Evidence map›Paper›PMID 35062928›Full record

ArticleBMC public health2022

The cost-effectiveness of antenatal and postnatal education and support interventions for women aimed at promoting breastfeeding in the UK.

Ifigeneia Mavranezouli, Jo Varley-Campbell, Sarah Stockton, Jennifer Francis, Clare Macdonald, Sunita Sharma, Peter Fleming, Elizabeth Punter, Charlotte Barry, Maija Kallioinen and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
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  8. A Scoping Review of Interventions and Outcomes for Postpartum Mothers.Iranian journal of nursing and midwifery research
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ifigeneia MavranezouliCentre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. i.mavranezouli@ucl.ac.uk.
Jo Varley-CampbellCentre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Sarah StocktonNational Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK.
Jennifer FrancisNational Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK.
Clare MacdonaldCentral Surgery, Oadby, Leicestershire, UK.
Sunita SharmaChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Peter FlemingCentre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK.
Elizabeth PunterThe Dudley group NHS foundation Trust, Dudley, West Midlands, UK.
Charlotte BarryMidlands Maternity and Perinatal Mental Health Clinical Network, NHS England and NHS Improvement, London, UK.
Maija KallioinenNational Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK.
Nina KhazaezadehGuy's & St. Thomas NHS Foundation Trust, London, UK.
David JewellChair of the committee responsible for the NICE guideline on postnatal care and General Practitioner, Bristol, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreastfeeding is associated with health benefits to mothers and babies and cost-savings to the health service. Breastfeeding rates in the UK are low for various reasons including cultural barriers, inadequate support to initiate and sustain breastfeeding, lack of information, or choice not to breastfeed. Education and support interventions have been developed aiming at promoting breastfeeding rates. The objective of this study was to assess the cost-effectiveness of such interventions for women, initiated antenatally or in the first 8 weeks postnatally, aiming at improving breastfeeding rates, in the UK.

methodsA decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of a breastfeeding intervention from the perspective of health and personal social services in England. Data on intervention effectiveness and the benefits of breastfeeding were derived from systematic reviews. Other model input parameters were obtained from published sources, supplemented by expert opinion.

resultsThe incremental cost-effectiveness ratio (ICER) of the modelled intervention added on standard care versus standard care was £51,946/QALY, suggesting that the intervention is not cost-effective under National Institute for Health and Care Excellence (NICE) criteria in England. Sensitivity analysis suggested that the cost-effectiveness of the intervention improved as its effectiveness increased and intervention cost decreased. At the base-case effect (increase in breastfeeding rates 16-26 weeks after birth by 19%), the intervention was cost-effective (<£20,000/QALY) if its cost per woman receiving the intervention became ≈£40-£45. At the base-case cost (£84), the intervention was cost-effective if it increased breastfeeding rates by at least 35-40%.

conclusionsAvailable breastfeeding interventions do not appear to be cost-effective under NICE criteria in England. Future breastfeeding interventions need to have higher effectiveness or lower cost compared with currently available interventions in order to become cost-effective. Public health and other societal interventions that protect, promote and support breastfeeding may be key in improving breastfeeding rates in the UK.

Indexed as

Breast FeedingHealth ServicesCost-Benefit AnalysisEnglandFemaleHumansPregnancyQuality-Adjusted Life YearsBreastfeeding interventionsCost-effectivenessDecision-analytic modellingEconomic evaluation

Identifiers

PMID35062928
PMCPMC8783468

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.