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Affordable Care Act and Breast Pumps
(Durable Medical Equipment)
 
The Affordable Care Act (ACA) provides breastfeeding support, supplies, and equipment, such as breast pumps.

Many mothers are getting ineffective breast pumps from their insurances because of this coverage. As a result, mothers are not increasing their milk supply to be able to continue breast feeding. Breast pumps such as purchased hand-held pumps and double-electric pumps are not intended to increase mother’s milk supply when problems occur. Problems like when your milk isn’t coming in as expected (in 2-3 days after having your baby), as well as healthy babies who are having bilirubin testing for jaundice, or having to return to the doctor’s office for checking your baby’s weight can be helped by scheduling an appointment.

I am an Advanced Practice Nurse (APN) with expertise in the management of common breast feeding problems. Insurances providing breast pumps by the ACA have really helped many mothers to be able to pump their breast milk when there are no problems with milk supply and with infants.

It is a really good change to have this kind of health insurance benefit now instead of previous years when breast pumps were not covered at all. But, I have had the experience for several years that when there is a low milk supply, a Medela Symphony pump is the best pump choice. The Symphony pump is called a "hospital grade double electric" breast pump. Rentals for BCBSIL policyholders are covered from me as an in-network provider.

 
Why is the Symphony pump a good choice?
This pump features the closest sucking pattern to that of your baby at breast while feeding. There is a rate pattern shown by your newborn in the first 1-2 days after birth consisting of several sucks and a pause, then another cluster of sucks, and a pause, and this pattern repeats itself during the entire feed. After your initial days of breast feeding, your breasts should feel fuller as your milk is commonly termed “coming in.” Since the first milk, known as colostrum is present immediately at birth, this change in your milk has been recently called “coming to volume." As your breast milk changes, you should notice your newborn’s suck changing to a new suckling pattern of at least 6 sucks, or long jaw excursions, and then a swallow, and again at least 6 sucks and a swallow. This pattern should continue to be noticed until your baby is finished feeding.

Mothers often mistaken their babies are still breastfeeding when they appear to suck a few times (<6 times) towards the end of feedings and they have left their babies on the breast too long when feeding has been done. This has led to many moms struggling to breast feed due to spending an hour to 2 hours attempting to breast feed, and not being able to get sufficient sleep.
 
If you are experiencing a problem with providing enough breast milk for your infant, then I would recommend using a Symphony pump. This pump helps to increase milk supply by emptying the breast more fully than the other pumps. The more the breasts are emptied completely, the more milk your body will be stimulated to produce, known as “supply and demand." If your baby has lost a lot of weight, been jaundice, or born a little early, such as between 36-38 weeks into your pregnancy, then your baby may compromise your milk supply by not actively suckling and removing breast milk to completely empty your breasts.
Access to a hospital-grade pump, such as the Symphony enables mothers to express enough milk by adequate milk removal. Several types of breast pumps are being reimbursed by health insurances that are not based on the evidence for best practice in optimizing milk volume. There is an urgent need for education to occur for the insurances to offer an evidence-based hospital-grade electric breast pump at these times. Mothers need to use an effective pump until their infant consumes all milk directly from breast.

Another available feature for the Symphony pump is the use of what is called a Premie+ card. The name is confusing as it sounds as though it is only for premature infants use. However, this feature of the Symphony pump can help with increasing a mother’s milk supply in the early days for healthy full-term newborns. The Premie+ pattern on the Symphony pump has breast pump suction patterns (BPSPs) that mimic the sucking rates and rhythms used by actual infants at breast. This new technology provides the most effective and comfortable pumping strategy for effective stimulation and removal of breast milk.
 
Rates of Breastfeeding
In addition to the inclusion of breastfeeding support, supplies, and counseling by the ACA, a national campaign for the promotion of breastfeeding has been implemented to address exclusivity and duration rates which remain low. According to the Centers for Disease Control and Prevention (CDC) Breastfeeding Report Card–United States, 2012, 76.9% of infants ever breastfed, and exclusivity rates at 3 months and at 6 months were 36% and 16.3% respectively. Duration rates of breastfeeding were 47.2% and 25.5% at 6 months and at 12 months respectively. Participation in the promotion and support for breastfeeding in recent years includes the Healthy People 2020 targets to increase the proportion of infants who are ever breastfed to 81.9%, and targets for exclusivity and duration are:
  • Exclusivity rates of 46.2% and 25.5% at three and six months respectively.
  • Duration rates to 60.6% at six months and 34.1% at 12 months;
 

Although more mothers are initiating breastfeeding, too many quit breastfeeding shortly after delivery, causing current national rates of duration and exclusivity to fall far below the targets.

 

Health Benefits for All Newborns

According to The Surgeon General’s Call to Action to Support Breastfeeding (2011), breastfeeding for a year provides many health benefits for infants including protection from several infections and illnesses such as diarrhea, ear infections, and pneumonia. Infants who were breastfed are less likely to develop asthma, become obese, and have reduced risks of sudden infant death syndrome (SIDS). Besides the health benefits of breastfeeding, there are economic benefits. When optimal breastfeeding practices are followed, the savings on infant formula for the first year of life is estimated to be about $1,200-$1,500. The cost savings from reduced medical costs if mothers were to breastfeed for six months is estimated to be between three and 13 billion dollars for the United States.


Blue Cross / BlueShield of Illinois (BCBSIL) Policyholders - Insurance covered Breastpumps
 
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