Beyond Awareness: Making 'Support for All' a Reality in Lactation Care

Despite more than three decades of advocacy, a critical gap persists between awareness and action in lactation support. Campaigns like World Breastfeeding Week and National Breastfeeding Month successfully elevate the conversation each August. However, the ultimate goal must be to embed this support into our communities year-round, making it a consistent and readily available resource, not just a calendar event.

I've known the importance of lactation support for 25 years as an IBCLC, helping thousands of families reach their breastfeeding goals. And also this August, I became a grandma! As I watched my daughter begin her breastfeeding journey, I re-lived the entire spectrum of emotion—the magic, the fatigue, the sheer intensity. It reinforced on a visceral level why this support is so critical; it is not just helpful, it is fundamental. 

Why Awareness Isn't Enough

For centuries, breastfeeding was a skill passed down through generations. Children learned how to do it simply by watching their mothers, grandmothers, and others in their community. It was a normal, visible part of daily life. In modern society, this natural learning process was interrupted. Breastfeeding became much more private, and as a result, many people never see it happen. 

This lack of visibility created social and legal challenges. It wasn't until 2018 that all 50 U.S. states legally protected a woman's right to breastfeeding in public. Yes, that date is correct, 2018. Before this, many faced criticism and the threat of public indecency charges. Similarly, returning to work was a major hurdle for nursing parents until the 2022 PUMP Act that guarantees most employers allow reasonable break times and a private, non-bathroom space to pump milk.

While many expectant mothers seek out prenatal education on breastfeeding and childbirth, the rates are not as high as breastfeeding initiation itself, at 83%. By 6 months, which is when babies should still be breastfed, just over half of infants still breastfeed, a quarter are exclusively breastfed, and a majority of families are not breastfeeding as long as they intend to. Why?

Many families begin their lactation journey in the hospital, but once they walk out those doors that’s where the most significant questions and challenges arise. That’s where continuity of care from professionals is needed. Disparities by race, ethnicity as well as the state a new mother resides in, all affects her access. Ultimately, the conversation about infant feeding is a conversation about community health. A society is measured by how it treats its most vulnerable, and that includes ensuring every baby gets the healthiest possible start. The support a new family receives in those critical early weeks ripples outward, creating better health outcomes that strengthen our communities as a whole. 

When an ACA Mandate Doesn’t Mean Access

When the Affordable Care Act rolled out over a decade ago, the promise was clear but the reality is different. The goal: to remove cost as a barrier to breastfeeding support for new families. Yet, here we are in 2025, and the interpretation of that promise is left up to individual health insurance plans despite multiple studies showing that women who receive support from an IBCLC - International Board Certified Lactation Consultant - breastfeed longer.

Even with the attention breastfeeding gets in August, many still do not know about the ACA requirement, and families struggle to find the right support at the right time in their own communities. At Wildflower, we saw that accessing one-on-one lactation care was a challenge, and there was a clear need for high-quality clinical support that just wasn't easily available. To bridge that gap, Wildflower expanded our model of care to include virtual and in-person lactation consultations, providing guidance from IBCLCs to educate and empower families to achieve their breastfeeding goals. 

The Future of Breastfeeding Support – A Shared Responsibility

We’ve taken shared responsibility to heart in creating Wildflower’s lactation support program. We listened to our health plan, provider and health system partners. We collaborated with IBCLCs to build a portal that makes their patient care seamless and effective. And this collective effort has led to a broadly accessible, nationwide network of more than 1,500 Wildflower IBCLCs ready to support families, giving them the easy button to care that they need in the days, weeks and months after delivery.  

Despite these accomplishments at Wildflower, there’s more work to do. Forging a shared path toward sustainable and accessible lactation support is easier said than done. We know change takes time. What type of change are we advocating for?

1. Integrate Lactation into the Care Continuum: Ensuring that comprehensive, accessible lactation support is not just a statement, but a foundational pillar of maternal and infant health in those gaps after L&D, and between OB and pediatrician appointments.

2. Simplify Access and Enhance Network Adequacy: That the ACA requirement is upheld by our local and national health plans, with goals of clearer communications to members about lactation benefits, transparent claims processes, and proactive outreach to all growing families. 

3. Prioritize All Levels of Lactation Support: Acknowledge that IBCLCs are the highest clinical credential in lactation and ensure geographic coverage and cultural competence.

Here is my mission as an IBCLC, as a mom and now as a grandma: To collaborate, advocate and innovate to build a healthcare system where every family receives the qualified, sustained lactation support they deserve.