This is a late response to Dr Alla Gordina's post. I agree that it is 
inappropriate that the health insurance sector doesn't regard adoptive 
breastfeeding as part of lactation and it seems the coding depends on 
definitions that don't fit the whole range of human lactation.

Lactation is more robust that is generally considered, probably because many 
clinicians today only see breastfeeding as a short-duration situation 
between a birth mother and her baby - started and soon over. Mothers 
breastfeeding the babies they gave birth to can and do come in and out of 
lactation, with an older baby or toddler who was an experienced breastfeeder 
returning to the breast for comfort after an interval.  Yes, even when the 
mothers aren't motivated to relactate - but the child is. (See references 
below.)  One step further on is induced lactation done on purpose, whether 
for the birth mother's baby or an adopted baby. It is still part of the 
wonderful tapestry which is the diversity of human lactation. It looks as if 
the insurers need more exposure to this aspect of human lactation and the 
needs of the adoptive and foster mothers who breastfeeding their children. 
As you say, "it is an up-hill battle, but it can be won", and the way to do 
it is to keep on keeping on, keep making claims for reimbursement, keep 
talking to the insurers.

References:

Phillips V [Thorley V]. Relactation in mothers of children over 12 months. J 
Trop Pediatr 1993;39:45-48. [middle-class Caucasian Australians - written 
under my former surname]

Thorley V. Relactation: what the exceptions can tell us. Birth Issues 1997; 
6(1):24-29.

Marquis GS, et al. Recognizing the reversible nature of child-feeding 
decisions: breastfeeding, weaning and relactation patterns in a shanty town 
community of Lima, Peru. Soc Sci Med 1998; 47: 645-656.


Virginia

Virginia Thorley, OAM, PhD, IBCLC, FILCA
Lactation Consultant (original cohort of 1985).
Cultural historian of the History of Medicine.
Brisbane, Queensland, Australia.
Website: www.virginiathorley.com
[log in to unmask]

--------------------------------------------------------------------------------



----- Original Message ----- 
From: "Alla Gordina MD, IBCLC, FAAP" <>
To: <[log in to unmask]>
Sent: Thursday, September 12, 2013 7:55 AM
Subject: Adoptive breastfeeding


> To continue with the subject of adoptive breastfeeding.
> Unfortunately adoptive breastfeeding is not fully recognized as a 
> legitimate process on so many levels (coding and insurances included).
>
> IMHO the only way this situation can be changed is by keeping the issue in 
> the public eyes as much as possible.
>
> It is an up-hill battle, but it can be won. And by saying "the up-hill" I 
> do also mean the actual direction of information from the grass root 
> movement of dedicated mothers to the higher echelons of medical and 
> adoption/child welfare establishment.
>
> Last month I was happy to meet during the NACAC (North American Council on 
> Adoptable Children) annual meeting in Toronto adoptive and foster mothers 
> who did breastfeed their kids. And this November both New Jersey and New 
> York adoption conferences will finally hold adoptive breastfeeding 
> workshops!
>
> Alla
>
> -- 
> Alla Gordina, MD, IBCLC, FAAP
> General Pediatrics
> Breastfeeding Medicine
> Adoption and Foster Care Medicine

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