Despite the law, many new mothers have found it nearly impossible to get timely help for breast-feeding problems since Jan. 1, when health insurers began updating their coverage. While a 2011 Surgeon General's report hailed lactation consultants as important specialists, few insurers have added them to their networks.
Some insurers simply point women to pediatricians not necessarily trained in lactation. Even then, women often must locate help on their own, leading to delays that jeopardize a mother's milk supply.
Breast-feeding advocates fear this mandate is falling victim to bureaucratic foot-dragging, cost-saving and ambivalence.
"It's abysmal, the state of lactation services being provided by insurance companies currently," said Susanne Madden, a founder of the National Breastfeeding Center, which last month published an unsettling assessment of the breast-feeding policies of insurers nationwide. Twenty-eight out of 79 received D's or F's.
New mothers face a number of obstacles in breast-feeding, including insufficient milk or a painful infection. Problems must be resolved quickly: when a baby is hungry, there is little time to wrangle with an insurer over payment for a breast pump or a lactation consultant. A delay can mean that mothers turn to formula, don't establish an adequate supply, or quit.
Image: Breastfeeding mother, via Shutterstock