Affordable Care Act led to increase in breastfeeding, Indiana University research finds

BLOOMINGTON, Ind. -- Thousands more children were breastfed, and breastfeeding continued for more months, due to health insurance changes under the Affordable Care Act, according to new Indiana University research.

Both outcomes are seen as encouraging because breastfeeding offers remarkable disease protection for both mothers and children, said researcher Lindsey Bullinger of IU's School of Public and Environmental Affairs.

"The Affordable Care Act has had a significant, positive effect on breastfeeding, and our findings show that many more mothers and many more children will likely lead healthier lives as a result," Bullinger said.

With co-authors from the University of Kansas and the RAND Corporation, Bullinger reached these conclusions about the ACA's impact:

  • Increased probability that a baby would be breastfed. About 47,000 more infants were breastfed in just one year under the ACA, also known as Obamacare. The increases were especially notable for black, less educated and unmarried mothers. The researchers say the increase is due to the ACA mandating health insurance coverage of lactation support services and equipment. The finding was based on a study of data gleaned from the National Vital Statistics System's census of U.S. births.
  • Increased duration of breastfeeding. Data from the U.S. National Immunization Survey showed the increase was a few weeks for mothers who combined breastfeeding with formula and for those who breastfed exclusively.

Breastfeeding has generally been increasing in the U.S., but the Affordable Care Act gave the trend new momentum. It required large employers to provide reasonable break time and a private place for expressing breastmilk as well as mandating coverage of lactation support services and equipment. Those services can increase a woman's commitment to long-term breastfeeding since breast pumps are critical for mothers separated from their babies while at work or school.

"Many of the economic burdens, such as the costs of buying a breast pump, may be greater for less educated or unmarried mothers," Bullinger said. "These are groups that historically have had lower breastfeeding rates, so the increases we found are especially welcome."

Bullinger's co-researchers are Tami Gurley-Calvez of the University of Kansas Medical Center and Kandice Kapinos of the RAND Corporation. Their findings were published in peer-reviewed articles in the American Journal of Public Health ("Effect of the Affordable Care Act on Breastfeeding Outcomes") and in Health Services Research ("Lactation Support Services and Breastfeeding Initiation: Evidence from the Affordable Care Act").

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Jim Hanchett

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