Something every American should be able to agree on is that babies need a healthy start in life.  Yet First Lady Michele Obama’s recent remarks in support of the decision by the Internal Revenue Service to make breast pumps and other breastfeeding supplies tax deductable elicited vitriol as well as praise.  Representative Michele Bachmann (R-MN) called it the “new definition of the nanny state,” while public health and medical experts applauded, pointing to the voluminous data supporting the importance of human milk for babies.  While critics alleged that the government would be buying breast pumps, tax experts pointed out that this was not a direct government purchase but rather allowed the cost of pumps and other supplies to be reimbursed from Health Savings Accounts and Flexible Spending Accounts (using pre-tax dollars) or to be listed as an itemized medical expense once those expenses exceeded 7.5 percent of adjusted gross income.  Economic experts noted that the minimal costs to the government of such expenditures might well be met by lower costs for the Women, Infants, Children (WIC) program of the United States Department of Agriculture’s Food and Nutrition Service, the biggest single purchaser of infant formula in the United States.

Supporters of the ruling failed to sway individuals who believed that the federal government was embarking upon a new and dangerous path.  They might be surprised to learn that, if the definition of a “nanny state” is one that promotes sound public health practices, including breastfeeding, the federal government has taken this position for nearly a century.  And, they might be equally shocked to find out that for the past century ordinary Americans eagerly sought advice about pregnancy, infant care, and childcare from the federal government.

“To nurse her baby is the first duty of every mother,” proclaimed the 1913 pamphlet Prenatal Care published by the U.S. Children’s Bureau.  Founded in 1912 during the administration of President Taft and housed in the Department of Labor, the Children’s Bureau’s mission was to investigate and report "upon all matters pertaining to the welfare of children and child life among all classes of our people."  A key aim was the reduction of infant and child mortality.

Soon after its creation, the Children’s Bureau began producing inexpensive, easy-to-read advice pamphlets.  In 1914, Mrs. Max West, author of Prenatal Care produced Infant Care, a book that has been revised many times, was freely distributed by members of Congress to constituents, and scooped up by millions of mothers who shared it widely.  It remains in print and is the best-selling publication of the U.S. Government Printing Office.  The Children’s Bureau maintained a steadfast commitment to promoting breastfeeding.  In 1940, for example, it published a four-page pamphlet Mother! Nurse Your Baby!, which offered detailed advice and was reissued several times.

According to an official history of the Children’s Bureau, by 1955 the agency distributed over 34.6 million copies of Infant Care.  Clearly Americans welcomed advice about raising babies and had no objections to the government promotion of breastfeeding or other measure designed to insure the health of babies.

In recent years, with growing numbers of new mothers in the labor force, government breast-feeding advice began incorporating information on pumping and storing breast milk.  A 12-book Spanish and English language series Healthy Start, Grow Smart, offering advice for newborns up to age twelve months, begun as an initiative of Laura Welch Bush when she was First Lady of Texas, is now online and in print as a joint effort of the U.S. Department of Agriculture, the U.S. Department of Education and the U.S. Department of Health and Human Services.  Its adoption by the federal government in 2002 came at the behest of President George Bush and First Lady Laura Bush.  In addition to stating “your breast milk is the perfect food for your baby,” the booklet for one-month old babies includes the reminder that “you can breastfeed your baby after you return to work or school” and discusses learning to pump and store breast milk.  When they appeared, these pamphlets provoked no controversy or suspicion that they heralded a federal government effort to create a “nanny state.”

Nor should the recent decision by the IRS.  It might make breastfeeding a bit easier financially, but it certainly does not represent a new turn in government policy.  The ruling demonstrates the continuing commitment of the federal government to promoting the health and well being of its most vulnerable citizens through education—a mission it has undertaken for nearly a century.