Feeding our babies shouldn’t be this hard

Nearly 70,000 babies are born in the United States every week. 

That’s over 10,600 babies per day, 450 babies per hour, and eight babies per second.

Every single one of those babies must eat.

A persistent, unethical lactation coverage gap stands in the way of their nourishment.

As CEO of The Lactation Network, I spend every day working to ensure that every family that wants and needs lactation care has access to it. I know that human breast milk is universally acknowledged as the gold standard for infant feeding. 

That said, I also know that while breastfeeding may be natural, it is not always easy, and it is absolutely not free. Many families simply do not have the time, resources, support or physical ability to breastfeed their babies. For many of these families, the mental anguish that follows becomes an unbearable weight. Without accessible, comprehensive lactation care, parents don’t have the option to choose what’s best for their children at a critical time in their development.

I also know that breastfeeding is a choice, whereas lactation is a biological reality that demands expert healthcare. No matter how families choose to feed their babies, they deserve supportive, comprehensive lactation care.

The Lactation Network exists because babies have needed nourishment for all of time, but there continue to be barriers for families who intend to provide it. Of course, most parents don’t bank on having difficulty feeding their children. The picture of parents who need lactation care is diverse and often unpredictable: There are first-time parents with ample financial and community resources to support their feeding goals but who still need additional support. There are third, fourth, fifth-time parents who had smooth, easy breastfeeding experiences with their firstborns, only to be challenged by unique baby needs. There are LGBTQIA families and others from underrepresented demographics who require access to healthcare that fits their individual experiences. There are, and should be, providers for every family scenario. 

Enter the Affordable Care Act (ACA).  

The ACA specifies that parents have a right to expanded coverage for lactation support, including supplies and counseling among insured patients. The ACA also 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.

Instead, millions of families are falling through the cracks of a system where insurance providers find loopholes to avoid covering care, employers don’t understand the extent to which their coverage is failing employees, and lactation consultants can’t reach the patients that need them. 

The words ‘duration’ and ‘coverage’ are vital in the ACA mandate for several reasons. First, most families are released from the hospital with hours-old infants and brief episodes of lactation support at their bedside. It’s when parents get home and begin the adjustment to newborn life that they often require hands-on support. What happens when, weeks from delivery, mastitis symptoms appear? When a baby who latches just days prior no longer does? When milk supply runs low? That’s when covered care is most critical. 

Lactation consultants are also often the first to notice symptoms of and recommend care for postpartum depression and anxiety, to help parents transition seamlessly from maternity leave back into the workforce, and enable parents to decide when and for how long they’d like to breastfeed. But in the absence of a clinically trained lactation consultant, parents turn to their parents, spouses, partners, friends and community for unpaid labor and clinically unsound advice. We can no longer rely on patchwork, invisible labor to keep our families intact.

The Lactation Network has been on the front line of this issue for years and is the only national provider of expert, in-person lactation care delivered by international board certified lactation consultants (IBCLCs). TLN also raises awareness and advises on crucial federal legislation to increase equitable, insurance-covered lactation care as mandated under the Affordable Care Act. 

Moreover, we source proprietary data from thousands of parents across the country with myriad identities about their experiences with breastfeeding. Their stories became our 2023 Breastfeeding Sentiment Report, where we discovered more of what we already knew: When families can’t get the care they need, they suffer. Over half of those surveyed agreed that it’s too hard for women to access expert help for breastfeeding challenges, and nearly 60% agreed that if their insurance provided any/more coverage for lactation support, they would have seen a lactation consultant more times, or chosen to breastfeed longer. 

We’re taking all we learn from the experiences of lactating parents and applying it to everything we do. We are continuing to build the largest network of IBCLCs in the country. We have advised on critical legislation to expand lactation care certification to military families. We participate in critical work alongside The VA Community Care Network (VACCN) to ensure veterans across the country receive timely, high-quality healthcare. We provide grant funds to aspiring IBCLCs from underrepresented communities to offset the cost of hundreds of clinical hours and exam fees. We offer breast pumps, share resources, and connect thousands of patients with transformative lactation care every month. 

We’re also kicking off an advocacy hub this month to ensure that families, allies and employers are armed with the information they need to drive the lactation coverage conversation forward and open pathways to care in the seasons to come. This digital space will tell the stories of parents who encounter obstacles to lactation care in workplaces and with insurance companies, offer self-assessments for employers to check for adequate coverage through their employee benefits plans, and provide a petition for engaged visitors to make their voices heard in their networks. We’re hoping it’s a wake-up call to employers and health plans to make lactation care accessible to all families.

This work isn’t even close to being done, but neither is our resolve. At a time when the postpartum period is only getting deadlier, our charter could not be more urgent: We will not rest until every family has access to expert, life-saving lactation care.