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Really, IRS? Agency doesn’t recognize breastfeeding as form of preventive medicine

In my year-plus of writing for this blog, and in my numerous years of covering medical and health issues before that, few things have enraged me as much as something I encountered in today's New York Times. But David Kocieniewski, if you're reading, it's not you - it's what you reported on. It's that the Internal Revenue Service, in determining which products qualify for those tax-sheltered health care spending accounts, ruled that breastfeeding supplies don't qualify. And it's that - get this - the agency based its decision on its belief that breastfeeding "does not have enough health benefits to quality as a form of medical care."

Come again? Study after study has shown that breastfeeding brings significant health benefits to both mom and baby. Research has linked breastfeeding with a child's decreased risk of, among other ailments, sudden infant death syndrome, asthma, leukemia, type 1 diabetes, and obesity. Kocieniewski references a paper showing that breastfeeding can prevent the premature death of 900 babies a year - and that same study showed that $13 billion could be saved annually if 90 percent of moms were able to breastfeed exclusively for six months. (The figure comes from the costs associated with all those diseases that breastfeeding helps prevent.)

As Kocieniewski reports, the new health law has a goal to "control medical costs by encouraging preventive procedures like immunizations and screenings." You would think breastfeeding fits in nicely with said goal, but the IRS, upon request by the American Academy of Pediatrics to reclassify breastfeeding supplies as a medical care expense, refused to recognize breastfeeding as a preventive tool. Instead, it continues to consider breastmilk a food that can promote health (like pomegranate juice?), and:

...Because the I.R.S. code considers nutrition a necessity rather than a medical condition, the agency's analysts view the cost of breast pumps, bottles and pads as no more deserving of a tax break than an orange juicer.

The IRS's decision is unlikely to affect the number of women who breastfeed; after all, those of us who choose to do so learn to overcome various challenges (the high price of those breast pumps being just one of them). But the ruling does two things I find so terribly troubling: It ignores the medical literature, which clearly shows that breastfeeding can improve childhood health and save lives and money; and it sends a message to moms that what they're doing for their child isn't really about health or medicine after all. It feels like a slap in the face.

Some of the women quoted in the Times story struck a hopeful tone - saying there has been a lot of progress over the years in how the public and policy-makers view breastfeeding. That may be true, but I don't feel very hopeful this morning. I just feel mad.

Previously: Breastfeeding called a "secret weapon to save billions of dollars"
Photo by Topinambour

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