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Accessible Breastfeeding Support

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Making preventative care accessible for women was, and is, a laudable goal of the Affordable Care Act. And because breastfeeding provides many benefits for women and their families, it is wisely considered preventative care.

Breast-feeding support, at home, in a clinic, in the hospital, is supposed to be available for the duration of a woman’s breastfeeding experience with no co-pay or deductible.

However, the definition of breastfeeding support is not clear. We’re aiming for IBCLC as a standard for licensure to clarify what defines comprehensive breastfeeding support.

Why licensure? Why IBCLC?
• 1.  Licensure leads to, we hope, insurance coverage. Insurance companies often refuse to pay for breastfeeding services because IBCLCs are not licensed. (Except in Rhode Island and Georgia). Ironically, an MD with a license can be paid for breastfeeding support, even though that MD doesn’t have as much training and referred a mother to an IBCLC for help.

It’s so frustrating that families with Medicaid plans (such as Mass Health) don’t have coverage for IBCLC support. That’s because Medicaid requires licensed providers. So those who need help and are least likely to afford it can’t get it. That is the opposite of accessibility! *

2. The IBCLC is considered the most rigorous standard for lactation education. It takes about 5 years of academic and clinical experience to qualify for the exam. Then we have to pass the exam…. every ten years.

Shouldn’t every family be able to consult with someone with that much background? This is especially so for families with complex medical problems…. a mom with a difficult health history or a premature baby are two examples.

A standard for licensing assures parents they are consulting with someone who has thorough clinical experience and training in lactation. It assures insurance companies and health care providers of a level of quality.

Women in low-income communities need more access to that IBCLC level of care. An excellent example of improving this support is the Mother Nurture Lactation College in Detroit. With mentorship and clinical experience, women in the community are guided to become IBCLCs for their own community. That’s the best service for everyone.

Licensure can help families have more access to IBCLC care. We’re moving towards that goal of improving access to preventative care for women. Support for Project Licensure is a step in the right direction.

Come to our conference! “Breastfeeding the Preterm Infant: Transitioning from NICU to Home” this November 5th at Tufts.

•  Jessica Lang, Heather Bingham and myself will have a paper about ”Massachusetts Families Experiences with Insurance Coverage for Lactation Consultant (IBCLC) Services.” in a forthcoming issue of Clinical Lactation.