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A comparison of tertiary level NICU costs for infants born <1250 g supplemented with human versus bovine milk-based fortifiers

Journal of Perinatology volume 43, pages 1113–1118 (2023)Cite this article

Subjects

Abstract

Background

Human milk-based fortifiers (HMBF) are more costly than bovine milk-based fortifiers (BMBF); but, the efficacy of human or bovine fortification for infants born <1250 g has yet to be fully elucidated. Our objective was to determine the effect of fortifier source on tertiary neonatal costs.

Methods

Costs associated with tertiary neonatal care, including direct and indirect hospital expenditures, feed-related costs and physician billing were analysed retrospectively for participants of OptiMoM (NCT02137473), a blinded RCT comparing fortifier type for babies born <1250 g. A generalized linear model of cost according to fortifier type was created.

Results

Mean [95% confidence interval] daily costs per patient, adjusted for birth gestation and weight, was significantly greater in the human than the BMBF group ($3,452 [$3,186 – $3,740] Canadian dollars (CAD) versus $2,451 [$2,257 – $2,662] CAD) respectively, p < 0.0001).

Conclusion

HMBF usage entails additional costs on NICU stay that should be considered with implementation.

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Data availability

The datasets generated during and/or analysed during the current study are not publically available due to a risk for breeching patient confidentiality but may be available from the corresponding author on reasonable request.

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Acknowledgements

Fees incurred for analysis of costs were kindly waived by the finance departments of Sinai Health and The Hospital for Sick Children.

Funding

This work was funded by the Canadian Institutes of Health Research by a grant to SU, DO and AK (CIHR FDN 143233). CIHR had no role in the design and conduct of the study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Sinai Health, Toronto, ON, Canada

    Telford Yeung, Deborah L. O’Connor & Sharon Unger

  2. Section of Neonatology, Windsor Regional Hospital, Windsor, ON, Canada

    Telford Yeung

  3. Neonatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Asaph Rolnitsky

  4. Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    Asaph Rolnitsky & Sharon Unger

  5. Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada

    Nicole Bando & Deborah L. O’Connor

  6. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada

    Susan Trang, Deborah L. O’Connor & Sharon Unger

  7. System Funding and Analytics, Sinai Health, Toronto, ON, Canada

    Andy Geer

  8. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Alex Kiss

  9. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

    Alex Kiss

Authors
  1. Telford Yeung
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  2. Asaph Rolnitsky
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  3. Nicole Bando
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  4. Susan Trang
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  5. Andy Geer
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  6. Alex Kiss
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  7. Deborah L. O’Connor
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  8. Sharon Unger
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Contributions

The study design was conducted by TY, AR, NB, ST, DOC and SU. Data analysis was performed by TY, AR, AG, and AK. The manuscript was prepared by TY and critically edited by AR, NB, ST, AK, DOC, and SU.

Corresponding author

Correspondence to Sharon Unger.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

This study was performed in accordance with the Declaration of Helsinki. Research ethics approval was obtained from Mount Sinai Hospital (REB number 14-0044-A) and The Hospital for Sick Children (REB number 1000063564).

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Yeung, T., Rolnitsky, A., Bando, N. et al. A comparison of tertiary level NICU costs for infants born <1250 g supplemented with human versus bovine milk-based fortifiers. J Perinatol 43, 1113–1118 (2023). https://doi.org/10.1038/s41372-023-01677-6

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  • DOI: https://doi.org/10.1038/s41372-023-01677-6

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