The issues of choice and motherhood have dominated headlines over the past week. This discourse has centered around a woman’s choice to have a child, but there is also a lesser-discussed maternal choice becoming eliminated for some women: the choice of how they will feed their newborn.
The U.S. has a severe lack of accessible breastfeeding resources for pregnant women as they prepare for their child’s arrival. Many women do not know where to turn to get help or do not have the time to look during the already overwhelming journey of becoming a mother, so they choose not to breastfeed. For the women who are able to find a lactation consultant, they often must spend hours trying to get their insurance to cover the appointments, all while being a presumably stressed mother to a newborn. To address this problem, Trinity Health Of New England teamed up with Nest Collaborative, a startup providing telehealth breastfeeding support, to offer its services to patients free of charge.
The partnership comes at an especially opportune time, as mothers’ choice to breastfeed is being complicated by the nationwide formula shortage. Many women feel like they have to breastfeed their child because they might not be able to access formula, but there are still not enough resources to prepare all them, according to Dr. Walter Trymbulak Jr., an obstetrician at Trinity Health Of New England.
Judith Nowlin, Nest Collaborative’s CEO, agreed.
“We no longer live in households with our own mothers, grandmothers, aunties, cousins and sisters,” she said. “If we rewind just 100 years ago, that was the case. We lived in a built-in support network of people who can help us know what to do when it comes to birthing and breastfeeding and parenting. Nest Collaborative came in to fill that gap of isolation families encounter as soon as they’re sent home from the hospital.”
Nest Collaborative, founded in 2017, provides reimbursed lactation support telehealth appointments with International Board Certified Lactation Consultants (IBCLCs). Patients visit the company’s website, choose an appointment time that best suits them and select an IBCLC who speaks one of eight languages. They also enter their insurance or Medicaid information, and then Nest Collaborative “does all the hard work on the back end” to get the appointments covered, according to Nowlin. Once this initial process is completed, patients can see a lactation consultant on the platform in as little as two hours.
The platform also offers a discounted self-pay rate for uninsured patients. For its partnership with Trinity Health Of New England, Nest Collaborative is covering costs for the health system’s uninsured patients, Dr. Trymbulak said.
During appointments, Nest Collaborative’s IBCLCs build a breastfeeding plan based on each patient’s unique needs. These plans vary and can focus on various elements, such as prenatal education, positioning of the baby, teething, preparing the home breastfeeding space, jaundice prevention and returning to work. The platform serves more than 10,000 parents and babies across the country.
Mothers who breastfeed typically run into difficulty during the first 72 hours post-discharge, according to Dr. Trymbulak. He said his health system pursued its partnership with Nest Collaborative to ensure more women could quickly and comfortably access breastfeeding support when they need it.
“She can log in, she can find an IBCLC who speaks her language, and she can get the help that she needs when she needs it in her own space,” he said. “She doesn’t have to pack the baby up and travel anywhere — it happens right at home.”
To Dr. Trymbulak, this partnership is important because he looks at breastfeeding as true preventative medicine. He said that not only has breastfeeding been shown to improve babies’ health, such as by reducing ear infections and asthma, but it also can help prevent obesity as children grow up. Babies who are fed formula usually get a measured amount, often two ounces, and are fed until the liquid is gone. With breastfeeding, there is not a measurement. Babies who are breastfed learn to accept their own satiety signals, meaning they eat when they are hungry and stop when they are full.
Children who were breastfed usually struggle less with overeating when they are transitioned to table food, and this population usually has fewer rates of childhood obesity, Dr. Trymbulak said. He said this benefit of breastfeeding is often overlooked, as the “return on investment” is seen further into a child’s life.
Through Trinity Health Of New England’s partnership with Nest Collaborative, he hopes patients will receive more access to information on breastfeeding’s benefits and how it can fit into their life.
“I’m huge about choice. I just don’t know that breastfeeding is a choice that people can pick fairly, because I don’t believe that there is support and information in the community,” Dr. Trymbulak said. “To that end, I think it’s important from a public health standpoint, from a prevention standpoint, that we increase our breastfeeding rates.”
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