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Infant Formula Sampling and Discharge Gift Bags in Hospitals

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Mother, Baby, Hospital, Nurse, Feeding

American hospitals have distributed discharge kits to mothers of newborns for more than four decades. When provided by infant formula manufacturers, these kits include infant formula samples and other items, such as bottles of water, nipples, educational materials, infant vitamins, and lotions for mothers’ use during the early postpartum period. 

Whether a woman breastfeeds, formula feeds or does a combination of both to nourish her infant, it is not a simple one-size-fits-all-choice. The International Formula Council (IFC)* agrees with the American Academy of Pediatrics (AAP) that breastfeeding is the ideal infant feeding and that it offers specific infant and maternal health benefits. The IFC also believes that mothers should be trusted to make the best choices for their babies according to their life circumstances and the needs of their families.

Results of research into any relationship between infant formula hospital sample distribution and breastfeeding have been inconsistent; some studies show an association while others do not.

Breastfeeding Rates Have Increased Over the Last Decade

Although samples of infant formula have been actively distributed at hospitals to mothers of newborns, data from the Center for Disease Control and Prevention (CDC) National Immunization Survey shows breastfeeding rates have increased over the past decade.1

CDC’s Research Shows No Effect on Breastfeeding and Receipt of Discharge Kit

Data from the Center for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA)’s study, Infant Feeding Practices Survey II, published four years ago2 (Di Girolamo et al., Pediatrics in 2008), examined hospital practices, including receipt of a formula sample or coupon in a hospital gift pack, to determine if any were linked to early termination of breastfeeding.  The authors concluded, “We did not find an association between not providing a formula sample or coupon in a hospital gift pack and increased breastfeeding duration.”  <?xml:namespace prefix = o />

Mothers Want Hospital Discharge Bags

A 2009 national mothers survey conducted by Greenberg Quinlan Rosner Research on behalf of IFC surveyed a nationally representative sample of 876 mothers of infants aged 0-12 and found that almost all mothers (92%) approve of hospitals distributing diaper bags that include free infant formula samples.3  

Surgeon General Endorses Infant Feeding Choice for Mothers

In August, 2011, U.S. Surgeon General Dr. Regina M. Benjamin said, “The decision to breastfeed is a personal one, and a mother should not be made to feel guilty if she cannot or chooses not to breastfeed.”4  The IFC believes that infant feeding choice is personal and it is the right of every mother, parent, and caregiver to be fully informed about all infant feeding options in order to make the best choice for his/her family situation.

UK Study Documents Importance of Formula Education for Moms

A 2009 review study in the UK (Lakshman et al. 2009)5 found that mothers reported receiving little information on bottle-feeding from their healthcare professionals and due to this lack of information, made common mistakes in preparation of bottles.  The authors concluded that "inadequate information and support for mothers who decide to bottle-feed may put the health of their babies at risk. While it is important to promote breastfeeding, it is also necessary to ensure that the needs of bottle-feeding mothers are met."

IFC Joins AAP In Support Of Breastfeeding

The IFC agrees with the American Academy of Pediatrics (AAP) that breastfeeding is the ideal infant feeding and that it offers specific infant and maternal health benefits.  IFC also agrees with the AAP that for mothers who cannot or choose not to breastfeed, iron-fortified infant formula is the only safe and recommended alternative.

The Real Barriers to Long-term Breastfeeding

According to data from the CDC’s National Immunization Survey (NIS)1 there is a significant reduction in breastfeeding rates at three months, which is typically when women with newborns return to the workforce. Focusing on discharge bags as a key variable detracts from the importance of this and other major factors.

The 2009 national mothers’ survey asked why mothers stopped breastfeeding.3  Many described barriers that interfered with breastfeeding duration, including:

  • Demands of work or school (82%)
  • The inability to produce enough milk (81%)
  • The expense of a breast pump (74%)
  • The feeling that breastfeeding restricts freedom (76%)
  • No time to pump at work (59%)

References Cited:

1. Centers for Disease Control and Prevention, National Immunization Survey; available at:  http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm
2. DiGirolamo AM, Grummer-Strawn LM, Fein SB. Effect of maternity-care practices on breastfeeding. Pediatrics 2008;122 Suppl 2:S43-9.
3. Greenberg Quinlan Rosner Research and Public Opinion Strategies.  National Public Opinion Poll on Infant Feeding.  May 2009.
4. Statement from Surgeon General Dr. Regina M. Benjamin on World Breastfeeding Week, August 1-7, 2011; available at: http://www.hhs.gov/news/press/2011pres/08/20110801e.html
5. Lakshman R, Ogilvie D, Ong K. Mothers' experiences of bottle feeding: a systematic review of qualitative and quantitative studies. Arch Dis Child 2009.

*The International Formula Council is an association of manufacturers and marketers of formulated nutrition products, e.g., infant formulas and adult nutritionals, whose members are based predominantly in North America.  IFC members are:  Abbott Nutrition; Mead Johnson Nutrition; Nestle Infant Nutrition; PBM Products, LLC, A Perrigo Company; and Pfizer Nutrition.

Debra Berliner
Theresa Hedricks MS, RD, LD
404-252-3663