The exclusion of breastpumps from accepted flexible medical spending account spending made the front page of the New York Times this week. Breastfeeding advocates have been frustrated by this apparent lack of support for breastfeeding but a thoughtful post from Alison Stuebe of the Academy of Breastfeeding Medicine points out how complicated this issue is:

I’m strangely ambivalent about the decision to exclude pumps from flexible spending accounts. I worry about the pervasiveness of breast pumps in breastfeeding in the US. Pump companies have pushed mightily to convince every American mother that an electric breast pump is an essential, regardless of whether she plans to return to work. If FSAs covered pumps, I’m certain that pump manufacturers would step up their marketing to make sure that every American mother sets aside $300 tax-free dollars to buy that pump that she can’t possibly breastfeed without. Such a policy would be a windfall for pump companies – But I’m not convinced it would be good for breastfeeding.

One of the most disturbing facts that Dr. Stuebe cites is that about 1 in 7 women that uses a breastpump is injured by the pump. Pumping is not always a simple, harmless option that all women should feel like they need to choose.

Like with so many public policy issues there is no simple on-size-fits-all right answer here. For the health of women and children we need to support breastfeeding but we also need to be thoughtful about what that support includes. There needs to be a conversation about maternity leave options, peer support, and professional lactation support rather than just assuming that providing pumps is that same as being breastfeeding-friendly.