Public Citizen to Hospitals: Stop Handing Out Industry-Provided Samples of Infant Formula

Hospitals should stop including industry-provided samples of infant formula in new mothers' discharge bags because the distribution is unethical and violates good public health policy, Public Citizen said in letters, co-signed by more than 100 other organizations, sent to more than 2,600 hospitals across the country. The letters are part of a new, nationwide Public Citizen campaign that is aimed at both hospitals and major formula makers.

Public Citizen also is launching an online petition calling on the three major formula makers - Abbott (maker of Similac), Mead Johnson (maker of Enfamil) and Nestle (maker of Gerber) - to stop marketing their products in healthcare facilities.

Hospital promotion of infant formula in discharge bags contravenes the consensus by all major healthcare provider organizations that exclusive breastfeeding for the first six months after a child is born is best for the health of both babies and mothers. Research convincingly shows that mothers who received infant formula samples are less likely to breastfeed exclusively and are more likely to breastfeed for shorter durations. Hospitals that distribute formula samples are in violation of a 1981 World Health Organization (WHO) code that prohibits healthcare facilities from marketing infant formula.

Yet, at least two-thirds of hospitals in the U.S. distribute samples of infant formula, even if mothers have indicated that they plan to breastfeed. Succumbing to infant formula companies' marketing techniques is costly, both in terms of money spent on formula and the health of mothers and children. Formula feeding costs between $800 and $2,800 per year. Additionally, the formula samples usually are brand-name products, which cost up to 66 percent more than store brands. Families typically continue to use the same expensive brand they receive in samples.

"Hospitals and doctors' offices shouldn't be used as marketing vehicles for any product, period," Public Citizen President Robert Weissman said. "They certainly shouldn't be pushing products that harm the health and well-being of babies and new moms."

Added Elizabeth Ben-Ishai, campaign coordinator for Public Citizen's Commercial Alert project, "When hospitals distribute formula samples, they are engaging in marketing for major pharmaceutical and food companies. Many hospitals are actively trying to promote breastfeeding in their obstetrics units. But by continuing to allow marketing of infant formula in their facilities, they are undermining their own efforts."

Children that are not breastfed have more medical problems, including severe lower respiratory tract infections, obesity, diabetes, childhood leukemia and more. Women who do not breastfeed have higher rates of diabetes, breast and ovarian cancer, post-partum depression and bladder infections.

"Health care providers weaken their own credibility by allowing themselves to be used as marketing conduits and readily distributing infant formula samples," said Jeanne Blankenship, chair of the United States Breastfeeding Committee. "This simple action gives the appearance that they sanction and encourage formula use for all mothers."

U.S. Surgeon General Regina Benjamin, acknowledging that breastfeeding is one of the most highly effective preventive health measures for mothers and babies, in 2011 issued a Call to Action to Support Breastfeeding. Among other actions, Benjamin highlighted the need to "ensure that the marketing of infant formula is conducted in a way that minimizes its negative impacts on exclusive breastfeeding." She called for holding marketers of infant formula accountable to the WHO code and ensuring that health care clinicians do not market formula by providing venues for its advertisement or distributing samples.

Many hospitals across the country have stopped distributing formula samples. A 2009 study by the Centers for Disease Control and Prevention found that 34.2 percent of hospitals nationwide have stopped the practice, and in November 2011, Rhode Island became the first state in which all hospitals with maternity wards stopped distributing formula samples to new mothers. A recent study noted that in states with higher numbers of hospitals eliminating the distribution of formula samples, there are higher rates of breastfeeding.

To read Public Citizen's letter, view a complete list of hospitals that have received the letter and learn more about the organization's campaign to stop infant formula marketing in healthcare facilities, click here. The petition is available here.