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Breast milk is medicine: New Pa. legislation ensures babies on Medicaid will get their prescription

A woman holds a baby bottle half full of infant formula.
Eric Gay
Many premature babies are prescribed pasteurized donor human breast milk. Formula can lead to severe gastrointestinal issues that can be fatal. But breast milk is expensive. According to the Mid-Atlantic Mothers’ Milk Bank, it can cost families as much as $100 a day.

Premature babies are sometimes prescribed pasteurized donor human breast milk, which can be very costly. But Pennsylvania lawmakers have sent a bill to Gov. Josh Shapiro's desk that aims to lessen this financial burden on families.

When a premature infant is in the neonatal intensive care unit, or NICU, a new parent gets less skin-to-skin contact with their baby — this and other factors can make it hard for them to produce enough breast milk.

At the same time, drinking formula puts these tiny patients at risk of developing severe gastrointestinal issues that can be fatal. So, pediatricians like Dr. Greg Barretto at UPMC Children's Hospital of Pittsburgh will often prescribe breast milk.

"Their bowel, their body was not yet really ready to be born," said Barretto. "And breast milk has really been much gentler on their body. It's much gentler in their bowels. "

Breast milk also contains immunoglobulins and antibodies that help babies fight infections.

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Despite the benefits of prescribing breast milk, some insurance providers will not pay for what Barretto says is essentially medication for premature infants.

A bill that unanimously passed the Pennsylvania Senate and House will change that. It requires pasteurized breast milk to be covered by the state's Medical Assistance program, or Medicaid. Medicaid primarily provides health insurance to low-income people, though it also covers people with specific disabilities, including some medically fragile infants.

"This is really an absolute game changer," Dr. Amaka Nnamani, the co-chair of the PA Chapter of the American Academy of Pediatrics' Advocacy Committee. Nnamani notes that infants with heart conditions and those born to parents addicted to opioids also stand to benefit.

This development is also welcomed news to Denise O'Connor, the executive director of the Mid-Atlantic Mothers' Milk Bank, located in Pittsburgh's Strip District. Though the nonprofit provides milk on a sliding scale, it can cost a family up to $100 a day to feed their baby.

Parents who can't afford pasteurized breast milk turn to formula despite the possible health complications. Others go to online forums and ask strangers for milk donations. O'Connor says while people who give away their breast milk to internet strangers are generous, the milk is unscreened and therefore poses health risks.

"There are things that would be compatible with breastfeeding your own baby, which are OK — medications, supplements, things like that — that could be extremely problematic for a baby who has compromised or is sick," said O'Connor, who added that pasteurizing the milk ensures it's free of viruses and bacteria that could harm a medically fragile infant.

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.