Sonoma County breastfeeding advocates applaud expanded Medi-Cal coverage for supplemental breast milk

Sonoma County breastfeeding advocates have begun spreading the word about a new state policy that significantly expands Medi-Cal coverage for new moms seeking donated breast milk for their babies.

Under the new policy, which took effect late last year, new mothers with Medi-Cal now will have free access to donated breast milk if, among other things, the mother is having trouble producing sufficient milk or if their baby is having trouble breastfeeding.

Previously, Medi-Cal, the state’s Medicaid program, benefiting lower-income residents, only covered donated milk in cases where the infant weighed less than 3.3 pounds, said Dr. Lauren Spieler, a family physician and breastfeeding medicine specialist for Kaiser Permanente.

“This is really exciting and a huge step in the right direction,” said Spieler, who runs Kaiser’s local breastfeeding medicine clinic.

Conditions that affect a mother’s own milk supply include previous history of breast surgery or hormonal conditions where they’re unable to produce milk, Spieler said. For newborns, the problem could be trouble latching onto a mother’s breast due to lack of strength or coordination, she said.

Spieler, who is also the medical director of the Sonoma County Breastfeeding Coalition, said the new state policy also expands the pool of clinicians who can prescribe donated milk for Medi-Cal patients. Aside from physicians, that pool now includes midwives and nurse practitioners, she added.

A mother’s breast milk is widely considered the “gold standard” for achieving optimal baby health, said Susie McCulloch, a lactation consultant for the county’s Women, Infants and Children (WIC) office. McCulloch, who chairs the local breastfeeding coalition, said her organization is making an aggressive push to educate local health care providers about the new policy.

There are two state-approved and licensed, nonprofit breast milk banks in California. The closest for North Bay families is Mother’s Milk Bank in San Jose, where the out-of-pocket cost to buy donated human milk is $3.50 an ounce.

McCulloch said the cost can add up, as the average one-month-old baby consumes 25 to 30 ounces of human milk a day. The cost previously put donated human milk out of reach of moms with Medi-Cal.

Spieler said expanding Medi-Cal coverage will help reduce the practice of informal sharing of breast milk, as well as that of mothers turning to the online “dark market,” where the quality of the donated milk is often questionable. In some cases, she said, human milk obtained online has been found to contain cow’s milk, which can be harmful to babies.

Human milk banks ship donated milk on ice using a courier service. The amount depends on how much a mother needs and is prescribed, McCulloch said.

About 95% of moms who breastfeed their infants do not have a problem doing so, she said. The rest may have some issues with their milk supply in the beginning of the breastfeeding process, she added.

Advocates said one of the challenges posed by the new expansion of Medi-Cal coverage will be an expected growth in demand and the need to increase donations.

Angelica Rojas, a spokesperson for Mother’s Milk Bank, said medically vulnerable babies, particularly premature infants in neonatal intensive care units are the bank’s biggest priority. The bank mainly serves families in California, but also caters to those in states where there are no donated milk banks.

“The demand is always higher than supply,” Rojas said. “In California, the need for donated human milk is always higher because we do have a high population of (intensive care-unit) babies.”

Last year, the bank distributed 925,000 ounces of human milk, she said. “Our goal this year is to increase supply and to reach out to mothers who can donate milk,” she added.

Rojas said most insurance plans will cover the cost of donated mother’s milk. Foster babies who have Medi-Cal also will have access to donated human milk, she said.

Human milk provides health benefits for all newborn infants but is particularly good for high-risk infants, especially those born with very low birth weight, less than 3.3 pounds, according to the American Academy of Pediatrics.

State health officials say that mother’s milk can help decrease rates of necrotizing enterocolitis, or NEC, a serious gastrointestinal problem that mostly affects premature babies.

Ashley Mora, a registered nurse and lactation consultant at Santa Rosa Community Health, said most of her patients are able to successfully breastfeed. The new state policy, she said, “is huge and levels the playing field as far as access to breast milk for mothers who need the supplementation for their babies.”

Mora said that previously parents had to pay out of pocket for expensive donated milk, or supplement with formula. Having access to donated breast milk covered by insurance provides mothers the choice to give exclusive breast milk to their babies, she said.

For more information on how to donate human milk, visit mothersmilk.org or call 877-375-6645

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.