Sunday, January 27, 2013

Breast Pump Coverage Is Needed

I heard a story on NPR the other morning about how the new breast pump coverage in the Affordable Care Act is affecting the sale of breast pumps.  According to the business featured in the story, things are really booming.  The story went on to tell of women who already had breast pumps but who, since pumps are now "free", were going to go ahead and get another one - "why not?"  It then featured a very snooty economist who opined that these breast pumps were not necessarily going to encourage breastfeeding (and therefore be worth the cost by lowering health care costs) and would very likely be used by women who were "going to breastfeed anyway".  The gist of the story being that this provision of the Affordable Care Act was resulting in a bunch of expensive mooching off the government for no worthwhile result.

Clearly, the economist featured in the story and the planners of the story have never tried to desperately maintain a milk supply while at work using a cheap-ass pump.

You may not know that I am the Supreme Goddess of Pumping.  Really.  Go ahead - bow down - I am impressive.  I have two children.  I breastfed both of them exclusively for six months until they started eating solids and continued to nurse them afterwards for as long as they liked while still keeping a roof over their tiny little heads.  I pumped for one year for each child while at work and neither of them ever tasted a drop of formula.  The secret to my amazing Goddessness?  


Stubbornness certainly was a factor that I can take credit for because I would not have made it, even with the luck, without the stubbornness - pumping is hard - but the stubbornness would not have been enough either without the luck.  Luck was really the deciding factor.

So much for Goddesses and the whole bowing down thing.  Yeah - I don't actually deserve that.

The luck was threefold:  

One - healthy babies - the most important and best luck.  

Two - a job with flexible hours that allowed me to pump for over thirty minutes twice a day while taking phone calls and doing paperwork and still run over to the daycare and nurse at lunch most days.  I don't know how people with less flexible jobs like the one I have now do it because I barely pulled it off.

Three - a good Medela breast pump. (Medela!  Let me sing your praises!  Medela!  The only game worth playing!  Medela!  I love you forever, oh!  Oh!  Medela!)  I was lucky enough to be able to afford to rent (first time - they didn't have the personal ones yet) or borrow (second time - thank you, Sarah) a good Medela, the only brand of pump worth having.

As I nursed my babies over my lunch breaks and while dropping them off and picking them up at daycare, I would see countless new mommies start out with their good breastfeeding intentions and crappy pumps and within a few weeks of starting to work full time, they would give up and turn to formula and their little four-month-olds would start the long daycare dance of gastrointestinal and respiratory illnesses that just seem normal after awhile.

These mothers did plan to breastfeed anyway, as the article says, but they were not lucky.  They could not afford the $300 Pump-In-Style and were trying to make do with a $40 crap-job from Gerber or the tiny Medela pumplet thing that is meant for pumping a bottle every few months or so when you might have to go to a doctor appointment without your baby.

Actually, I do know how mothers with less flexible schedules than I had then manage now - when they are lucky enough to have a good Medela.  Today's Medelas are much better than the good Medelas of my day - as much better than mine as mine was better than the crappy non-Medela pumps.  Almost every year, they improve the technology, creating pumps that mimic a baby's suck better and thus empty the breast more efficiently so that a mother can keep up her supply at work without having to spend a couple of hours a day at the pump.

Many mothers who intend to breastfeed can afford a crappy pump without health insurance, and if you are an at-home mother with a healthy baby, a crappy pump is all you need, for those occasional bottles in unusual situations.  If, however, you have a sick baby who is too weak to suck at the breast or if you must work or attend school full-time while nursing your baby, your intentions and a crappy pump are not going to be enough to keep up your milk supply, no matter how awesome you are.  You need a good Medela pump to make it work.  

Babies are expensive, especially when you are paying for daycare - something you do not want to do on the cheap - and many mothers cannot afford the pump they need to keep their babies healthy while they work.  The coverage that the Affordable Care Act now provides will make all the difference for working mothers who were not as lucky as I was.  

I just hope that as all the details settle, the pumps that get covered are the good Medela ones.  Deciding that only cheap crappy ones get covered really won't help.  I don't work for Medela or anything, I assure you - I just care about healthy babies.  

For now, the Affordable Care Act does, too.


Andrea said...

Here, here! I, too, had luck on my side: I was able to take a year off of work for each birth (unfortunately not each baby) and bought a used Medela off of a co-worker for super cheap. I also grew up in a home with lots of breastfed babies, so I had no cultural, familial, or societal inhibitions; it just seemed like the normal thing to do.

I hope you sent this as a letter to NPR and stick it to that economist (not to mention the reporter who did not do a good job balancing this schmuck with a voice like yours).

Anonymous said...

Hi there! I found you from a chain of random trackbacks, but I LOVE your post.

MY son is 8 months, and I've been exclusively pumping since I went back to work at 3 months post partum. Little guy liked the ease of the bottle.

Stubborness (competitive) and a medela pump are the only reasons I am still pumping today. I purchased mine outright (not second hand, borrowed, or on sale) and it was hard for me to shell out all that cash. Little did I know it was the BEST investment I could make for my baby's health.

I was thrilled with the new health care coverage of pumps, but unfortunately I missed the window. It would not go into effect until my new health care year started (after baby was born). By the time I could request a pump, I would have already needed it.

If I purchased a cruddy cheap pump, I can guarantee you that I would be buying formula right now. :)