IfPA Releases Policy Brief on Human Milk Diet for Preemies

December 4, 2015

by Amanda Conschafter, blog editor

Milk is medicine, explains a new policy brief from the Institute of Patient Access, and access to an exclusive human milk diet has measurable benefits for premature infants. Authored by Mitchell Goldstein, MD, medical director the National Coalition for Infant Health, the brief explores the value of human milk diets, the importance of safety measure for donor milk and the access barriers that some mothers and premature infants face.

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Human milk and breastfeeding correlate with reduced incidences of respiratory complications, gastrointestinal infections and sudden infant death syndrome, explains “The Value of Human Milk Access for Premature Infants.” Moreover, research suggests that the diet significantly reduces the risk of necrotizing enterocolitis, or NEC—a life-threatening condition to which premature infants are particularly vulnerable. With the help of a human milk diet that includes human milk-based fortifier, NEC incidences are reduced by 77 percent.

Because very pre-term mothers often struggle to produce the calories their infants need, human donor milk can be necessary to provide an exclusive human-milk diet. A multi-step process of screening donors and testing and assessing milk quality works to ensure donor milk’s safety and quality.

Yet despite increased availability of donor milk and growing awareness about the value of an exclusive human-milk diet, families of premature infants face a number of challenges in getting this diet for their infants:

  1. Access to hospital-grade breast pumps. The personal pumps that many mothers’ health plans cover do not match the capabilities of hospital-grade pumps in supporting an exclusive human-milk diet.
  2. Insurance and Medicaid coverage for donor milk. Donor milk is important for mothers who have a delayed or inadequate supply of their own milk, yet few hospitals have onsite donor banks. Moreover, some insurers cover the cost of donor milk only under specified conditions. Standards on coverage, as well as Medicaid provisions for lactation services, vary widely—creating confusion and leaving gaps in coverage.
  3. Lack of adequate safety nets for Medicaid recipients. Low-income families may lack education about the value of a human-milk diet; they may also struggle with the logistics of traveling back and forth to the NICU or with providing milk for their infants when they do not have paid time off or maternity leave.

In addition to these barriers, current protocol often requires mothers to opt-in to an exclusive human-milk diet. Scientific consensus, the brief explains, suggests that hospitals should instead require parents to opt out if they choose a non-human milk diet.

To learn more, read “The Value of Human Milk Diets for Premature Infants.”

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