Dawn informed us of the mother who was told she had to pay higher insurance
premiums because she developed mastitis while breastfeeding. Unfortunately
this absurd action will be seen more and more in the US. Many HMOs have hired
people to look closely at physician and medication use patterns in covered
patients and recommend actions to reduce anything that looks to be a
potentially recurrent condition.

This mother has some recourse. The first thing she may wish to do is obtain
the following article: Ball TM, Wright AL. Health care costs of
formula-feeding in the first year of life. Pediatrics 1999; 103:870-876. This
details three recurrent infant diseases and the $331-$475 that the HMO will
pay for these for never-breastfed babies. She should then write a letter of
complaint to her insurance carrier and attach the article asking how they can
justify raising her premiums and not the premiums of all bottle fed babies.

Then, she should file a complaint with her state's insurance commissioner.
Each state has a grievance process. Next she should contact her elected
representative and report this injustice. She should continue to stay in
contact with the state insurance commissioner's office as well as the state's
attorney general. The attorney general may help her if there is a violation
of her rights.

We should all be on the lookout for this in not only breastfeeding mothers
but in the insurance coverage of the baby.

Marsha Walker, RN, IBCLC
Weston, MA

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