Breast Pump Insurance Coverage & Reimbursement

   As the Affordable Care Act is enacted and more and more moms are becoming aware of the benefits of it, we are learning more and more about getting insurance to cover your breast pump.
 First, don't take "no" for an answer.  Call your insurance company.  If the representative tells you that a breast pump is not covered ask why.  Some insurance companies are still classifying breast pumps as "personal comfort" items.  According to the US Government Department of Health & Human Services, " Non-grandfathered plans and issuers are required to provide coverage without cost sharing consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012."
     The Affordable Care Act covers Breastfeeding support, supplies, and counseling.  Some insurance companies are covering hospital grade breast pump rentals, but others are covering quality personal use pumps sold by DME supplies like Lactation Connection.  We found the United Health Care policies buried in a table entitled Expanded Women's Preventative Health and it states that these items are required coverage for plans beginning after 8/1/12.
     Make sure to get prior approval from your insurance company before purchasing from an out of network supplier, especially if you are on an HMO.  But it is always a good idea to call your insurance company first for information on how to get reimbursement.  Take down the name of the person you spoke to.   If the answer is "we don't cover that"  ask why and if the answer is not that you have to buy "in network" or that your plan is grandfathered.  Call back and speak to someone else until you get a knowledgeable helpful representative.  Finally, ask what paperwork you need to submit for reimbursement.  Lactation Connection provides you a receipt with the appropriate insurance codes attached for your convenience when you purchase at http://www.lactationconnection.com

http://www.hrsa.gov/womensguidelines/
http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen
https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Preventive_Care_Services_CD.pdf

Comparing Hygeia Breast Pump Models

     The Hygeia EnJoye Breast Pump has become our most requested pump of 2013, but the different models can be confusing.  First, all EnJoye pumps have the same motor with the same three year warranty. All three are "green" pump so they are approved by the FDA for multi-person uses so can be resold.  If you are purchasing a used Hygeia EnJoye you will need your own sanitary double pumping kit which includes the tubing, filters bottles and valves. And all three have the CARE function witch is an audio recording device to record your baby's coos or cries and play them back to assist with let down while pumping.  The distinctions are below:
Hygeia EnJoye EPS Breast Pump has an external power supply (AC adapter) only and can be purchased on our site with or without a tote.
Hygeia EnJoye EXT Breast Pump has both the AC adapter and an external AA battery pack.  You can purchase these with a brown or black tote which makes a very nice diaper bag as well.
Hygeia EnJoye LBI Breast Pump has both the AC adapter and includes an internal lithium ion rechargeable battery for moms who don't have access to an outlet and reply on a battery to pump.

The Hygeia EnJoye Breast Pump is an excellent purchase and is covered under your insurance plan if purchased from either a network provider or a DME supplier like Lactation Connection in most cases.  Always check with your insurance company for details on breast pump insurance coverage, but know that in 2013 a breast pump is covered as preventative care under the Affordable Care Act so don't take no for an answer.  Breastpumps and breastfeeding supplies are covered. 
     If your insurance company pays for breast pump rental, the Hygeia EnDeare is an excellent choice.

Stocking Up and Storing Breastmilk

It is always a good idea to have a stockpile of breastmilk in the freezer.  You never know when you might have a medical procedure come up or your hubby may want to wisk you away for a romantic weekend.  Sometimes it is a daunting task to get a significant amount of breastmilk stored, so here are some tips:
1.  Pump Efficiently:  Purchase an effective breast pump.  Pumping with a bad breast pump will make any mom want to throw in the towel.  You don't have to spend $300 on a pump, but budgeting a months worth of what you would have spent on formula and getting the basic model of the Ameda Purely Yours is just the ticket at less than $150 or the Spectra S2 Breast Pump for under $200.
2.  Start Early:  Don't confuse the advice that says that you should not give your baby a bottle for 6 weeks to mean don't pump for the first six weeks.  The former is to avoid nipple confusion.  If you begin pumping in the early weeks, you will have more to store before your milk supply regulates and you will be ahead of the game.
3.  Pump Early:  On the average, moms get 1 oz after feeding in the morning hours as opposed to half an oz later in the day.  So if you pump in the mornings, you will get more for your effort.
4.  Replacement Pump:  If Dad gives a bottle of stored milk because you are running late getting back from the store, pump immediately and you will replace the entire amount!
5.  Pump Easy:  Pump into the same refrigerated container for up to 24 hours and then place in the freezer.  Since breastmilk has antibacterial properties, you can also just rinse breastshields and re-use as opposed to sterilizing each time.  Do sterilize parts once per day. 
6.  Store Smart:  Pump in 2-4 oz increments so you can easily defrost just what you need to avoid waste.  You can save space with breast milk freezer bags or save time by pumping into the same bottles you are going to use to feed.  If you use bottles, use a sealing disc and don't put nipples in the freezer.
7.  If you have an upcoming event to store up for, you can use lactation cookies or bars to boost supply so you can stock up faster

For moms storing breast milk short term to use during the same week, using a system to organize your milk keeps you from wasting freshly expressed breast milk. Breastmilk Bandit easily labels your milk with My Mommy's Milk and the Day of the week making this an economical and easier method that tagging your milk with post-its.

Happy Pumping!
Tanya

Are you Mom Enough: Time to Speak Out!

Unfortunately, the Time Magazine article picture did not help to promote breastfeeding.  This photo was shot to sell magazines, not to help make breastfeeding the norm.  While I personally nursed my children for up to 18 months, there is no doubt that breastmilk is beneficial for much longer.  The controversy comes in with the child standing and the captioning challening moms to nurse their older child.  As a retired lactation consultant, I always tried to help moms meet their personal goals and encourage them to nurse at each stage of breastfeeding.  Whether it was the first month, three months or hopefully at least a year.  I gave advice on partial weaning when a mom did not want to pump when returning to work and advice on gradual and baby led weaning when asked about weaning.  The caption depicts all who promote breastfeeding as breastfeeding Nazis and not the supporters of mothers and babies who we are.  It makes nursing mothers look radical instead of impassioned.  While I support the mother on the cover and her personal decision to nurse her toddler, I reject the notion that we are all out there screaming that if you don't nurse for over a year, or at all, that you aren't mom enough!  Breastfeeding can take tenacity.  Tenacity which you need when you are parenting teenagers later on, but moms should be encouraged, not called out in a confrontational manner for not breastfeeding.  Having said that, I personally have been atacked for statements such as "breast milk has never been recalled".  Proponets of breastfeeding should be allowed to speak the truth without it being perceived that we are attacking the other side.  Truth is truth whether you believe it or not and whether you choose it or not.

Breastfeeding Diet: How to Lose Weight While Breastfeeding

      As a retired lactation consultant, mother of 3 and grandmother of one, I get asked this question quite often:  "How do I loose the baby weight?"  More recently I was asked about diet pills, which are unsafe for the nursing mother.  That caused me to take action so I am giving you a guideline below based on two decades of experience and the additional 500 calories per day needed by nursing mothers or 1000 extra calories if you are nursing twins.  As with any diet, consult your doctor before beginning this and do no begin until the baby is at least 3 months old. 

     Losing weight is not necessarily how much you eat, but what combination of foods you eat in order to jump start your metabolism.  Start by measuring yourself and not just weighing yourself because you begin to lose inches faster than pounds so it is encouraging to see the smaller waistline, etc.  An inexpensive food scale and measuring cups is helpful for this process.  Do not “cheat” by exchanging servings and eat everything recommended in the course of the day.  Serving size for veggies is 1 cup and fruit 1 apple, orange, etc. 

7 oz meat (nothing fried; cheese is included in this category)

3 fruit

2-3 non-starchy vegetable (not peas or corn)

4 bread (1 cup pasta, regular sliced bread  = 1, but a muffin or biscuit = 2)

3 cup dairy (1% milk or yogurt, not Yoplait or any brand with corn syrup, no ice cream)

1 fat = (1 TBS salad dressing or peanut butter or low-fat mayonnaise)

Weight loss varies depending on how much weight you gained during the last pregnancy ad this weight comes of faster than extra pounds that have been there for years.  Typical weight loss after you reach pre-pregnancy weight should be 1-2 lbs per week, do don't skimp on food to make it go faster. You are better off keeping weight off than loosing too quickly!  Please don't make your goal getting back into your favorite jeans from high school, that is unrealistic.  You goal is a healthy weight, womanly curves are not your enemy.  After all, you need hips to carry your toddler around!

For additional breastfeeding tips, visit our website!

Happy, healthy eating!

Tanya Roberts
Lactation Connection

Exclusive Pumping: Keeping Up Breast Milk Production While Pumping

I often get moms who want to exclusively pump instead of breast feed directly.  If you choose to pump exclusively, it is very important that stimulation starts in the hospital within 1 hour of the baby's birth.  Moms should double pump with a hospital or professional quality pump like the Ameda, Medela or Hygeia hospital grade rental pumps or a brand new (not used) professional quality pump like the Ameda Purely Yours,  Hygeia EnJoye Breast Pump or Spectra S2 Breast Pump. 



To initiate milk supply, pump every 2-3 hours with a 5 hour stretch at night for a total of at least 8 times per day of 10-15 minute double pumping sessions.  Many pumping moms get discouraged during the first 3-5 days as it is hard to see much going into the bottles as colostrum comes in teaspoons, not ounces.  Do not let this dissuade you, but draw this liquid gold up in a syringe and give it to the baby as it is chalked full of antibodies.  This schedule goes on for the first six months for the most part, but there are times when normal babies go through growth spurts that you will have to simulate with a pump.  When the baby is 2-3 weeks old and again when the baby is 3 months old, set aside a 5 day period that you will step up the pumping schedule to every 2 hours for a total of at least 11-12 times per day.  This must be 5 days in a row.  If your schedule gets interrupted, start over.   As you can see, this is a lot of pumping and cleaning of pump parts.  You will want at least 2-3 sets of breast flanges to use.  Some moms start this because it only takes 10-15 minutes to pump and a newborn baby takes 45 minutes to nurse, but as the baby gets older breastfeeding directly is much easier.  No bottles or pump parts to clean and most 2-6 month old babies will nurse in 20 minutes so you may want to reconsider your decision.  Pumping is great for the working mother, but if you choose to exclusively pump, experience shows me that these moms do not nurse as long as their direct breastfeeding counterparts.  If you breastfeed directly, it gets much easier by 6 weeks and by 3 months you feel sorry for moms who mix formula.   After all, have milk will travel!

If you do choose to exclusively pump, in addition to a quality breast pump a few key accessories will make your life easier.  These include a hands-free pumping bra so that you can multi-task while you are pumping, a breast pump cooler bag for transporting your pump and breast milk, an air dry bag to store and dry your breast pump parts on-the-go, and re-usable sterilizer bags to keep your parts sanitary anywhere you pump that you have access to a microwave.

Happy Traveling,
Tanya
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Every Ounce Counts!

Recently, I was asked to be the guest speaker for a breastfeeding reception at our local WIC clinic. August is always an exciting time to be in the business of breastfeeding because the first week is officially World Breastfeeding Week. Many cities and government agencies promote breastfeeding during this week and I am honored to be a part of the celebration in Granbury, TX.

As I was preparing, I researched the WIC theme, "Every Ounce Counts". What a great slogan! I encourage you to check out the WIC website because their campaign rivals those of major companies. Not only do they have great pictures of babies and what they might be when they grow up, but a song that can only be an encouragement to any nursing mother. The WIC ads include babies that want to grow up to be firefighters and doctors because breastmilk makes you stronger and smarter, which is very true! Breastfed babies develop better with fewer health problems and their IQ scores and performance in school is markedly better than their formula-fed counterparts. The next thing that came to my mind, was the composition of breast milk and how many moms are fooled into thinking that their milk isn't good enough or that the time they breastfeed isn't important. Collostrum comes in teaspoons, not ounces and yet it is the baby's first immunization against the world's diseases. Moms are also fooled into thinking that a bottle of formula occasionally doesn't affect anything, but supplementing even once per day before the age of 3-4 months, can cause early weaning. Babies who are breastfed just three months already have a reduced risk of juvenile diabetes, multiple sclerosis, heart disease and even childhood cancer!  The breast milk made the difference and the longer you nurse, the better. Babies who are breastfed for four months are less likely to be hospitalized for respiratory illness.

Those are some great benefits of breastmilk, but lets look at the flip-side. Diarrheal disease is four times more likely in formula-fed infants and formula-feeding increases risk of childhood obesity by 20-30%. Those are some statistics you can't argue with. And did you know that breastfed babies have fewer cavities than their artificially fed counterparts?

So many moms are discouraged from breastfeeding because they think their milk is not good enough or they
think that after a certain age, the benefits are gone. Nutritional content of breastmilk is consistent from mother
to mother even in third world countries. Between the ages of 12-24 months, toddlers can still get about 15 oz per day from nursing. These 15 oz provide the following RDA: 29% of energy, 43% protein, 36% calcium, 75% vitamin A, 76% folate, 94% vitamin B12, and 60% of Vit C. That is a lot more nutrition than they can get from chicken nuggets!

So moms, take heart. Every ounce does count and not just for your baby, but for you too. Not only does making breastmilk burn calories, but if you nurse for a total of 2 years, even if that is 3 babies for 8 months each, your reduce your risk of breast cancer, uterine cancer and ovarian cancer. Do remember, whether you nurse for 2 weeks or 2 years, any breast milk is good for your baby.

My Dad always had a saying, plan your work and work your plan. Most moms plan how to feed their baby, so there are a few things that are need to know. First, supplementing early causes early weaning. Moms who think they can nurse and feed formula early on, loose their milk supply. To keep up milk supply, partial weaning which is what we call it when moms choose to nurse at home, but not at work, can be accomplished only after your milk supply is well established. This happens when your baby is 4 months old. Full milk supply is best achieved when moms do not supplement solids until the baby is 6 months old and even then after the nursing, not before. Next, watch for growth spurts. Babies are supposed to act like they are hungry all the time at 3 weeks, 6 weeks, 3 months and 6 months. This is normal, don't schedule them, just use it or loose it!

For more answers to breastfeeding questions, check out our Q & A:
http://www.lactationconnection.com/breastfeeding_questions.aspx