.

, were

Human Milk Oligosaccharide Composition Differs between Donor Milk and Mother’s Own Milk in the NICU

74,004 (95% confidence interval,

Long term healthcare costs of infants who survived neonatal necrotizing enterocolitis: a retrospective longitudinal study among infants enrolled in Texas Medicaid.

47,051-

Human milk oligosaccharide composition predicts risk of necrotising enterocolitis in preterm infants

100,957) and

Challenges in the practice of human milk nutrition in the neonatal intensive care unit.

198,040 (95% confidence interval,

Growth and Tolerance of Preterm Infants Fed a New Extensively Hydrolyzed Liquid Human Milk Fortifier

159,261-

Pooling Expressed Breastmilk to Provide a Consistent Feeding Composition for Premature Infants

236,819) per infant, respectively. Extremely premature infants fed with 100% human-milk based products had lower expected NICU length of stay and total expected costs of hospitalization, resulting in net direct savings of 3.9 NICU days and

Human milk and necrotizing enterocolitis

8,167.17 (95% confidence interval,

Wide Variability in Caloric Density of Expressed Human Milk Can Lead to Major Underestimation or Overestimation of Nutrient Content

4,405-