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Do Hospitals Discourage Breastfeeding by Gifting Formula?

For decades, hospitals have supplied new moms with gift bags filled with blankets, booties and baby formula. But formula freebies are increasingly disappearing from these goodie bags as studies show that mothers may view the gift as an implied endorsement from doctors that formula is better than breastfeeding.

"At the time of birth, many women are sitting on the fence on their decision to breastfeed or not," says Rafael Perez-Escamilla, director of the Office of Public Health Practice at Yale's School of Public Health. "Formula samples received from a medical facility signals to the mom that formula feeding is medically endorsed."

But it's not, according to the American Academy of Pediatrics. Pediatricians recommend breastfeeding over formula for myriad health benefits—from boosted immunity to lower rates of conditions such as allergies and asthma to reduced obesity, diabetes and ear infections.

Meanwhile, seven out of 11 studies of women who received free formula from hospitals found that such women had lower rates of exclusive breastfeeding rates, according to an epidemiological review by the Centers for Disease Control and Prevention.

"The less a baby suckles, usually because formula is introduced, the less milk a woman produces, setting up a downward cycle so that eventually mother will have insufficient milk," says Chessa Lutter, senior adviser of food and nutrition at the Pan American Health Organization, a regional arm of the World Health Organization.

This raises an obvious question: If pediatricians overwhelmingly believe mothers should be nursing, why do the latest CDC figures show that half of U.S. hospitals still give away baby formula gift bags?

The answer stretches back more than half a century. In the late 1950s, formula manufacturers began providing inexpensive formula to hospitals and pediatricians as part of their marketing campaigns. By the '70s, three-fourths of American babies were being fed formula, according to researchers with The Journal of Nutrition. But marketing efforts pushing formula on mothers have been hindered in recent years by medical research that indicates breastfeeding provides numerous health benefits over formula for both mothers and babies.

Hospitals around the country are increasingly dropping formula from their discharge bags. The city of Philadelphia recently made headlines when all of its major birthing hospitals stopped gifting formula to new moms. Breastfeeding advocacy groups are pushing hospitals to bar the gift bags. The national campaign Ban The Bags reports that 26 percent of all U.S. hospitals and birth centers have banned the gift bag practice. The intensity of the movement stems from the belief that even occasional formula feeding can cause problems.

"Giving bottles here and there because you're having a perceived low supply problem may lead to problems with breastfeeding down the line," says Gail M. Herrine, director of Temple University Health System's postpartum unit.

First, the baby doesn't have an incentive to suck from the breast, and then a mother will struggle to maintain her milk supply if she isn't regularly nursing. So rather than handing out formula freebies, hospitals and healthcare workers are taking a more organic approach: providing assistance to mothers during the earliest stages of nursing, such as:

  • Providing breastfeeding education. Educating caregivers, hospital staff and new moms is key. If more people know the best ways to help mothers nurse, it's likely more moms will stick with it.
  • Chatting with moms. Some new mothers may not recognize the benefits of breastfeeding. If a new mom is struggling to decide how to feed her baby, healthcare workers can take one simple step: talk with her. And they should start the dialogue long before birthing, letting pregnant women know what to expect when the baby arrives and before it's time to nurse.
  • Offering extra assistance. If mothers get the support they need in the first four weeks of a baby's life, they are more likely to keep nursing, according to the CDC. Moms may need help with breastfeeding after they leave the hospital. Making such resources readily available can make all the difference.

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