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US state policies for Medicaid coverage of donor human milk

Journal of Perinatology volume 42, pages 829–834 (2022)Cite this article

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Abstract

Donor human milk is recommended by the American Academy of Pediatrics for high-risk infants when mother’s own milk is absent or insufficient in quantity. Several factors may contribute to the inequitable use of or access to donor human milk, including a limited knowledge of its effects, cost, reimbursement, and regulatory barriers. The American Academy of Pediatrics and the United States Surgeon General have called for investigating barriers that prevent use of donor human milk for high-risk infants and for changes to public policy known to improve availability and affordability. We review the current legislative, regulatory, and economic landscape surrounding donor human milk use in the United States, as well as suggest state- and federal-level solutions to increase access to donor human milk.

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Fig. 1: Percent of very low birth weight infants born in a state with a donor human milk policy.

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Acknowledgements

We are most grateful for the assistance of Pam Brannon, Georgia State University College of Law Coordinator of Faculty Services, and student research assistants Madison Hayes, Colin Daniels, and Kevin Schukle as well as Jennifer Williams, RN INCLC, Andrea K. Welker, J.D, M.A., and the Child Advocacy Today CAT Legal Clinical Program. In addition we would like to thank the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine for grant support to the Georgia Chapter of the American Academy of Pediatrics to advocate for Medicaid coverage of donor human milk in Georgia.

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Author notes

  1. These authors contributed equally: Allison T. Rose, Emily R. Miller.

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Allison T. Rose & Ravi M. Patel

  2. Division of Neonatology, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Emily R. Miller & Jae H. Kim

  3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Emily R. Miller & Jae H. Kim

  4. Georgia State University College of Law, Atlanta, GA, USA

    Margaret Butler

  5. Georgia Chapter-American Academy of Pediatrics, Atlanta, GA, USA

    Claire Eden

  6. Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, New York, NY, USA

    Shetal I. Shah

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Contributions

SIS and RMP conceived the manuscript subject. ATR and ERM equally contributed to the main conceptual ideas, drafted the manuscript with contribution and critical revisions from all authors. MB devised the legal search strategy, reviewed, collated, and interpreted results. All authors discussed the results, edited, and approved the final manuscript.

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Correspondence to Allison T. Rose.

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Competing interests

RMP and ATR receive salary support from the NEC Society for a PCORI-funded capacity-building and research prioritization award on NEC. RMP serves on the data monitoring committee for IBT Therapeutics and Premier Research. JHK is a paid consultant for Fujifilm and serves as a medical advisor for Medela. He is on the Board of Directors for Innara Health and owns shares in Astarte Medical and Nicolette. All other authors declare no competing interests.

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Rose, A.T., Miller, E.R., Butler, M. et al. US state policies for Medicaid coverage of donor human milk. J Perinatol 42, 829–834 (2022). https://doi.org/10.1038/s41372-022-01375-9

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