TY - JOUR
T1 - Lactation Support Services and Breastfeeding Initiation
T2 - Evidence from the Affordable Care Act
AU - Kapinos, Kandice A.
AU - Bullinger, Lindsey
AU - Gurley-Calvez, Tami
N1 - Funding Information:
Joint Acknowledgment/Disclosure Statement: This study was supported by grant R40MC28305, MCH Research Program, from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. Disclosures: None. Disclaimers: None.
Publisher Copyright:
© Health Research and Educational Trust
PY - 2017/12
Y1 - 2017/12
N2 - Objective: Despite substantial evidence of the benefits of breastfeeding for both mothers and children, rates of sustained breastfeeding in the United States are quite low. This study examined whether mandated coverage of lactation support services under the Affordable Care Act (ACA) affects breastfeeding behavior. Data Source: We studied the census of U.S. births included in the National Vital Statistics System from 2009 to 2014. Study Design: We used regression-adjusted difference-in-differences (DD) to examine changes in breastfeeding rates for privately insured mothers relative to those covered by Medicaid. We adjusted for several health and sociodemographic measures. We also examined the extent to which the effect varied across vulnerable populations—by race/ethnicity, maternal education, WIC status, and mode of delivery. Principal Findings: Results suggest that the ACA mandate increased the probability of breastfeeding initiation by 2.5 percentage points, which translates into about 47,000 more infants for whom breastfeeding was initiated in 2014. We find larger effects for black, less educated, and unmarried mothers. Conclusions: The Affordable Care Act–mandated coverage of lactation services increased breastfeeding initiation among privately insured mothers relative to mothers covered by Medicaid. The magnitude of the effect size varied with some evidence of certain groups being more likely to increase breastfeeding rates.
AB - Objective: Despite substantial evidence of the benefits of breastfeeding for both mothers and children, rates of sustained breastfeeding in the United States are quite low. This study examined whether mandated coverage of lactation support services under the Affordable Care Act (ACA) affects breastfeeding behavior. Data Source: We studied the census of U.S. births included in the National Vital Statistics System from 2009 to 2014. Study Design: We used regression-adjusted difference-in-differences (DD) to examine changes in breastfeeding rates for privately insured mothers relative to those covered by Medicaid. We adjusted for several health and sociodemographic measures. We also examined the extent to which the effect varied across vulnerable populations—by race/ethnicity, maternal education, WIC status, and mode of delivery. Principal Findings: Results suggest that the ACA mandate increased the probability of breastfeeding initiation by 2.5 percentage points, which translates into about 47,000 more infants for whom breastfeeding was initiated in 2014. We find larger effects for black, less educated, and unmarried mothers. Conclusions: The Affordable Care Act–mandated coverage of lactation services increased breastfeeding initiation among privately insured mothers relative to mothers covered by Medicaid. The magnitude of the effect size varied with some evidence of certain groups being more likely to increase breastfeeding rates.
KW - Affordable Care Act
KW - Breastfeeding
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U2 - 10.1111/1475-6773.12598
DO - 10.1111/1475-6773.12598
M3 - Article
C2 - 27861824
AN - SCOPUS:85033434598
SN - 0017-9124
VL - 52
SP - 2175
EP - 2196
JO - Health Services Research
JF - Health Services Research
IS - 6
ER -