Infant Formula Freebies from the Hospital: Regional Trends among 13 US States

Background: In violation of the WHO Code for the Marketing of Breast Milk Substitutes, infant formula manufacturers distribute free formula samples, packaged as diaper discharge bags, via the hospital, to new mothers in the US. This practice undermines breastfeeding rates. Objective: To determine the extent of formula discharge bag distribution at hospital and population levels in 13 NE states and DC. Design/Methods: Researchers called the maternity service at each hospital and, using a prepared script, asked the answering provider if the hospital distributed formula-company sponsored diaper discharge bags. Whenever the respondent said bags were not distributed, a 2nd, independent researcher called and confirmed the information. Data were obtained on (1) number of hospitals giving out bags; (2) proportion of births affected by the practice in each state. Results: Dependent on state, between 71% and 100% of hospitals gave out free formula discharge packs. The proportion of births affected varied from 58.7% (Vermont) to 100% (4 states). States where all hospitals distributed formula bags were clustered in the DC region. Conclusions: Most hospitals in the northeastern US distribute formula discharge packs. Distribution varies between states, with evidence of regional patterns and differences. Ongoing study will assess any correlation that may exist between formula pack distribution and state breastfeeding rates.