In a landmark reversal, the I.R.S. announced that breast pumps are now a tax-deductible expense.
Under this ruling, women will now be able to use pre-tax Flex Spending Accounts (FSAs) to buy breast pumps and related accessories. For those without FSAs, the cost of pumps will be tax-deductible if their total medical costs meet the required percentage of adjusted gross income.
For some families, this will be a nice way to save some money. But for the moms who struggle to pay for a quality breast pump, this policy will make it possible for them to continue breastfeeding their babies while they work and for the full 12 months recommended by the American Academy of Pediatrics. And that means the likelihood that the U.S. will reach the goals set in Healthy People 2020 for breastfeeding is much greater.
In a country where employers are only required to provide 12 weeks of unpaid maternity leave, the challenges associated with breastfeeding after the return to work are the No. 1 reason moms report as the cause for early cessation of breastfeeding. Breastmilk production follows the rule of supply and demand. If a breastfeeding mom regularly goes a full day without expressing breastmilk, her supply wanes and will eventually dry up, leaving her no choice but to use formula. When mom and baby are separated for an extended period, breast pumps make it possible to stimulate milk production while the pumped milk can be stored for later use.
Studies have shown that breastfed babies are protected against common childhood gastrointestinal and respiratory infections, stomach cancers and peptic ulcers; have a reduced risk of depression and behavioral problems; might even have higher IQ; and are less likely to be obese later in life -- a cause championed by First Lady Michelle Obama in her Let's Move Campaign to reduce the rate of childhood obesity.
Further, women who breastfeed are less likely to develop cardiovascular disease and risk factors, such as high blood pressure, diabetes and high cholesterol. Research has also shown that the longer a woman breastfed her babies, the less likely she is to develop breast cancer. And the weight loss many women report as a bonus of breastfeeding is a significant benefit in a culture plagued by obesity and its associated health risks.
To say this decision by the I.R.S. makes this a big day for breastfeeding would be a huge understatement. And it's a policy change that's been a long time in the making. It was January 2009 when the AAP and several other medical organizations penned a letter to Commissioner of Internal Revenue Douglas Shulman urging the I.R.S. to consider revising current I.R.S. policy and allow breast pumps and related equipment to be reimbursed under FSAs. Their argument was that it would increase access to breast pumps and promote longer duration of breastfeeding and improved health outcomes for infants and their mothers.
The response from the I.R.S. in September 2010 sought to justify their decision by reasoning that breast pumps and related accessories did not qualify because breastmilk was deemed by the I.R.S. to be simply a nutritious food. And since nutrition was not considered a medical condition, pumps and related accessories would not qualify for a tax break. Meanwhile, those same tax-sheltered accounts could be used to pay for dentures, braces, acne creams and more.
Apparently, at the time of the initial decision the mounting evidence-based research on the importance and benefits of breastfeeding and the uproar from various medical organizations was not enough to sway the I.R.S. Even research published in Pediatrics that found that if 90 percent of U.S. women breastfed exclusively for the first six months of a baby's life, the U.S. would save $13 billion per year and prevent 911 infant deaths was not enough to convince the I.R.S.
When the news of the I.R.S's initial response broke, the blogosphere and traditional media outlets lit up. How was it possible that breast pumps, necessary to express milk when mom and baby are apart, weren't considered medical care? I was one of the bloggers reporting on the situation, and directed readers to a petition to tell the I.R.S not to discriminate against breastfeeding.
Congress became involved in November 2010 and sent a letter to Commissioner Shulman that protested the way breast pumps were classified by the I.R.S. It was signed by 45 state representatives and read:
As strong supporters of efforts to improve infant health by making it easier for nursing mothers to breastfeed, we were troubled to learn that the Internal Revenue Service ruled that breastfeeding does not provide enough health benefits to qualify as a medical care expense, and, consequently, these expenses are not tax-deductible, and flexible health spending account cannot be used to pay for breast pumps and other breastfeeding supplies.
This decision by the I.R.S is at odds with the growing body of medical evidence showing that breastfeeding has proven health benefits for both mothers and babies... we urge the Internal Revenue Service to reconsider its decision in this matter."
Today, all of us who were outraged by this injustice to moms and babies got the answer we were waiting for. It's a victory for families in the U.S., and a significant turning point as our country makes decisions that underscore the importance of breastfeeding.