IRS shortsighted in not recognizing breast pumps as disease prevention tools – National Consumers League

NCL recently sent the following letter to the Internal Revenue Service, calling for change with the way the IRS doesn’t classify breast pumps for breast-feeding moms as an item (under IRS Publication 502) that can be reimbursed because they aid in the  “prevention of disease” — an outrageous idea to health advocates who cite numerous data about the proven reduction in health risks to both nursing moms and babies. The letter originally appeared in the Disruptive Women in Health Care blog.

December 29, 2010

Dear Internal Revenue Service Commissioner Douglas H. Shulman:

The National Consumers League has been advocating on behalf of women and children’s health since our founding in 1899. We were therefore very concerned to read about the IRS’ decision to deny nursing mothers the ability to use  their tax-sheltered health care accounts to pay for breast pumps and other supplies. Under IRS regulations, eligible medical expenses under the flex programs.

According to IRS Publication 502, items that can be reimbursed  include those that aid in the  “prevention of disease.” The IRS apparently has inexplicably determined that breastfeeding does not help in the “prevention of disease.” The National Consumers League could not disagree more with this determination. We ask that you review and reverse this misguided decision. Indeed, the medical evidence is overwhelming that far more widespread breastfeeding would not only “prevent disease” in the United States, but would save our health care system billions of dollars.

Consider the following evidence about the myriad health benefits to both mother and child of breastfeeding:

  • According to a Harvard study published in April of this year, if 90 percent of US families would comply with medical recommendationsto breastfeed exclusively for 6 months, the United States wouldsave $13 billion per year and prevent an excess 911 deaths,nearly all of which would be among infants ($10.5 billion and 741deaths at 80 percent compliance).
  • The risk of infant death due to Sudden Infant Death Syndrome (SIDS) is lowered, and respiratory infections such as pneumonia, and necrotizing enterocolitis is nearly eliminated if mothers breastfeed their infants until at least six months after birth.
  • The US Department of Health and Human Services has found that  breastfed infants have a lower risk of contracting ear infections, stomach viruses, atopic dermatitis, type 1 and 2 diabetes, childhood leukemia, and other health problems.
  • Mothers also benefit from breastfeeding because of lower risk of contracting type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression (PPD).
  • A former acting Surgeon General, Steven Galson, has noted that for most women, breastfeeding is biologically possible. Both babies and mothers gain many benefits from breastfeeding. Breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections.
  • Breastfed infants typically need fewer sick care visits, Congress recently acknowledged the importance of breastfeeding in the landmark health care reform legislation it enacted this year by requiring that workplaces provide women with a private place to nurse or use a breast pump.

As  Dr. Robert W. Block, president-elect of the American Academy of Pediatrics noted in the New York Times this week “The old adage that breast-feeding is a child’s first immunization really is true … So we need to do everything we can to remove the barriers that make it difficult.”

We agree with Dr. Block. We need to encourage, not discourage, barriers to widespread breastfeeding. Unfortunately, the IRS determination NOT to allow parents to use their tax-sheltered flex accounts to cover the cost of breast pumps has the impact of further discouraging  women  from breast-feeding and directly undermines what is by every measure a critical practice for improved public health.  We ask that you, as IRS Commissioner, review this decision and, in light of the overwhelming evidence, reverse it. We believe the cost of breast pumps should and must be a covered cost in these flex plans.

Thank you for your attention to our concerns.


Sally Greenberg
Executive Director, National Consumers League


Senate HELP Committee Chairman Tom Harkin
Treasury Secretary Timothy Geithner
Surgeon General Regina Benjamin
House Energy and Commerce Chairman Henry Waxman