Sadly I see this all the time.  I ask mom what she is doing, she says BF,
then I hear about some bottles and I ask how much and she says 4 oz every 3
hours!  And then I know it is an essentially bottle fed baby who still is
willing to pacify at the breast.  This is usually at the first visit, it's
almost all over in 2 weeks.  The important time for getting BF established
is over and gone before mom /baby are ever seen.

I work in an office that is very strict about insurance.  State medicaid
usually is taking about 3 months + before it is all straightened out
(covered, on an HMO, on our monthly patient panel list).  IF mom doesn't go
physically into medicaid office within baby's first 30 days (preferably 1st
week) the whole thing takes even months longer.

It is a deplorable situation and so inefficient and dangerous! and it is
the state and federal bureaucracy (read poor workers and old computers)
that makes it that way.  We will see babies for "sick" visits, but no shots
are given or health starts done.   And even then most of these visits are
pro bono,  neither medicaid or state HMOs ever get around to covering them.
 They are much more likely to  take their pitiful capitation back and we
have no recourse.

We eventually get paid for 1 or 2 out of 10 nursery fees!  We have 2 women
in our office who are like the gestapo.  They are very familiar with every
company's rules, filing  etc. and nothing gets by them insurance-wise.
They do their job on our end very well.   I want to scream at somebody
every day, but I haven't figured out yet who that person should be.

sorry this hasn't got much to do with BF.  Just needed to vent.  Sincerely,
Pat in SNJ

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