In “Acne Cream? Tax-Sheltered. Breast Pump? No,” David Kocieniewski explains a flaw in our tax structure which contributes to low breastfeeding rates with babies older than 3 months in the U.S. Focusing on a regulatory provision under which new mothers are not permitted to pay for breast pumps and other supplies like bottles and pads using tax-exempt, employment-based health care accounts, Kocieniewski casts light on another dilemma working mothers face feeding their new children in the most safe, natural, and healthy way possible.

Non-coverage of breastfeeding materials is due to an Internal Revenue Service (IRS) ruling that breast-feeding lacks enough health benefits for qualification as a medical care expense (acne creams and denture adhesives do qualify, go figure). Instead, the IRS considers breast milk “food,” and fears opening the door to other exceptions that would erode the integrity of the tax code. According to a recent Harvard Medical School study, though, breastfeeding benefits people’s health as well as their pockets: 741 infant deaths would be prevented, as well as $13 billion saved, each year if 90 percent of mothers were able to follow the general medical recommendation to exclusively breastfeed their children for the first six months of life.

Health Benefits of Breastfeeding

Dr. Robert Block, president-elect of the American Academy of Pediatrics, says that “breast-feeding is a child’s first immunization.” Human breast milk provides complete nutrition as well as antibodies babies need to thrive. Research has shown that breastfed babies tend to have better brain and nervous system development as well as higher IQ scores. Additionally, breastfeeding is associated with reduced risk of sudden infant death syndrome (SIDS) and childhood leukemia, asthma, and obesity, as well as lower respiratory tract infections, type 1 diabetes, gastrointestinal irritation and disease, chronic skin disorders, and ear infections.

As milk-making burns 500+ calories per day, breastfeeding also helps mothers shed excess pregnancy weight and naturally spaces pregnancies; it may also help the uterus get back to normal size. Studies have also shown that women who breastfeed reduce their risk of ovarian and breast cancer, osteoporosis, and anemia.

Breastfeeding's Emotional, Financial and Environmental Benefits

Breastfeeding help bond mothers and infants, and it provides newborns with a sense of security, warmth and comfort. Some advocates, like Baby Friendly USA, Inc., say breastfeeding also emotionally empowers women, knowing they are giving their children the best possible nutrition. Additionally, breastfeeding is more environmentally sound than its alternative: with no infant formula packaging materials, breastfeeding helps to cut down on garbage and recycling waste.

With the exception of pumping supplies, breastfeeding is free. It saves the costs of formula as well as health care costs associated with greater risk of abovementioned health issues for children who are not breastfed. Breastfeeding as a preventative health measure may also mean less work time lost to caring for sick children. The community benefits from healthier children in terms of overall medical costs and taxes, and a lesser burden on government and community programs. More money saved by everyone can be spent to boost local economies.

Why Aren’t More Mothers Breastfeeding?

According to the Centers for Disease Control (CDC) 2010 “Breastfeeding Report Card,” 75 percent of mothers start out breastfeeding their newborns (a number which meets The Healthy People 2010 national objective for breastfeeding), but this number plummets as babies reach 6 and 12 months of age. The CDC says the percentage remains “stagnant and low” for exclusive breastfeeding (where a baby receives no other dietary sustenance) at 3 and 6 months. While these percentages reflect that new mothers want, and try, to exclusively breastfeed their newborns, they also highlight the multiple barriers women face which hinder their ability to continue doing so for the medically recommended six-month period.

Most working mothers face limitations in the amount of maternity leave they take, which necessarily affects duration of breastfeeding, especially if breast pumping is not economically or strategically feasible when they return to work. Of the 100 family-friendliest companies selected by Working Mother magazine, 28 percent provided up to six weeks, and 24 percent provided four or fewer weeks, of paid maternity leave; 7 percent offered no paid leave. While under the 1993 Family Leave and Medical Act, working women can take 12 weeks unpaid time to care for a new child without losing their job, many women cannot afford to do so, and those working for companies with less than 50 employees are not afforded this legal protection.

For many working mothers, breast pumps are the only way to continue providing their babies breast milk until six months of age, and finding the time and space to pump breast milk can be quite challenging. Pumping can also be costly, averaging between $500 and $1,000 a year. Without some tax break for breast pumping, infant formula seems the most convenient and least awkward option; however, commercial infant formula, especially soy formula which is linked to various health risks, is a poor substitute, as far as health is concerned. The new health care reform law (“Obamacare”), effectuated March 2009, does contain a new breakthrough mandate that at least permits nursing mothers unpaid breaks for breast pumps. Advocates of breast feeding say they will further attempt to establish tax breaks through Congressional action.

Making Breastfeeding Commonplace

Change is a collective societal effort, and, thankfully, there’s some decent guidance and activist efforts in the making. The United States Breastfeeding Committee, for example, has posted links to action campaigns through which we can participate in prioritizing breastfeeding, including contacting Congress in support of the Breastfeeding Promotion Act, writing letters to media, signing the Breastfeeding Petition to President Obama, and getting involved in Healthy People 2020.

UNICEF and World Health Organization (WHO) also created BFHI, the Baby Friendly Hospital Initiative, a worldwide program designed to encourage hospitals and birthing centers to offer optimum levels of care for baby feeding, and recognize the ones that already do. Baby Friendly USA, Inc. is the American authority (BFHI USA) for its implementation, and provides BFHI-based information for parents, hospitals, and breastfeeding advocates.

At womenshealth.gov, the National Women’s Health Information Center offers “the Business Case for Breastfeeding,” a comprehensive educational program through which employers can learn about why and how to support their breastfeeding employees; there are also programs for employees and health professionals. Womenshealth.gov also provides plenty of general information for new mothers about breastfeeding.

In “Making the Case for Breastfeeding: The Health Argument Isn’t Enough,” the Berkeley Media Studies Group for the California WIC Association provides tips to breastfeeding advocates about how to better frame arguments by going beyond the obvious health angle of breastfeeding and telling a bigger story - one that will communicate how breast feeding will benefit society at large, especially people without children. The policies revolving around breastfeeding and maternity care will be better implemented when people are more aware of social and cultural changes that need to be made, for example, in workplaces and hospitals.

Keeping it Clean

Although he applauds women who are breastfeeding. Dr. Sinatra cautions them to be extra careful about what they put in their bodies and what they expose themselves to, as far as toxins are concerned. As breast milk is 10 times more concentrated than other bodily fluids, it has much greater toxic potential. It’s crucial that new mothers to be able to recognize dietary and environmental sources of toxins as well as avoid them. Our Toxic World, by Dr. Doris Rapp, a board-certified environmental medical specialist and pediatric allergist, is a great resource from which to start.

Mothers need to be self-sacrificial and honor their commitment to their babies’ health, says Dr. Sinatra. They cannot drink any alcohol whatsoever while breastfeeding, nor eat canned tuna, farm raised fish, or non-organic food. Breastfeeding mothers should also abstain from pharmaceutical and over-the-counter drug use, stay as far away from wireless emissions as possible, and use “green” personal care and cleaning products. Breastfeeding, especially when toxin-free, is a gift of good health for both mother and baby, not to mention a wonderful opportunity to foster wonderful emotional bonds. While six months (15, counting pregnancy) of cleaner-than-clean living may be challenging, bottom line, it can mean a lifetime of better health for children.

References and Resources:

• Kocieniewski, David. “Acne Cream? Tax-Sheltered. Breast Pump? No.” Nytimes.com, Oct. 26, 2010.
  
• Bartick M, Reinhold A. The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pediatrics, April 5, 2010; doi:10.1542/peds.2009-1616. [Abstract]
  
• The United States Breastfeeding Committee
  
• Saint Louis, Catherine. “Breastfeed the Baby: Love the Calorie Burn.” Nytimes.com, Nov. 11, 2009.
  
• Baby Friendly USA, Inc.
• Centers for Disease Control web site. “Breastfeeding Report Card – United States, 2010.”
  
• U.S. Dept. of Health and Human Services Office of Disease Prevention and Health Promotion. "Healthy People 2010"; vol. 2:2nd ed.
  
• U.S. Dept of Health and Human Services Office on Women’s Health: National Women’s Health Information Center. “Breastfeeding.”
  
• Brown, Heidi. “U.S. Maternity Leave Benefits are Still Dismal.” Forbes.com, May 4, 2009.
  
• Institute for Women’s Policy Research. "Fact Sheet: Maternity Leave in the U.S.” August 2007.

© 2010 Heart MD Institute, PA