By Rose Hoban
Breastfeeding is one of the most natural things a mother can do for her baby. But for some women, the task doesn’t come naturally. Babies can have trouble latching on, women can have difficulty with pain or milk flow, and frustration can quickly build.
With some coaching, science and patience, lactation specialists can get a mom breastfeeding. But for years, few of the mothers in North Carolina’s Medicaid program were able to access help with breastfeeding because the policy around payment was confusing and cumbersome.
No more. Starting in early 2016, women covered by Medicaid who give birth will be able to get help from lactation consultants, and that help will be covered.
“Technically, the service was covered, but the policy was too vague for providers and families to understand,” said Tom Vitaglione, a long-time advocate with NC Child. He said only a handful of people in the state accessed the lactation consultation services because of problems interpreting what was and wasn’t covered.
For infants and mothers covered by private insurance, it’s typical to have medical support for breastfeeding included in their health care package; optimal breastfeeding can usually be accomplished in only one or two visits from a lactation consultant.
Vitaglione said the state Division of Medical Assistance, which runs the Medicaid program, is revising and clarifying the policy around lactation consultation services for North Carolina’s 57,000 or so mothers who are covered by the program.
Low-income women are eligible for Medicaid coverage while pregnant and for three months postpartum; about half of North Carolina’s births last year were covered by the program.
The legislative Child Fatality Task Force started looking at the lactation consultation issue several years ago as part of an effort to decrease the state’s infant mortality rate.
Research has shown that breastfeeding confers life-long benefits and death rates drop among babies who are breastfed for at least six months. Breastfeeding infants are also less likely to develop lower respiratory infections, gastroenteritis and necrotizing enterocolitis, a serious condition in which parts of a premature newborn’s intestine stops functioning properly and can become gangrenous. The condition occurs primarily in formula-fed babies who are several weeks premature and requires hospitalization in a neonatal intensive care unit.
Vitaglione said necrotizing enterocolitis is almost completely prevented by breastfeeding, so having Medicaid pay for breastfeeding support actually saves the state money.
“The estimate the Child Fatality Task Force came up with is it’d cost a little more than $4 million to provide the coverage, but that it’d save more than $7 million,” he said.
“Just with the savings from avoided gastroenteritis, lower respiratory infection and necrotising enterocolitis, we felt that was a safe estimate.”