State Medicaid Program to Cover Breastfeeding Support

December 2015

Post Author

By Tom Vitaglione, Senior Fellow

The heartwarming image of a mother nursing her newborn elicits almost universal feelings of sweetness and family bonding. Breastfeeding provides enormous health benefits for both mother and infant, but problems can arise in both starting and continuing to breastfeed, particularly for infants born with special needs. Without help, some mothers are unable to breastfeed successfully.

That is when medical breastfeeding support (called medical lactation support) provided by a highly qualified lactation consultant can be critically important. For infants and mothers covered by private insurance, it’s typical to have medical support for breastfeeding included in their health care package. But for the 57,000 newborns and their mothers who are covered by Medicaid, more than half the births in the state each year, medical support for solving problems with breastfeeding has not been covered.

Now, in a move that will save the state and families money and provide documented health benefits to infants and mothers, the State Medicaid Program is moving toward covering medical support for breastfeeding. The action is in response to a recommendation by the Child Fatality Task Force, a legislative study commission. After the public comment period and other agency actions, the service will be added to the benefits provided by Medicaid, likely sometime in the first half of 2016.

When it comes to the health benefits of breastfeeding, the evidence is clear and well documented. Breastfeeding reduces the occurrence of sudden infant death syndrome, gastrointestinal infection, upper and lower respiratory infection and hospitalization, childhood leukemia, asthma, otitis media, childhood obesity and diabetes mellitus. Breastfeeding also lowers maternal risk of breast and ovarian cancer, hypertension, and metabolic diseases.

Realizing that breastfeeding reduces infant deaths while also reducing health care costs, most insurance plans cover medical lactation support to assist women in continuing breastfeeding for the recommended duration of six months, and preferably a year. 

Lack of coverage contributes to lower rates of women on Medicaid starting to breastfeed and continuing to do so. For example, in 2011 48 percent of new mothers in our state continued breastfeeding for at least six months, but just 23 percent of new mothers on Medicaid did so.

With the implementation of the medical lactation support benefit, breastfeeding rates should improve, and that will lead to fewer infant deaths and severe illnesses, while also saving Medicaid costs for medical services, such as very expensive infant intensive care. 

This step by the Medicaid Program is a strong and positive one that will make thousands of children healthier every year, and will benefit every community.