Table 1 Key data sources and assumptions
Parameter | Description | Source | ||
|---|---|---|---|---|
Number of live births | 140,541 live births in Ontario (2019) | Statistics Canada [18] | ||
Infant and neonatal mortality rate | 4.6 infant and 3.6 neonatal deaths per 1000 live births | Statistics Canada [19] | ||
Breastfeeding rates | 36.3% (exclusive rate at six months); 64.9% (exclusive rate at hospital discharge after delivery); 92.1% (breastfeeding initiation rate); 73.8% (any breastfeeding rate at discharge) 64.6% (any breastfeeding rate at 6 months);32.9% any breastfeeding at NICU discharge | |||
Lower respiratory tract infection | ||||
 Incidence of LRTI | 37% among FF and 25% among EBF | Quesada et al. 2020 [21] | ||
 Incidence of care | 23% cases visit outpatient care; 6% have inpatient stays | |||
 Duration of care | 3 days in inpatient care per episode; 1.9 days outpatient visits per episode | |||
 Cost of care | US $911 (US $222- US $8,112)* per inpatient stay; US $166 (US $99 – US $11,660)* per LRTI case in outpatient care | OCCI [23] | ||
Gastrointestinal infection | ||||
 Incidence of GI | 31% among FF and 14% among EBF | Quesada et al. 2020 [21] | ||
 Incidence of care | 22% cases visit outpatient care; 44% have inpatient stays | |||
 Duration of care | 3.6 days in inpatient care per episode; 1.9 days of outpatient visits per episode | |||
 Annual cost of care | US $1,055 (US $810 – US $9088)* per inpatient stay; US $166 (US $144 – US $1,338)* per GI case in outpatient care | OCCI [23] | ||
Acute otitis media | ||||
 Incidence of AOM | 37% among FF and 25% among EBF | Quesada et al. 2020 [21] | ||
 Incidence of care | 94% cases visited a health professional | Dubé et al. 2011 [26] | ||
 Duration of episode | 2.2 AOM episodes per annum; 5.9 days per AOM episode | Dubé et al. 2011 [27] | ||
 Annual cost of care | US $97.71 (US $ 87 – US $1,919)* per AOM case in outpatient care | OCCI [23] | ||
Necrotising enterocolitis | ||||
 Number of preterm babies | About 1.16% of live births are early preterm (< 32 weeks gestation age) in Canada | CIHI 2009 [22] | ||
 Breastfeeding rates | 32.9% of premature newborns are EBF and 40.6% are mixed fed at NICU discharge | CNN [6] | ||
 Incidence of NEC | 7% among AF and 1% among exclusively breastmilk fed (EBF)neonates | Quesada et al. 2020 [21] | ||
 Incidence of care | We assume all newborns with NEC receives care | Analyst’s assumption | ||
 Duration of care | 32.9 days in inpatient care days per admission | OCCI [23] | ||
 Distribution of treatment | 31% of cases would need surgical treatment while 69% would need medical treatment only | Rees et al. 2010 [28] | ||
 Annual cost of care | US $60, 326 (US $42,035 – US $87,658)* per NEC case treated in NICU | OCCI [23] | ||
Childhood acute lymphoblastic leukemia | ||||
 Incidence of acute lymphoblastic leukemia | 7.0 cases per 100,000 population of 0–4-year-olds in Ontario | Statistics Canada [29] | ||
 Probability of infection | 1.70% probability of developing acute lymphoblastic leukemia for < 5 years olds in Canada | CCSAC [26] | ||
 Probability of death | 0.9% probability of dying from acute lymphoblastic leukemia in Canada | CCSAC [26] | ||
 Survival rate | 94% predicted 5 year observed survival proportion | CCSAC [26] | ||
 Breastfeeding and acute lymphoblastic leukemia risk | 0.84 (0.75–0.94) odds ratio for any breastfeeding for ≥ 6 months vs. <6 months; 0.91 (0.8–0.94 CI) odds ratio for ever breastfed vs. never breastfed | Amitay et al. 2015 [30] | ||
 Healthcare seeking | About 92% of cases sought care at pre-diagnosis and initial phase, 85% will spend and seek care time at continuing care phase, and 18% would enter terminal phase and accumulate healthcare cost in Ontario, Canada. | McBride et al. (2020) [31] | ||
 Mean (14 year)cost of care | US $3,919.70 pre-diagnosis care, US $125,034 initial/1-year post diagnosis care, US $17,141.6 continuing care, and US $345,759.1 terminal care phase in Canada. | McBirde et al. 2020 [32] | ||
Child obesity | ||||
 Prevalence rate | 13.1% of children aged 1–19 are obese in Canada | Rao et al., 2016 [33] | ||
 Breastfeeding and child obesity risk | 0.66 (0.50–0.88 CI) odds ratio in favour of EBF at 6 months vs. FF | Ma et al. 2020 [34] | ||
 Excess healthcare use | Childhood obesity results in an increase in annual per capita healthcare cost by US $305.72 (US $241.39 – US $374.04) | Ling et al. 2022 [35] | ||
Pediatric asthma | ||||
 Incidence rate | 24.8 per 1000 person-years among zero to 10 year olds in Ontario Canada | Radhakrishnan et al. 2021 [36] | ||
 Breastfeeding and child asthma risk | 0.70 (0.53–0.92 CI) odds ratio in favor of EBF vs. not EBF | Xue et al. 2021 [37] | ||
 Age at onset | In Canada, 39.9%, 42.9%, and 17.2% of children had the first asthma or wheezing diagnosis at between 0–3 years, 4–7 years, and 8–12 years of age, respectively | Chen et al. 2021 [31] | ||
 Annual cost | Pediatric asthma results in a US$828.86 (US $761.67 – US $1,304.75) increase in annual healthcare expenditure | Ungar et al., 2001 [38] | ||