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Feb-12-2008 15:20printcomments

Free Formula in Hospitals is Reducing Natural Breastfeeding

The American Academy of Pediatrics recommends that infants be exclusively fed breast milk for the first six months of life.
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(PORTLAND ,Ore.) - Providing free infant formula to breastfeeding mothers upon hospital discharge leads women to stop nursing their babies sooner than they had planned, according to a new study from the Oregon Department of Human Services.

Breast milk is the best form of nutrition for infants, with documented benefits such as reduced risk of infectious disease, respiratory infections, allergies and chronic disease. The American Academy of Pediatrics recommends that infants be exclusively fed breast milk, which means no other liquids or solids, for the first six months of life.

"If hospitals stop giving out free formula to women who are breastfeeding, they will breastfeed for a longer period of time." said Ken Rosenberg, M.D., medical epidemiologist in the DHS Public Health Division and lead researcher of the study, which looked at the association between free formula discharge packs and exclusive breastfeeding duration.

Public health researchers analyzed survey responses from 2,684 new mothers. Almost 67 percent said they were breastfeeding at the time they left the hospital and were still given a free discharge pack containing infant formula. Further exploration of the data showed the women who received the free formula breastfed for a shorter time period than women who went home without a formula gift pack.

"Most hospitals encourage breastfeeding and staff help new mothers learn how to breastfeed while they are there," Rosenberg said. "Giving away free formula upon discharge presents a mixed message and undercuts the breastfeeding support that a new mother has just been given."

Rosenberg said formula manufacturers have given free gift packs to hospitals for distribution to new mothers for more than 40 years. "The manufacturers have found this is an effective way to increase profits, because it encourages women to stop breastfeeding sooner than they had planned," he said.

Last year Portland became the first city in the nation where no major hospitals give out free infant formula at discharge. Some other Oregon hospitals have also halted the practice. St. Charles Medical Centers in Bend and Redmond has also recently banned gift packs.

"As this issue gets more visibility, we hope even more hospitals will follow their example," said Rosenberg. "This study clearly shows that free formula can undermine a mother's confidence that she can successfully breastfeed."

Oregon women are more likely to breastfeed their babies than women in other states, according to Rosenberg. However, Rosenberg noted that only 20 percent of Oregon women exclusively breastfeed their babies for the first six months of life, placing Oregon third among all states behind only Washington and Alaska.

Hospitals that DHS knows do not give out free formula gift bags are mentioned below.

DHS is aware that these Oregon hospitals do not distribute free formula upon discharge:

  • All Providence Hospitals
  • All Legacy Hospitals
  • Portland Adventist
  • OHSU Doernbecher Hospital
  • St. Charles Medical Center in Bend and Redmond
  • All four Oregon "Baby Friendly Hospitals"
  • Kaiser Sunnyside Medical Center, Clackamas, Oregon
  • PeaceHealth Nurse Midwifery Birth Center, Eugene, Oregon
  • Providence Medford Medical Center, Medford, Oregon
  • Three Rivers Community Hospital, Grants Pass, Oregon

Notably missing from that list is Salem, Hospital, here in the capitol city. Hospital spokesperson ‎Sherryll Johnson Hoar told Salem-News today that the question comes at an interesting time, as their Family Birth Center that opened in 2004 has a new director as well as some possible new directions.

"We're looking at everything from the top to the bottom right now with a new nurse educator in place, so the question of whether we are going to move into these areas is something we are exploring along with many other things," Hoar said.

So the bottom line is that Salem Hospital does provide free formula as part of the new mom's exit package from the maternity ward, but they don't provide very much.

"What we give them is an amount of formula that will only make four half-ounce servings. So it really isn't very much." She says a larger part of the package new moms leave with is their Breastfeeding support kits which has a number of accessories for nursing mothers. "It really is geared more in that way if you look in one of these bags and see the contents. There are things that can really help a woman who is breastfeeding."

Hoar says the hospital considered joining the movement that began in Boston eight years ago, but there was cost involved.

My understanding is that the hospital decided against using money there, and they decided to use the funds to hire a lactation specialist. As a result of that, we are able to do a lot of education.

(Nationwide there are 62 Baby-Friendly Hospitals. Further information about the Baby-Friendly initiative is on the Web at

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Joni Shahin January 10, 2009 7:06 am (Pacific time)

I wish with all my heart hospitals AND WIC would STOP giving away formula... It is really doing damage to what could be BEAUTIFUL breastfeeding relationships.. I understand that breastfeeding cannot be easy I have had mastitis 5 times between nursing my two children- as well as latch and other issues- But with proper support and proper information you get through it- Our medical communities are FAILING us as women by not informing properly of the outright DANGERS OF ARTIFICIAL FEEDING_ Educate yourselves ladies!!

Nanc Tuttle March 4, 2008 11:16 am (Pacific time)

In response to the February 12, 2008 article "Free Formula in Hospitals is Reducing Natural Breastfeeding." I read the article and found it difficult to believe that hospitals think they have such influence on how mothers should care for their babies by cutting out "baby formula gift bags" in an effort to promote breastfeeding. We all go to hospitals believing they are looking out for our “best” interest but it seems to me that breastfeeding is 100% the mother’s choice and in most cases has been decided long before the delivery day. We all have read and been told starting the baby off by breastfeeding is great but to say it is the “best” puts an awful lot of burden on the mother; maybe the decision she makes is based on what is “best” for her. There are many reasons why a woman may choose not to breastfeed none of which can be influenced by the hospital giving a couple cans of baby formula. Hospitals should not be in the business of telling mother’s what is best for them that should be left to the physician - the pros and cons I am sure have already been communicated to her. Finally, who cares what brand the hospital hands out – not for one moment would that influence my choice - my mom, my sister, my friends and finally the baby would help make that decision, not a couple of free cans of formula.

mom x 2 February 13, 2008 1:39 pm (Pacific time)

i breastfed my first baby baby for just over a year with no problem. my second baby was a nightmare.PAINFULL! the formula that salem hospital gave me was a godsend to give me a break for a few days. if i hadn't had that break i wouldn't have continued to breastfeed him for 11 more months. formula is not evil, it is overused but you are not a failure at motherhood if you can't make breastfeeding work. just don't give up!

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