The economic burden of bottle-feeding.

Bottle-feeding has been associated with excess childhood disease. The costs of managing this burden have not yet been quantified in Canada. This thesis estimated the direct costs of three childhood diseases (diarrhea, otitis media and lower respiratory infection) attributable to bottle-feeding among Ontario infants under the age of one year in 1994. A systematic review identified relative risks among bottle-fed children. The prevalence of bottle-feeding was determined from the National Longitudinal Survey of Children and Youth, 1994/1995. Impact fractions were calculated for each of the three diseases and applied to the costs of physician visits and hospitalizations which were provided by the Institute for Clinical Evaluative Sciences. The net direct costs of bottle-feeding were estimated as the sum of attributable costs minus cost savings. The cost of health care attributable to bottle-feeding was estimated to be $2.2 million. A sensitivity analysis revealed that bottle-feeding could have yielded cost savings of $88,900 or cost just under $4.0 million. This estimate was conservative as the costs of drugs were not included