BACKGROUND:
The cost to the global economy of not breastfeeding has been estimated at £242 billion. Key stakeholders need to know whether the provision of breastfeeding support interventions is cost-saving and cost-effective for health services.

OBJECTIVES:
To conduct a systematic review of evidence on the costs (cost-savings) and cost-effectiveness of breastfeeding support interventions for healthy mothers with healthy babies.

METHODS:
Guidance on conducting reviews of economic evidence was adhered to, with stakeholder engagement informing key decisions. A search strategy was developed to identify and assess records for eligibility. Studies that estimated the incremental costs and cost-effectiveness of breastfeeding support interventions compared to an alternative of likely benefit (typically standard care) were included. Following identification, studies were appraised, synthesised and assessed for consistency in findings. Studies were synthesised by the level of support provided (breastfeeding only/breastfeeding plus) and by context of the setting (high/low resource).

RESULTS:
A total of 39 studies were included in the review. On appraisal, studies were limited by the narrow scope of cost categories and the short time horizons for measuring resource consequences. Thus, there was uncertainty in the findings with likely underestimation of cost-effectiveness. Consistency in findings was greatest for studies estimating the incremental cost per additional woman exclusively breastfeeding their infant following breastfeeding only support in high-resource settings (GBP £67 at 5-12 days to £112 at 8-weeks at 2024 prices). Stakeholder engagement indicated a willingness-to-pay threshold of GBP £105 per woman at 2024 prices for a 1% increase in exclusive breastfeeding rates at 6-weeks’ postpartum.

CONCLUSIONS:
If policy and decision-makers are willing-to-pay an additional GBP £105 per woman to provide additional breastfeeding support, it would be considered worth the investment.

KEY MESSAGE:
Breastfeeding only support interventions may be a cost-effective use of maternity service resources in the short term with benefits to mothers, infants and health services. Poster session 2 (Group A)