In the "World Health Roundup" (In the News, February), there is a mention of how misoprostol is being used to reduce the rate of acute severe postpartum hemorrhage in India; misoprostol is less expensive and more stable than oxytocin (Pitocin), and is being used successfully in low-risk women. Breastfeeding in the first minutes and hour after delivery also reduces the risk of hemorrhage. Several papers have been published on the preventive impact of early breastfeeding on early postpartum hemorrhage.1, 2, 3 Breastfeeding after delivery reduces health care costs and initiates a life-preserving activity.

In 1997 it cost about $4.50 per birth for the equipment to administer medication to reduce the risk of postpartum hemorrhage. That didn't include the time spent by health care staff in administering the medication. Multiply that figure by the 4 million births in the United States annually, and one can see that breastfeeding after delivery offers both the potential for significant savings and a reduction in hazardous waste disposal.

Elkins Park, PA

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