Breast-Feeding Boost: Fewer Hospitals Handing Out Free Formula
MONDAY Sept. 26, 2011 -- Fewer U.S. hospitals send new mothers home with free infant formula, but the overwhelming majority still engage in the practice, to the dismay of breast-feeding proponents, a new survey finds.
To determine if the number of hospitals distributing industry-provided formula had changed since her 2007 survey, Anne Merewood of Boston University School of Medicine followed up in 2010 and found twice as many were not giving formula to new moms.
"Things are getting better, but still not that great," said Merewood, an associate professor of pediatrics. "The hospital should not be used as a marketing tool by the formula company."
Formula freebies undermine efforts to encourage breast-feeding and violates medical guidelines recommending that newborns be breast-fed, she said.
In the 2007 survey of all 50 states and Washington, D.C., the researchers found that only 14 percent of hospitals did not hand out free formula to new moms. Three years later, they re-surveyed 1,239 hospitals in 20 states -- the 10 states with the best formula distribution record in 2007 and the 10 states with the worst record. They found that 28 percent were not handing out formula.
The study is published online Sept. 26 and in the October print issue of the journal Pediatrics.
The American Academy of Pediatrics recommends exclusive breast-feeding for six months and continued breast-feeding for the first year and after if desired.
Distributing the formula violates the World Health Organization's international code regarding the marketing of breast-milk substitutes, Merewood said. The code says the substitute products should not be advertised or promoted to the general public.
"Breast-feeding is not easy to begin with. It's a learning curve," said Leigh Anne O'Connor, a board-certified lactation consultant and spokesperson for the La Leche League, a breast-feeding advocacy group. Having formula in the house can sway a woman to give up quickly on breast-feeding, she said.
Calling the findings "a drop of progress," O'Connor said, "we have a long way to go."
The International Formula Council, an industry group, issued a statement Wednesday in response to the study. "This study did not demonstrate any effect of infant formula sample packs on breast-feeding rates, which have continued to increase over the past decade," the statement said in part.
The council also said a 2009 survey it commissioned found 92 percent of mothers polled approved of hospitals giving away diaper bags with formula samples.
MeadJohnson, makers of Infamil, said in a statement Wednesday that restricting formula handouts hinders valuable communication between mothers and doctors.
"Prohibiting or restricting health care professionals from providing formula samples and information limits communication with parents and interferes with health care professionals responsibility to help ensure the health and well being of their patients," the company said.
According to the U.S. Centers for Disease Control and Prevention, breast-feeding rates have increased in recent decades. Whereas 60 percent of children born in 1993-1994 were ever breast-fed, 77 percent of those born in 2005-2006 were breast-fed at some point, CDC figures show. However, the rate of breast-feeding at age 6 months didn't change from 1993 to 2004.
Merewood acknowledged that the study has limitations. The researchers only interviewed hospital maternity departments. Other departments could still give away formula, she said. So could obstetrician offices. Also, some companies send formula samples directly to women's homes, she said.
States making the most progress were those that had the best record in 2007, she said. The 10 best-record states from 2007 were: Washington, Minnesota, California, Vermont, Massachusetts, Wisconsin, New Mexico, New Hampshire, Oregon and Rhode Island. The percentage of hospitals in each state stopping free formula increased from the first to the second survey.
Of the 10 states with the worst record in 2007, Texas improved the most, Merewood said. Now, 15 percent of its hospitals don't give away formula, compared to 1 percent in 2007. Others on the 2007 worst-record states list include Arkansas, Washington, D.C., Maryland, Mississippi, New Jersey, Oklahoma, South Dakota, West Virginia and Iowa.
To learn more about breast-feeding, visit the American Academy of Pediatrics.
Posted: September 2011