Breast-feeding and taxes

New IRS ruling means equipment is considered a medical expense

Betsy Q. Cliff / The Bulletin /

Published Mar 24, 2011 at 05:00AM

Is providing a baby breast milk preventive medicine, crucial for an infant’s development, or a healthy food?

Until recently, the Internal Revenue Service had determined it was a healthy food, no more deserving of tax breaks than buying fresh produce.

Then, in January, the IRS reversed course, determining that items that assist moms in breast-feeding, namely breast pumps, can be considered medical supplies. That means, starting in tax year 2010, they can be paid for through flexible spending accounts or, in some cases, deducted from taxes.

Advocates lauded the news.

“Anything that promotes and supports our moms as they’re trying to go back to work is a huge thing,” said Katie Boone, who runs the local chapter of La Leche League, an international organization that promotes breast-feeding. “Moms are stopping and a lot of times they’re stopping before they want to.”

Becky McColl, a lactation consultant at St. Charles Health System, said the message was as important as the change. “The financial part is important, but I think the most important part is it shows the support” for breast-feeding moms, she said. “It’s nice to see federal-level support.”

The rule change means that women who have flexible spending accounts, often set up through an employer, can expense the cost of breast-feeding supplies through those accounts.

If you don’t receive reimbursement through a flexible spending account, the cost can be counted as a medical expense. If a person or family has medical expenses that exceed 7.5 percent of their income, the excess expenses are eligible for a tax deduction.

The largest expense for most families is the cost of a breast pump, which typically costs several hundred dollars new. Women could also deduct pumping accessories such as extra tubes and milk storage bags.

“In some cases, (women) need a pump or equipment to provide milk for their babies,” said Dr. Richard Schanler, a neonatologist in New York and chair of the American Academy of Pediatrics’ section on breast-feeding. “We’re hoping this will prolong the time that she does it.”

Though 75 percent of women in the United States begin breast-feeding, just 43 percent are still breast-feeding at six months. At one year, the minimum time the AAP recommends that women breast-feed, just 22 percent of women are still breast-feeding.

Oregon’s numbers are slightly higher, with 62 percent breast-feeding at six months and 40 percent breast-feeding at 12 months.

“What I hear a lot is, ‘I lost my milk supply once I went back to work,’” said Boone. “We want to support what the mom wants to do.”

Boone said helping moms pay for pumps is one part of that support.

She also said Oregon legislation passed in 2007, which requires employers to give women breaks to pump at work, was crucial to helping women continue to breast-feed once they have returned to work. (That rule now applies nationally; it was enacted as part of the national health reform law passed a year ago.)

The reversal of policy by IRS came after members of Congress, including Sen. Jeff Merkley, sent a letter to the IRS in November asking for a change in policy. “We were troubled to learn that the Internal Revenue Service ruled that breastfeeding does not provide enough health benefits to qualify as a medical expense,” the Congress members wrote. “This decision by the IRS is at odds with the growing body of medical evidence showing that breastfeeding has proven health benefits for both mothers and babies.”

In his letter back to Congress, dated Jan. 31, IRS Commissioner Douglas Shulman said that after review, the agency had concluded that breast pumps and other supplies that assist in lactation could be considered medical expenses.