After Andrea Ippolito, MEng, MS gave birth to her first daughter, she discovered what a lot of women realize as new mothers: breastfeeding is incredibly hard. “Breastfeeding is so deeply connected to a mom’s and her baby’s health. It’s no days off and no nights off. Plus, it evolves over time,” says Ippolito.
In the U.S., over 83 percent of infants start out receiving some breast milk, but by six months, only about half receive any breast milk and just under 25 percent receive breast milk exclusively.
Ippolito was uniquely positioned to do something to support all mothers as they navigate breastfeeding. As a biomedical engineer and an academic, she’s spent her career in healthcare. At the time of her daughter’s birth, she was working at the Department of Veterans Affairs using telehealth to improve care access for service members with post traumatic stress. “As a former government stakeholder and academic researcher entrenched in this industry and as a new parent figuring out baby feeding I thought, there’s got to be a better way to improve access to breastfeeding care,” she says.
Today, Ippolito is CEO and founder of SimpliFed, a virtual baby feeding and breastfeeding support service, fully covered by health plans. Close to 50 providers support new moms and babies in 50 states.
Access to lactation support in the U.S. is fragmented
Breastfed infants have reduced risks of developing diseases like asthma, obesity and type 2 diabetes. In infant years, they have lower rates of ear and respiratory infections and sudden infant death syndrome (SIDS). Breastfeeding can also help lower a mother’s risk of hypertension, type 2 diabetes and ovarian and breast cancer.
Despite breastfeeding’s benefits and challenges, lactation support is rarely built into a woman’s ongoing postpartum healthcare journey in the U.S. Lactation consultants can be hard to access in some parts of the country, and visits are not always covered by insurance. “Baby feeding impacts every human being, no matter how you feed. And yet, lactation consulting is still seen as niche,” says Ippolito.
Ippolito illustrates this point with breast pumps, which are medical devices for breasts – which she points out are organs. “There is no other world where someone gets no guidance on how to use a medical device that’s connected to your organs.”
Hospitals provide breastfeeding support after birth from nurses and lactation consultants, but Ippolito insists this isn’t enough. “Women need more than one visit with a lactation consultant on the labor and delivery floor when your milk hasn’t come in yet, and you’re recovering physically and emotionally from giving birth,” she says.
Medical coverage for lactation support is a federal requirement
In 2012 it became a federal requirement under the Affordable Care Act to cover breastfeeding education, consultations and pumps beginning in pregnancy through weaning. But, still today, according to the Kaufman Family Foundation, many health plans and state Medicaid programs aren’t in compliance with this Federal policy.
Last September, over a decade after the policy was passed, the White House announced in the National Strategy on Hunger, Nutrition and Health that the Department of Health and Human Services is going to begin enforcing the 2012 ACA requirement to cover lactation services.
Even among those states and health plans that are in compliance, lactation support can be limited. In rural areas, especially, there often aren’t accessible lactation consultants in network available. Some states only cover services in the hospital, but it’s difficult to get out of the house with a newborn after giving birth. “Lactation consulting in clinical environments is important and wonderful, but it’s in a sterile clinic environment that you’re not going to be in when you’re feeding at home,” says Ippolito.
How to better support breastfeeding moms
Raising awareness about the federal requirement to cover lactation services is an important way to help all breastfeeding moms and babies. Ippolito recommends the following three ways to support breastfeeding.
Continuous lactation care starting during pregnancy
Feeding evolves over time, so recommending lactation services to parents as a resource will help them tweak things as their baby feeding journey evolves. Parents in the U.S. are covered for lactation visits from pregnancy through weaning. It’s important for care to start during pregnancy so families can make a plan that works for them.
Access a call script for coverage
For those who struggle to access coverage, the National Women’s Law Center has a script to use when calling a health plan.
Refer parents to telehealth
Parents need lactation support where they breastfeed. Organizations like SimpliFed provide virtual access to lactation consultants covered by health plans.
Ippolito says there’s still a long way to go until all those who have a baby have full access to lactation support from pregnancy to weaning. As a mom who recently gave birth to her third daughter and finally had the full continuum of support she needed, she knows just how much of a difference this can make for mothers and babies.
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