By Brenda Bandy
It’s been another long night. The baby’s been crying and no one has slept much. When was the last time he needed a diaper change? Why does nursing hurt so much? He just doesn’t settle after nursing for what seems like hours. Is this normal? Is he getting enough?
A quick call to the doctor’s office in the morning reveals why it can be so difficult to continue breastfeeding in Kansas – this mother’s KanCare coverage just expired after the baby’s 2-month checkup. And the baby’s doctor and nurse aren’t quite sure what’s wrong and they don’t have enough time to watch a full feeding. They refer the family to a lactation consultant who explains that KanCare doesn’t cover her services, so the family will have to pay her fee out of pocket.
This story is all too familiar to many families on Medicaid in Kansas. The gaps in KanCare coverage after the birth of a child leave many families with few options to access the skilled clinical care they need to answer breastfeeding questions. More than 90 percent of mothers in Kansas choose to breastfeed. Yet only a third of babies make it to their first birthday still receiving breast milk as recommended by health care providers. The most recent data from the U.S. Centers for Disease Control and Prevention identifies the rate of breastfeeding for one year at only 34.6 percent in Kansas.
Low breastfeeding rates in Kansas result in significant excess health care costs and preventable deaths. The economic benefits of breastfeeding to the family, health care system and workplace are widely published in the literature. If 90 percent of babies in Kansas were breastfed according to universal medical recommendations, Kansas would save nearly $27 million per year in health care costs alone. It is estimated 22 women’s lives would be saved each year due to fewer cases of breast cancer, heart disease, diabetes and hypertension. Increased breastfeeding beyond the early days could save the lives of seven children, due mostly to Sudden Infant Death Syndrome (SIDS).
KanCare expansion matters to families after the birth of a baby. By expanding access to lactation support to more families, more mothers will be able to breastfeed for longer. Many women are left without insurance coverage after 60 days postpartum, at a particularly vulnerable phase of their lives. Lack of health insurance among women of childbearing age is nearly twice as high in states that have not expanded Medicaid. When mothers receive inadequate prenatal and delivery care, their babies face a higher risk of disease and premature death. States that have expanded Medicaid have seen a 10 percent increase in breastfeeding duration rates. Medicaid expansion has been proven to lower maternal and infant mortality and support women’s health before, during and after pregnancy.
Medicaid expansion in Kansas matters to the families who are falling through the coverage gap. It’s time we expand KanCare so we can all get a good night’s sleep.
Brenda Bandy, IBCLC, is executive director of the Kansas Breastfeeding Coalition