Milky Way Celebrates 20 Years!

This month, Milky Way Lactation Services celebrates its 20th anniversary supporting breastfeeding mothers in Southern Maryland.  I can’t believe that it has been that long since my dream to start a lactation service came to fruition.  A lot has changed in the world of breastfeeding over the past 20 years!

When I first started Milky Way in 1996, I had already spent years as a La Leche Leader, so I was familiar with the challenges of breastfeeding in an unsupportive society.  It wasn’t until I took things to the next level, however, achieving IBCLC certification and actually opening a business, that I found out just how bad things were!  I had lived a charmed life of supportive family and friends while I breastfed.  I soon learned, however, that my social circle was not exactly representative!  My first shock came when I sent a business announcement to the local newspaper.  I was called by an assistant editor who reamed me out for “bad mouthing” doctors by suggesting that women don’t always get all the support they need to breastfeed successfully.  He felt that by simply opening this business, I was insulting the medical profession, and, as he put it, women wouldn’t even choose to breastfeed in the first place unless they already had the help they needed!

My first act of assertiveness was to go over this editor’s head to insist that my business announcement be posted.  It was, and things went on well for a while.  Sure, this was before the days when women in Maryland had legal protection to breastfeed in public.  This was back when the American Academy of Pediatrics had strong financial ties with the formula companies.  No hospitals in the area had even considered progressing to Baby-Friendly status, and all of them gave out bags of formula, even to breastfeeding mothers.  There were no advertisements on TV or in magazines about the importance of breastfeeding.  Yet, most women I worked with felt breastfeeding was still worth doing, and they struggled to make sure it worked for them and their babies.

Another shock came a few years later when an OB/GYN in the area insisted that breastfeeding mothers can’t breastfeed if they have a fever.  When I provided him with copies of overwhelming evidence that fever is not a contraindication, I got no response.  That was nothing compared to my experience with another OB/GYN who called me to yell at me and insist that I was committing insurance fraud by trying to help mothers get insurance reimbursement.  How ironic that today the Federal Government mandates that insurance MUST cover lactation services!

Despite these negative experiences, working with mother and babies in Southern Maryland was full of positive reinforcement, so I soldiered on!  I have worked with mothers who breastfed after mastectomies, who maintained lactation while deployed, who breastfed babies with serious birth defects.  I have been so inspired by their persistence.

At the same time, the physicians in the area and I have developed a good working rapport.  I feel comfortable talking to them about specific concerns or ideas, and on many occasions they have contacted me to ask my opinion about a breastfeeding issue.  Most of the hospitals in the area developed dedicated lactation programs to help their mothers get off to a good start, and none of them give out free formula bags anymore!

Society at large has changed its attitudes toward breastfeeding.  Breastfeeding in public is now a legal right.  Time and place to pump at work is now legally protected.  Insurance companies are required to provide pumps and coverage for lactation services.  The importance of breastfeeding is regularly part of public health announcements.  Those who argue against breastfeeding are widely seen as out-of-touch or on the defensive due to their own concerns.

In many ways, this is a wonderful time to be a lactation consultant.  Except when it isn’t.  In my next post, what has not changed for the better over the past 20 years.



Insurance Reimbursement Update

It has been almost 3 years since I wrote about insurance coverage for lactation services. A lot has changed in that time.  Most insurances will now provide new mothers with an electric breast pump as soon as the baby is born, if not before, at no cost to her.  The insurance plans now comply with the Affordable Care Act when it comes to breast pumps.  However, coverage for lactation help is still spotty.

Insurances which otherwise must abide by the Affordable Care Act are required to cover lactation services as well.  Some of my clients have found, though, that when they inquire about this coverage, they are given several excuses of why they will not be reimbursed for a lactation consultation.  The most common excuses are

1.  We only cover lactation services while you are in the hospital

2.  We only cover services provided by a licensed provider

3.  We only cover services provided by in-network providers

Luckily, the Federal government has gotten wind of these excuses and is putting a halt to them!  In October of 2015, the US Department of Labor published a document that addressed these excuses and other concerns about preventive services covered by the Affordable Care Act.  You can read the document yourself at

If you don’t want to read the whole thing, however, then here are the most important facts to know when you discuss this with your insurance company.

1.  Insurers must provide coverage for lactation services for THE DURATION OF BREASTFEEDING.  That means they must cover it if you need help at any point while you are breastfeeding, not just in the hospital.

2.  There is only one state in the United States which currently offers licensing for lactation consultants.  Insurers may not refuse to cover for an unlicensed provider, so you should be covered to see an IBCLC (International Board Certified Lactation Consultant).

3.  Insurers must provide coverage for out-of-network providers if they have no in-network providers in your area.  This is usually the case as there are very few in-network lactation consultants around the country, and, currently,  none in Southern Maryland.

This is all good news, but it doesn’t mean that dealing with the insurance company is always easy.  You still need to pay up front and then submit for reimbursement from your insurance company.  I’m sure you will agree, though, that that is a small price to pay for expert help in your home when you most need it!

The Affordable Care Act has definitely changed insurance company involvement in breastfeeding, but one thing remains the same.  Expert lactation help is worth the investment.  Even if you have to pay for it, it will more than pay for itself as you save on formula and doctor’s visits.  And who can put a price on peace of mind?