To: Blue Cross Blue Shield

Date: September 20, 2025

Subject: Urgent Request to Reinstate Coverage for Lactation Services from IBCLCs

Dear Blue Cross Blue Shield Representative,

I am writing as a concerned citizen regarding your recent decision to end an out of network contract with The Lactation Network, which has left thousands of women across our state without affordable access to International Board Certified Lactation Consultants (IBCLC). This change has caused millions of women to lose access to the vital expert help they need during one of the most critical and vulnerable times of a mother's journey: breastfeeding.

 This loss of coverage does not only hurt mothers and infants, but also significantly contributes to Alabama’s overall maternal and infant mortality score, which is  currently an F rating, according to the March of Dimes.

IBCLCs are the highest-trained professionals in lactation care. Their specialized clinical skills are essential in identifying and addressing breastfeeding challenges, including latch issues, milk supply concerns, infant weight loss, nipple pain, and feeding complications. These problems, if not promptly addressed, can lead to early cessation of breastfeeding and significant health impacts for both mother and baby.

While BCBS has stated its support for nursing mothers and encouraged them to consult OB-GYNs or pediatricians, these providers—while excellent in their fields—often lack specific training in lactation management. They also may not have the time or capacity for the in-depth, hands-on care required to resolve complex breastfeeding issues. In-network options for IBCLCs are extremely limited or nonexistent in many areas, and virtual care is not a viable solution due to the physical and personalized nature of effective

lactation support.

This gap in coverage is not merely an inconvenience—it presents a public health

issue. Breastfeeding significantly reduces the risk of respiratory infections, gastrointestinal illness, SIDS, diabetes, and obesity in infants. It also supports maternal health, reducing risks of breast and ovarian cancers, heart disease, and postpartum depression.

We urge Blue Cross Blue Shield to take immediate action to:

1. Expand in-network access by credentialing IBCLCs as outpatient providers, or reinstate

out-of-network billing contracts, such as The Lactation Network, Wildflower Health, etc.

2. Ensure reimbursement pathways are available with quick, effective, and un-cumbersome reporting so families are not burdened with out-of-pocket costs for necessary lactation care.

3. Create a pathway for IBCLCs to be able to bill directly as an in-network provider at a

reasonable reimbursement rate.

Families deserve timely, expert breastfeeding support—without barriers or

burdens. Please prioritize access to outpatient IBCLC services in your coverage policies and help improve maternal and infant health outcomes nationwide.

Sincerely,