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Subject:
From:
Jen Delaney <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 10 Sep 2006 19:54:46 -0700
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Hi all.  I'm hoping someone might have had an experience with this previously and has information.
   
  I am working with a mom who's baby is now around 2 1/2 months old (maybe closer to 3 mo. now).
    Mom has PCOS and diabetes. She has lost her supply completely now and has had baby on alimentum (sp?) formula for a few weeks now, exclusively. Baby has severe constipation and was a preemie, 4 weeks, I believe, and below 6 lbs. I don't have the numbers in front of me at the moment, but the main point was this. We, mom and I, were able to get her pediatrician to write a script for breastmilk from the milk bank so very close by to us up until baby is 6 months old, then he wants to reevaluate baby.
   The problem is getting prior approval from medicade. I called them and got a department that stated they "only" cover formula or commercially made foods for baby.  I got the number for the policy making department for the state of Michigan and the supervisor's name.  I have not heard back from her yet and will be calling again tommorrow.  This is my question.  Does Medicade cover donor milk (I think they do...at least for the NICU) and if not, how do you go about requesting a waiver so they WILL cover it, or how do you file a protest? grievance? complaint? if they just flat out will NOT cover donor milk?
   This mom worked SO hard to breastfeed for as long as she could working with me and a very experienced LC, and is very discouraged that she can no longer nurse.  She does occasionally nurse and I advised her she could use a sns if she wanted to nurse while feeding the abm.  She loves the idea of being able to nurse with a SNS with donor milk. She knows baby will be more comfortable and much less constipated.
   I feel so frustrated that medicade's wheels move so slow.  This baby has "colic"  - I would too if I couldn't poop -  and screams for hours in the evening some days.
   could use some help, advice, information, resourses.  Thanks in advance.
   - Jennifer Delaney
    Breastfeeding PC, MSUE/WIC

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