Insurance Coverage for Donor Breast Milk

When a baby is born, preterm or full term, it’s immune system is undeveloped and it’s gut membrane is still immature. The first thing that goes in a baby’s belly, breast milk, provides immune factors and growth factors that help the gut membrane mature.

For this reason, when a baby needs a supplement for feeding, Pasteurized Donor Human Milk  (PDHM)* is an important option. This is especially so for premature and sick infants.

The problem is, this option is not available to every family. Some hospitals, not all, will provide PDHM in their Neonatal Intensive Care and Special Care Units. Nonetheless, when a family goes home, they will have to pay out of pocket to continue with this Donor Breast Milk. Nature provides us with this valuable resource though really, only certain people can have access to this.

• The Maine legislature is considering a bill:
• LD 1938: An Act Concerning MaineCare Coverage for Donor Breast Milk
• This would require MaineCare to reimburse for the cost of Donor Breast Milk.
• They are hearing testimonies on Thursday, January 23 at 1:00 pm.
• Burton M. Cross Office Building, Room 209   111 Sewall Street  in Augusta.
You can send a letter to your legislator and let them know your thoughts on this.

Cost is often what restricts families. In ten years as an IBCLC Lactation Consultant, I met only one family who could pay out of pocket for human donor milk. Their baby had been born preterm at 37 weeks and Donor Breast Milk was necessary for an extended time. I’m glad that they could afford it.

However, they were the only family I met who could pay for it. For parents with less income or who are low income … What are their options? Do I have to explain that their 37 weeker would really benefit from this but … they can’t have it?

A mother called me because her six week old baby was allergic to formula. Her baby daughter had rashes, digestive problems and was very unhappy. I could help the mother rebuild a milk supply. But what about helping her distressed baby in the meantime? I knew Donor Human Milk would help her immensely… if she could pay for it.

This is a blaring disparity that can be addressed here and now. Make PDHM, Donor Breast Milk,  available to any and all babies that need it by requiring insurance coverage. This includes Medicare and, in my opinion, private pay insurance companies as well.

Providing Donor Breast Milk from the beginning is an investment.  When provided with Donor Breast Milk in the N.I.C.U, infants have much lower rates of Neocrotizing Enterocolitis (NEC), and thus, less medication and surgery, lower mortality rates. Babies go home earlier, thus saving time and money in the N.I.C.U.

While the babies are getting the health benefits of breast milk, their mothers have time to recover and build their supply. Then those families are more likely to keep breastfeeding for longer. The benefits for both the mother and the baby continue. Insurance companies will have healthier clients: mothers and babies.  Less doctor visits, less need for medications is a long term investment and it’s two (mother and child) for the price of one.

Are we sure insurance companies will continue to cover the long term cost of medicines for a child with allergies or a compromised immune system? We’ve seen chronic medications (insulin for diabetes) and emergency medications (epipens for allergies) become suddenly, outrageously expensive. We’ve seen prescription benefits cut back.

Donor Breast Milk is a simple, clean, safe and affordable option, available right from the start. Remove the barrier of cost by requiring insurance coverage. This will support the health of our newest citizens and ultimately the well being of Maine.


*Pasteurized Donor Human Milk comes from one of the Milk Banks in the larger medical non-profit organization: The Human Milk Banks of North America. They provide (Pasteurized) Donor Breast Milk to hospitals and to families who pay out of pocket. It is Donor Breast Milk, though to be specific, it is pasteurized and comes from one of the HMBANA milk banks.