No insurance coverage for sick Calgary baby’s breast milk needs

Canadian insurers behind US counterparts in providing breast milk coverage

Baby Amalia was born with a hole in her heart, a condition that has resulted in weakened immunity and heightened infection risk, according to CBC News. To shore up her defenses, she needs 30 ounces of breast milk a day, but her mother Charlotte Wallewein can produce only a tenth of that amount.

To make up the difference, Wallewein has had to get a prescription from the Foothills Breastfeeding Clinic to purchase breast milk from a donor bank. NorthernStar Mothers Milk Bank, a Calgary-based non-profit organization, can supply the milk for $3,000 a month – “$17 for four ounces of breast milk,” according to Wallewein – which she and her husband, Adam Baranec, could not afford. And unfortunately, no health insurance provider in Canada is willing to pay for milk.

"This does seem like a lot of money, but it's our break-even cost," said Jannette Festival, executive director at NorthernStar. The price of the milk goes toward pasteurization, rent, wages, training, and other costs necessary for them to meet certain professional standards. Festival said she’s contained costs by employing only part-time workers, but the rigorous quality control process is non-negotiable as the milk is meant for sick and premature babies across Canada.

While Alberta Health services will cover the cost for babies in intensive care, they cut off support once the infants leave the hospital. “[We see struggling parents] on a weekly basis,” said Festival. “Many of them will borrow from family and friends.”

While NorthernStar has a charitable program to support low-income families, Wallewein and Baranec are not eligible as they are both teachers. Wallewein said she had contacted her insurance provider, Sun Life, and tried to make a claim, but was told that “the milk was considered food even though it's by prescription. But interestingly the insurance company will cover breast milk pumps. So if you're capable of producing that milk and you just need a pump to get it out, that's covered.”

NorthernStar is fully behind the call for insurance coverage. “If you can invest in that baby when it's very small so that it can have a healthier outlook, why wouldn't you do that?” said Festival, whose company has agreed to offer Wallewein a discount for the meantime. “I mean for an insurance company, it would lower their costs in the long run.”

In a statement to CBC News, Sun Life Financial said it sympathizes with Wallewein and her family. “Since this is not an expense that we have commonly been asked about, we are investigating the issue further,” the statement read. Wendy Hope, a vice president of the Canadian Life and Health Insurance Association, said that the concern will likewise be discussed among industry professionals.

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