The safest place for a baby to sleep is on his/her back, in an empty crib (no blankets, pillows, or stuffed animals), ideally in the same room as a parent. These steps are linked to a much lower rate of Sudden Infant Death Syndrome (SIDS) and infant suffocation. Since the National Institute for Health launched the Safe to Sleep campaign (previously called Back to Sleep) in 1994, SIDS deaths have declined 50 percent while rates of back-sleeping have increased. The campaign works with pediatricians and other medical professionals as well as community leaders to communicate the basics of safe sleep and connect families with resources to help address issues they face.
As part of Prematurity Awareness Month, the March of Dimes released their annual Premature Birth Report Card which revealed that the preterm birth rate increased nationally for the second year in a row – 9.8 percent of births in 2016 were “preterm” (defined as before 37 weeks gestation). Preterm births have serious health and development impacts on children long-term, though progress has been made on a variety of medical interventions and policies to help reduce both the frequency of early birth and improve the life changes for children born too early.
Breastmilk is linked to a number of health benefits for babies and moms, but the stakes are particularly high for babies who are born premature. Often, these babies face health challenges but moms may not be able to nurse as their milks has not yet come in. Human milk banks – which collect donor milk, screen and pasteurize it to ensure safety, and distribute it to families whose infants need it – can help.
According to the Human Milk Banking Association of North America (HMBANA), donor milk for premature babies “has been shown to reduce the incidence of necrotizing enterocolitis, sepsis, and infection, resulting in shorter hospital stays.” About 10 percent of premature babies (especially those born before 32 weeks) develop necrotizing enterocolitis (NEC), a potentially fatal intestinal disorder. Babies who receive breast milk are less likely to develop the condition compared to babies who receive formula.
Families must be prescribed donor milk from their doctors; HMBANA milk banks across the county prioritize the most seriously ill infants. However, families face a number of barriers. First, milk banks may not have enough milk to meet the need. Additionally, not all hospitals have a donor milk program, especially among hospitals with high Medicaid rates; learning about this option and acquiring milk may fall to already stressed parents whose babies are in the NICU.
One of the biggest barriers is the cost – while milk banks receive milk for free and operate as non-profits, the costs of processing and delivering the milk are borne by families at about $3 to $5 per ounce, which quickly adds up. Donor milk is more expensive for hospitals upfront than is formula; however, donor milk can save roughly $8,200 per NICU infant by reducing hospitalization for NEC and other conditions. Only five states and the District of Columbia require that Medicaid cover donor milk in some situations; New York recently passed such a bill as well.
While these laws don’t apply to all insurance, private companies often follow Medicaid’s lead in deciding what to cover – so covering donor milk for Medicaid families is an immediate help for low-income families most in need and a step towards donor milk for all families.
My son was born earlier this year – late, healthy, and hungry. From my access to paid maternity leave to health insurance coverage of OB/GYN visits and a lactation specialist when we struggled to flexible work policies and a welcoming community culture, these policies and practices allowed us to develop a strong nursing relationship and eventually become a milk donor. The process has been tremendously rewarding (and baby K’s first lesson in the importance of sharing!) but millions of American moms struggle with breastfeeding and pumping because they do not have these supports.
By supporting policies that we know help improve breastfeeding rates and pushing for health insurance coverage for donor milk, we can improve health outcomes for medically fragile infants and reduce hospital costs in treating premature babies.
By Megan Carolan, Director of Policy Research