Marsha Walker

BOSTON (WOMENSENEWS)–For years, hospitals have sent new mothers home with a gift bag of goodies.

The bags, usually stamped with the logo of an infant formula manufacturer, often contain baby books, diapers and coupons for infant-care products. They also often contain free infant formula donated by manufacturers, a practice that is becoming increasingly controversial.

This spring, the U.S. Department of Health and Human Services ended a two-year breastfeeding campaign by the New York-based Ad Council warning that not breastfeeding could hurt a newborn’s health.

Critics of the television announcements said they made bottle-feeding seem irresponsible, a message stoutly denied by the Atlanta-based International Formula Council.

But anti-formula sentiment is growing. This summer the Massachusetts Breastfeeding Coalition–working with members of the International Lactation Consultant Association–plans to launch a nationwide ban against formula in gift bags during the 21st International Lactation conference, which starts July 12 in Philadelphia and gathers lactation consultants to discuss techniques, new research, advocacy and other breastfeeding issues.

“We will launch the campaign at a plenary session before 800 to 900 people,” said Marsha Walker, a board member of the Massachusetts group who is also executive director of the National Alliance for Breastfeeding Advocacy, based in Weston, Mass. “We hope the other health care associations and state breastfeeding coalitions and generally the health care delivery sector will start taking a closer look at this. The ban-the-bag campaign will be a national campaign carried out state by state.”

The groups argue that the inclusion of formula encourages new mothers to choose the bottle over the breast despite growing evidence that breastfeeding is better for both child and mother.

Their plan includes having each state’s breastfeeding coalition work with the state health department to adjust hospital guidelines on the in-hospital marketing of infant formula. The group also plans to complete a full assessment of hospitals that do and don’t give out free infant formula.

Hospitals Restrict Formula Offerings

Many hospitals will only offer free infant formula when mothers specifically ask for it or when women need formula for medical reasons, said Mary Lofton, spokesperson for La Leche League International, the Schaumburg, Ill., breastfeeding advocacy and support group. “Many hospitals are not comfortable with this promotion of formula,” Lofton said.

By ditching the free formula, hospitals and breastfeeding coaches hope to encourage new mothers to breastfeed, a practice clinically shown to prevent diarrhea, improve the child’s immune system and prevent childhood obesity.

Mothers who breastfeed get the added benefit of weight loss, and possibly lower their chances of ovarian or breast cancer, according to the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services.

Advocates say that mothers who leave hospitals with formula samples are more likely to try the formula during a rough patch rather than stick to breastfeeding. That sentiment is echoed by the U.S. Department of Health and Human Services, which has described breastfeeding as a public health challenge and has said that hospital distribution of formula could unduly influence a mothers’ decision to breastfeed for as long as possible.

Some women may initially have a difficult time getting their infant to latch on to the breast. In other situations, a woman might not initially produce ample milk. Lactation consultants say that during those circumstances some hospitals are too quick to suggest bottle-feeding rather than working with the mother and infant to perfect the breastfeeding technique.

Marketing to New Mothers

The infant formula samples and bags stamped with the company names is essentially a marketing practice, added Walker.

“It’s a gimmick that really takes advantage,” she said. “You wouldn’t give a cardiac patient a coupon for Big Macs and french fries. Why would you give a new mother a bottle of free infant formula?”

However, many new mothers aren’t bothered by the free formula and those who have to immediately return to a workplace that does not support breastfeeding have said they find it easier to stick to the bottle.

The industry trade group, the International Formula Council, said it conducted its own study of mothers and found that many mothers like the free bags, which can also double as diaper bags. In some instances, several health agencies say, it might not be safe for a mother to breastfeed if she has certain viruses or diseases which could be spread through breast milk.

Marisa Salcines, a spokesperson for the International Formula Council, declined to be interviewed on the subject but provided a statement by e-mail. The industry group said it respects a hospital’s right to opt out of the free formula bags, but the group reiterates that if a mother chooses not to breastfeed, the only safe alternative is infant formula.

“Today, hospitals have the ability to make choices,” reads the statement. “The International Formula Council’s main concern is that restrictive policy eliminates a mother’s right to choose. We believe the choice should be made between the mother and her health care provider. Mothers should be allowed full access to all available information on infant-feeding options and practices, as well as discharge gift bags including samples, which can assist in informed infant-feeding decisions.”

The Formula Council group represents Mead Johnson Nutritionals; Nestle USA, Inc., Nutrition Division; PBM Products, LLC; Ross Products Division, Abbott Laboratories; Solus Products; and Wyeth Nutrition.

Baby-Friendly Brand

Some hospitals that recently stopped giving out formula samples are working toward a “baby-friendly” designation that has been given out in the United States since 1996 by Baby-Friendly USA, part of a global program sponsored by the World Health Organization and the United Nations Children’s Fund to encourage hospitals that offer a high level of care for breastfeeding mothers.

So far the designation applies to 55 U.S. hospitals spread across states including New Hampshire, Florida and Washington, according to the Web site of Baby-Friendly USA in Sandwich, Mass.

The designation goes to hospitals that fulfill a number of requirements, including having lactation consultants on staff, placing the mother and newborn in the same room for sleeping and encourage breastfeeding within the first hour of birth.

The U.S. government’s Healthy People 2010 initiative, managed by the Department of Health and Human Services, has a goal of getting about half of all new mothers to breastfeed exclusively or partially until the baby reaches six months of age. Yet, an absence of workplace lactation rooms or a financial hardship leading a mother to return to work quickly, hurts this goal, say officials.

Nationally, some 70.3 percent of women breastfeed their newborns, a number that drops to only 36.2 percent six months later, according to a study by the Centers for Disease Control. One year after birth, 17.8 percent of all women continue to breastfeed, the study found.

Adrienne P. Samuels is a journalist who has worked for The Miami Herald, The Boston Globe and the St. Petersburg (Fla.) Times. Her work has also appeared in Heart and Soul magazine and in Choices, a magazine documenting the work of the United Nations Development Programme.

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For more information:

Baby Friendly Hospital Initiative USA:

International Lactation Consultant Association:

Ban the Bags: