IRS Okays Breastfeeding Supplies As Medical Expenses (But Won’t Agree That Breast Is Best)

Is the IRS stepping its toes even further into the breastfeeding versus bottle fray?

This week, the IRS announced that, effective as of the 2010 tax year, mothers who breastfeed can get a tax break. Under the change in policy, taxpayers may now use pretax dollars in their FSAs (flexible spending accounts) to cover the cost of breastfeeding supplies. Taxpayers without FSAs may count the cost of breastfeeding supplies towards their deductible medical expenses if they itemize on Schedule A.

Breastfeeding supplies, or “supplies that assist lactation” (like you expected the IRS not to be as technical as possible here) would normally include breast pumps, bottles and pads. But before you rush right out to buy a breast pump for fun, be aware that the IRS wants you to use it, warning, “taxpayers should assess whether an item is used primarily for extracting milk or for other purposes.” Eww. I don’t even want to think about what kinds of “other purposes” the IRS might be thinking about.

Breastfeeding advocates, of course, applauded the ruling. The American Academy of Pediatrics (AAP) sent a letter to IRS Commissioner Doug Shulman last year (downloads as a pdf) asking the IRS to reverse their original position that breastfeeding supplies were not medical devices (downloads as a pdf) nor did they provide a medical benefit. In their letter, the AAP cited various health benefits related to breastfeeding including evidence that show that “children who are breastfed have lower rates of mortality, meningitis, some types of cancers, asthma and other respiratory illnesses, bacterial and viral infections, ear infections, juvenile diabetes, some chronic liver diseases, allergies and obesity.”

After consideration, the IRS reversed its position. The reversal did not specifically address the health benefits of breastfeeding but rather focused on classifying the equipment associated with breastfeeding as “for the purpose of affecting a structure or function of the body of the lactating woman.” Pure poetry, no?

Of course, for all that I make fun of the IRS’ carefully worded statements, there’s no doubt that words matter. The IRS isn’t being technical for the sake of being technical. Nor are they being political, despite our current climate. They’re being guarded for a reason: as recently as last year, they classified infant formula as food and therefore, not a medical expense. Clearly, then, they’re not going to rule that breast milk is considered nutrition and therefore, deductible, when infant formula is not. By classifying the related equipment as medical expenses, they seem to be circumventing that whole argument.


But what of the supplies? Here’s where I sense a challenge in the future… You see, I was a breastfeeding mom. I know how expensive pumps and periphery can be and I completely applaud the IRS ruling, especially on behalf of working mothers everywhere (not that I’m saying that pumping issues are restricted to working mothers). However, while classifying bottles as breastfeeding supplies makes sense (you can’t store expressed breast milk in your pocket), it feels discriminatory against those moms who don’t breastfeed. Infants who are fed formula require bottles, too, as it’s still a necessity. Those babies aren’t feeding out of troughs or using straws: they’re still using bottles. Why is it okay on the one hand and not on the other?

I understand that allowing bottles associated with infant formula to be considered medical expenses can lead down a slippery slope. It becomes very easy to jump to the next thing: why not teething biscuits? Or iron-enriched oatmeal?

Again, I’m glad to see this ruling. I think that the IRS did the right thing and I think they were thoughtful about their position. But I’m not so sure it’s settled.

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11 thoughts on “IRS Okays Breastfeeding Supplies As Medical Expenses (But Won’t Agree That Breast Is Best)

  1. So as a guy who doesn’t know about these things and the costs, let me ask in all sincerity: how many breasts pumps does one go through?

    what i’m getting at is, does it make sense to buy a breast pump you’re not gonna use if you can get the bottle deduction too?

  2. It depends on how much you pump. If you rely solely on pumping, a run of the mill $200 won’t cut it – you’ll either have to buy a couple, spend the big bucks on a hospital quality one or rent one (lots of my friends rented). I can’t imagine a scenario where you’d buy a pump just to get a deduction on the periphery – I guess IRS is trying to cover all of their bases!

  3. The ruling counts against the cost of renting a medical-grade breast pump as well. If you have two children, and pump on a daily basis (I like to donate my unused breast milk about a month before it expires if I feel we won’t use it, since I don’t work) then you spend anywhere from 4-10 hours a week attached to this thing by the breast. It should be comfortable and sturdy. It also must be sanitary since we’re transporting highly perishable milk that will end up in a highly vulnerable child’s body. What I think you’re alluding to is defrauding the government by telling them that you breast feed your child when you don’t so that you can itemize on Schedule A and deduct the cost of your bottles? I might be misinterpreting your question. Anyway, for us, this would add up to an additional $1200 a month give or take, just for the pump rental. I mean, our kids breast feed for a couple of years.

    Men pay LOTS more than $200 for things that “extract fluid” from their appendages, believe me.

  4. @Kim, I do not have children, nor would I do anything or advise anyone to do anything that could be considered defraudment. But I’m sure someone would consider it given the costs involved.

  5. @ Icarus, I should have been clearer; to be considered fraud, the intent would have to be there. Otherwise we’d be able to sue each and every manufacturer of crappy baby products. πŸ™‚ Gosh I must have been typing while under the influence of a child…of course YOU wouldn’t defraud the government, but someone who itemized their bottles on a schedule A when they hadn’t ever breast fed would be guilty of that, and for a very tiny deduction. We spent about $50 on bottles total (not counting all the ones we had to take back because apparently children have preferences concerning these kinds of things.) The risk (although small imo since they’d have to prove that your child never breastfed and as of yet, you cannot determine after-the-fact whether someone was BFE of bottle-fed) is just too great for such a small pay off. The hassle of itemizing for what would only amount to about $50 for someone who only bottle-fed wouldn’t be worth it.

    Anywho, no offense meant. Just pointing out that that would be dishonest.

  6. I also should have typed that it would be about $1200/year, not monthly. Jeez. I’m going to get coffee now. πŸ™‚ Great article!

  7. @Kim, no offense taken. I’d love to buy you that cup of coffee for clueing me in. πŸ™‚

    1200 a year versus a month is a huge difference and I was trying to establish motivation. It certainly isn’t worth the trouble or risk for many. On the other hand, perhaps there is someone who needs an extra 1200 a year and is just savvy enough to take advantage of this somehow.

    As you said you cannot prove Bottle-fed versus Breast-fed after the fact and I’m guessing babies don’t follow the US tax code very closely and don’t transistion from breast milk to solids at the start of a fiscal year. πŸ˜€

    With all that has been presented my take is this: it’s a small win for moms, and not a huge loss for the small percentage that might fudge their tax returns. It also sounds like the IRS could make life easier for everyone and win a victory in the PR dept if they would just let everyone deduct the cost of bottles.

  8. Ah, thank you. Sadly I’ve had my quota for today (caffeine makes babies not sleep, and that doesn’t work for me) but maybe next time? Its my understanding that they’d only get a deduction for the stuff they could actually show they’d already purchased. They’d have to spend $1200 to get a $1200 deduction off of the taxes they’ve already paid. Its more a break for people who were going to spend the money on the pumps to begin with. This really just makes it more appealing to breast feed imo. I mean the only way my limited experience (daughter of a minister and a police officer) could come up with to make it work would be to fudge receipts and they’re pretty efficient at figuring that stuff out. Ask the mafia. πŸ™‚

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