Affordable Care Act Linked To Increased Duration of BreastFeeding Interview with:
“Babies at Brunch!” by TJ DeGroat is licensed under CC BY 2.0
Kandice A. Kapinos, Ph.D.
RAND Corporation
Pardee RAND Graduate School What is the background for this study?

Response: In the U.S., we have relatively high rates of breastfeeding initiation – about 80% of mothers will attempt breastfeeding, but rates drop off precipitously in the first few months of an infant’s life. There are tremendous health benefits for both the mother and child from breastfeeding and estimates of significant cost savings from diseases prevented from breastfeeding. However, breastfeeding can be difficult, especially when you need to return to work or school. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, but only 22% of mothers breastfeed exclusively for 6 months.

My coauthors, Tami Gurley-Calvez and Lindsey Bullinger, and I were interested in evaluating provisions in recent healthcare legislation (the Affordable Care Act) that required private insurers to cover lactation support services, including breast pumps and visits with lactation consultants, without cost-sharing. What are the main findings?

Response: We found that this policy change resulted in significant increases in breastfeeding duration. Mothers breastfed for an additional 0.57 months overall, which was a 10% increase. We also found that among those breastfeeding, the policy change was associated with an additional 0.74 months in exclusive breastfeeding – a 21% increase. We found no increase in breastfeeding initiation or age at first formula feeding. What should readers take away from your report?

Response: There are many barriers to sustained breastfeeding for new mothers. Policy efforts to promote breastfeeding that increase mothers’ access to support services and equipment can improve the amount of time infants are breastfed. What recommendations do you have for future research as a result of this study?

Response: Our study examined a policy change that affected access to support services and breast pumps, but there are several other barriers that can be studied.

For example, the ACA also required large employers to provide adequate time and space for new mothers to express their breastmilk. Although evidence on similar state mandates have found small increases in breastfeeding, we don’t know how effective a larger scale, national policy change will be. We also know that there are significant socio-economic disparities in breastfeeding rates but more research is needed to learn how to mitigate those differences.

Disclosures: The authors received funding from Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (Title V, Social Security Act) grant R40MC28305 to complete this work). Thank you for your contribution to the community.


Effect of the Affordable Care Act on Breastfeeding
American Journal of Public Health
By Kandice A. Kapinos

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on January 2, 2018 by Marie Benz MD FAAD