What do lactation consultants and doulas do, and how do their roles differ? What does it look like to be an Aeroflow Health lactation consultant? 

Leteace: As a lactation consultant, we’re there to sometimes clarify breastfeeding goals with moms and give them the education and support that they need. We know that with breastfeeding, support is one of the most significant indicators of success and preparedness, so we try to give them a headstart for that and also let them know that we’re there to support them after the baby arrives. Currently, Aeroflow Breastpumps offers both group and 1:1 education sessions for moms. The group sessions seek to help further clarify knowledge on specific topics, and then 1:1 sessions are dedicated to meeting mothers where they are in an individualized format. This could look like helping write a birth plan or providing tailor-made tips and education based on mom’s needs. A recent Aeroflow Breastpumps study that found that 97% of moms who attended our classes felt more confident in their breastfeeding journey. 

Aleah: A doula is a non-medical person trained to assist families during childbirth and who might also support the family after the baby is born. Where doulas and lactation consultants differ is that not all doulas will have additional lactation-specific education and training. As far as doula certification, many doulas will take more breastfeeding classes to get basic knowledge but they may not get the full certification to attain the additional tools that help families be successful with breastfeeding initiation and to help with the duration of breastfeeding.

How do commercial insurance plans, typically employer-sponsored, differ from Medicaid programs in terms of providing these maternal health benefits?

Kiera: We’re seeing many differing coverages regarding policies for doulas and lactation consultants. In addition to what Aleah said, Aeroflow stands out when it comes to prenatal education. We help ensure that mom and dad or the parents feel prepared. We are seeing that we have to educate many health plans on the differences between doulas and lactation consultants. It can be easy to misunderstand the differences between the two. With commercial plans, we’re seeing a lot more coverage with doula services and lactation, which is wonderful, and we’re seeing a lot of Medicaid states break into that space as well. We are excited to see many policies really come to terms with the day and age of allowing telehealth services, which is wonderful as well.

As a physician who cares for mothers and babies and partners with Canopie, what opportunities do you see for health plans to better support their members with maternal mental health services, particularly about lactation?

Dr. Haggerty: There is definitely room for improvement in the lactation and mental health space. In my private practice, Fourth Trimester Doc, I focus on caring for dyads as a whole, so we see birthing people and newborns and serve them as a unit. We must identify that the health of the infant is reliant on the health of the birthing person and vice versa. Around the mental health space, I don’t see that health plans are providing the same level of coverage. Many people have cost-sharing requirements, out-of-pocket expenses or have trouble finding care with providers that are well-versed in perinatal education. This is definitely a barrier to care for folks.

Mental health is critical for breastfeeding or body-feeding success, especially when challenges arise. We see that lactation challenges and perinatal mental health disorders go hand in hand. When we have someone who has challenges with lactation, it’s almost inevitable that they will also have challenges with their mental health and vice versa. I actually use lactation challenges for diagnosing or deciding if there are mental health concerns that need to be addressed. For example, if someone has a huge freezer stash of breast milk that they keep storing, this is an indicator for me that there might be postpartum anxiety involved. This is just another reason why lactation and mental health go hand in hand and must be addressed in correlation to one another.

Recently, Aeroflow Health collaborated with Canopie, Florida Blue and GuideWell to better provide access to mental health services and reduce health disparities. Can you explain what we learned?

Ryan: It has been an interesting journey to partner with Canopie and Florida Blue. We’ve seen the evolution of the breastfeeding benefit that initially came about as a part of the Affordable Care Act and has slowly begun to change over the years. We’re starting to see the strides and elements coming together. The breast pump was one of the first items covered under the ACA for health plans and then breast pumps and supplies were introduced alongside the importance of access to clean parts to continue breastfeeding. Then came the introduction of lactation consulting and doulas, which has led to additional positive outcomes. Now, we’re seeing the opportunity to interweave mental health into the benefit. It was interesting in the Florida Blue pilot; we were able to reach many of their members who wouldn’t otherwise engage with their health benefits and then help them engage with maternal mental health resources through Canopie. We also were able to help Florida Blue identify members that were medium to high risk and needed extra support, and then Florida Blue was able to deploy their case management teams to better focus on those members who presented a need.

Based on a recent United States Lactation Consultant Association study, only 21% of IBCLCs identified as non-white. Why is this concerning, and what is a maternity care desert?

Leateace: Great question! Recently, March of Dimes released a report on maternity care deserts across the United States, speaking to how there is a lack of maternity care resources like hospitals, birth centers, and other locations where moms can get support during the perinatal period. Access is genuinely a concern. In terms of providers and diversity, it’s important because patients want to see themselves in their healthcare providers. While cultural humility is a big agenda item right now, it’s also vital to have culturally congruent care, where they feel like their provider is a safe space where they can share their concerns and worries and receive the support that’s specific to them. So, it’s important to try to increase the diversity in this profession. 

Aleah: One of the things we love to have, after our classes and consultations, specifically with Aeroflow, we have these surveys that patients can immediately fill out. It’s very helpful to get this feedback. For example, here’s one testimonial from a patient speaking about her experience with Leteace: “The Aeroflow classes have taught me a wide range of information that I did not get from taking classes for my first birth. Leteace consistently had great information to share with the classes I was in and was very knowledgeable about birth and breastfeeding, and I plan to work with her again if and when I schedule another appointment.” These moms are getting the care that they need and are very much coming back for seconds and thirds. They want this help and support via telehealth because they can’t sometimes get it in these maternity care deserts. Sometimes the people that we see in the classes are from small cities where there is 1 hospital and 1 lactation consultant or no consultant at all. Being able to provide that virtual space for these families is so helpful and they deserve to have it.