As CEO of The Lactation Network, I think when people ask me what they should know about insurance-covered lactation support, they assume I’ll launch into a lengthy address about the intricacies of law, capitalism, and the complicated systems that parents must navigate when they decide to grow their families.
Nope.
Federal law mandates that health plans cover lactation care for the duration of the breastfeeding journey.
Pretty simple, right?
Unfortunately, the reality for most families is much more complex. Many don’t know that expert lactation care exists, that it’s supposed to be insurance-covered, or that their health plans don’t have any in-network lactation consultants nearby. Ultimately, insurance-covered lactation support boils down to one simple thing: Access.
While breastfeeding is often perceived as natural, it is not always easy, and it is absolutely not free. As long as the falsehood that breastfeeding is free and easy persists, health plans won’t value it as necessary and worthy of coverage. Breastfeeding is a skill that must be learned, and learning to perform a skill well requires time, money, and consultation with experts in the field. Think of breastfeeding like the specialized skills of someone certified in CPR, a scuba diving instructor, or a pilot — the consequences of poor training are just as dire. Lactation care can be the difference between life and death for some families (more on this later).
While breastfeeding is a choice, lactation is a biological reality – and that biological reality requires expert healthcare.
Here’s where the access piece comes in.
Many families simply do not have the time, resources, support, or physical ability to breastfeed their babies. Most parents don’t intend to have difficulty breastfeeding their children. By the time they’re ready to deliver, they’ve likely been inundated with messages about the many benefits of breastfeeding but little about how to breastfeed. Many assume the brief lactation consult they might get at their hospital bedside will be enough to carry them through the journey to weaning their child when the time is right.
But parents are often caught off guard by the difficulties they face — in fact, 70% of parents believe we should be talking more about how challenging breastfeeding is. Each day, thousands of families return home with newborns nationwide only to be confronted with unforeseen obstacles like mastitis, low milk supply, latching issues, or postpartum depression and anxiety. For many of these families, the mental anguish that follows becomes unbearable. One in five mothers in the U.S. suffers from mood and anxiety disorders during pregnancy or soon after birth (trigger warning: that piece contains visceral examples of self-harm and suicide). Without accessible, comprehensive lactation care, parents don’t have the option to choose what’s best for themselves or their children at a critical time in their development.
Whether for first-time, fifth-time, adoptive, surrogate, or LGBTQIA+ parents, lactation consultants (IBCLCs) exist for every family breastfeeding scenario. And as IBCLCs are top-credentialed clinical practitioners providing gold-standard healthcare (and are often the first to notice symptoms of and recommend care for postpartum depression and anxiety), their services should be covered by insurance. Full stop.
What we see instead, though, is health plans doing the bare minimum or nothing at all, even when the Affordable Care Act (ACA) mandates that health plans provide coverage for lactation services throughout the duration of the lactation journey, provide patients with in-network lactation consultants, and cover services when no in-network providers are available.
For now, The Lactation Network is standing in the gap by continuing to build the largest network of lactation consultants (IBCLCs) in the country, advising on critical legislation to expand lactation care certification to military families, and offering breast pumps and educational information to families and allies so they can partner with us to hold health plans accountable for ACA mandates.
We’ve also launched The Lactation Coverage Gap, an advocacy campaign telling the stories of parents encountering obstacles to lactation care in workplaces and with health plans. In it, we provide families, allies, and employers with the information they need to ensure health plans adequately deliver the lactation care families rightfully deserve. You can sign our petition here, or download email templates to send to your employers so they gain clarity on the care they provide. Your voice is vital to contribute to this fight, but we cannot fight what we don’t name.
If you’re a parent looking for care, connect with The Lactation Network. We’ll do everything we can to connect you to the resources you need. You can also look for in-network lactation consultants in your health plan provider directory, or, if none are available or accessible, see an out-of-network provider and request a superbill (a document that outlines the services you’ve received from your lactation consultant) to seek reimbursement.
No matter how families choose to feed their babies, they deserve accessible lactation care. We get there by holding health plans accountable for supporting families.
