This article about free formula bags given to families in hospitals is written by Anne M. Murphy, RNC, an experienced nurse at a large birthing hospital in Iowa. What are your thoughts about giving free formula bags to families before they are discharged from the hospital?  Share your thoughts by posting below.

I recently read a Medscape editorial:  “U.S. Hospitals Pressured to End Free Baby Formula”.  The article pointed out that giving formula gift packs to breastfeeding moms at discharge from the hospital is in violation of the World Health Organization Code and recommendations from not only the CDC, but also the AAP, ACOG and the GAO.  I was curious to read more on the subject, as I was unaware of these recommendations and I followed up by reading several other journal articles.

One article was from the Journal of Human Lactation, “US Hospitals Violate WHO Policy on the Distribution of Formula Sample Packs: Results of a National Survey” by Anne Merewood, et al, published September 24, 2010.  Another article is “Hospital Practices and Women’s Likelihood of Fulfilling Their Intention to Exclusively Breastfeed” by Eugene Declercq, MD, et al from the American Journal of Public Health, May 2009.  A third article is “Trends in US Hospital Distribution of Industry-Sponsored Infant Formula Sample Packs” by Radha Sadacharan, et al, published in Pediatrics, September 26, 2011.  I also read the Baby Friendly Hospital Initiatives that promote breastfeeding support as outlined by UNICEF/WHO.  Number 6 on this initiative is “Give newborn infants no food or drink other than breastmilk, unless medically indicated.” 

This gist of all the articles was that the majority of US hospitals, especially in the Midwest and South, still promote the use of formula by giving out the free formula gift packs to breastfeeding mothers, thereby conflicting new mothers and undermining successful breastfeeding.  US Healthy People 2010 objectives call for 60% of all new mothers to exclusively breastfeed at 6 months. Exclusive breastfeeding for the first 6 months is what AAP recommends also.  Supplementation of breastfeeding infants and being given free formula samples was significantly associated with mothers’ failure to fulfill their intentions to exclusively breastfeed according to these articles. Four hospital practices that have been statistically linked with likelihood of successful breasting are (1) helping mothers get started with breastfeeding,      (2) no supplementation with formula or water while in the hospital, (3) offering community resources for breastfeeding support after discharge, and (4) staff not giving the infant a pacifier.  In cases where mothers reported a comprehensive package of these supportive practices, primiparas were 6 times more likely to achieve their intention to exclusively breastfeed. Incidentally, some states and cities have actual bans on the practice of formula giveaways. 

In our director’s last newsletter, she pointed out that 86% of breastfeeding mothers surveyed at our hospital wished to receive the option of the formula samples.  Some surveys have even suggested that mothers would not choose a hospital where the option of free packs was not available.  Everyone likes to get free stuff.  This presents a conundrum for the postpartum nurse.  If  it is better for the nursing infant to go home without any formula samples, should we even be offering this to them?  Several years ago, it was suggested where I work to only give the formula packs to mothers who ask for them.  In other words, do not bring the subject up to them first.  This is the policy I go by.  I do not offer it to breastfeeding moms and only give them out if a mom asks me for it.  I’m anxious to hear everyone else’s thoughts and practices with this.