Annual Cost of NEC

1. Annual Cost of NEC Mortality Rates for NEC Range from 20-40% of All cases • Reference: Pediatrics 2002;109,423-428;Impact of Necrotizing Enterocolitis on Length of Stay and Hospital Charges in Very Low Birth Weight Infants • Chart based on taking 40% of the NEC population requiring surgery and 60% having Medical NEC • VON reports that 12% of patient population under 27 weeks develop NEC and 2% over the entire NICU population

2. 6,000,000 50% BF Rate Baseline 60% BF Scenario 70% BF Scenario 80% BF Scenario 90% BF Scenario 100% BF Scenario 5,000,000 4,000,000 3,000,000 Hospital Incurred Cost ($$) 2,000,000 1,000,000 0 Baseline 1%NEC Baseline 3%NEC Baseline 5%NEC Baseline 7%NEC Baseline 10%NEC Increased Breastmilk Usage Translating into Savings • Exclusively formula fed babies are 6-7 more times likely to develop NEC than exclusively breastmilk fed babies and 3 times more likely than those receiving both. (Graph assumes a 7x increase) • Chart Based on VON data of ~50% as a baseline of Population receiving some breastmilk by discharge • Baseline NEC rates are on the bottom and are represented with the 50% BF rate. By increasing the BF rates, the NEC percentages decrease • Based Hospital Admission of 500 annually

3. Additional Benefits of Breastmilk in the NICU • For every 10-ml/kg per day increase in • Breastmilk ingestion: • The Mental Development Index Increased • by 0.53 points • The Psychomotor Development Index • increased by 0.63 points • Behavior Rating Scale Percentile Score • increased by 0.82 points • Likelihood of rehospitalization decreased • by 6% Vohr et al., Beneficial effects of breastmilk in the neonatal intensive care unit on the developmental outcome of extremely low birthweight infants at 18 months of age; Pediatrics 2006;118;e115-e123 Schanler et al., Pediatrics 103, 1999;1150-1157

4. References