170961 Formula freebies from the hospital: Patterns of sample pack distribution in 50 US states

Monday, October 27, 2008: 11:05 AM

Anne Merewood, PhD, MPH, IBCLC , Division of General Pediatrics, Boston Medical Center, Boston, MA
Xena Grossman, RD, MS , Division of General Pediatrics, Boston Medical Center, Boston, MA
Marcella Singleton, MS, RD, IBCLC , Knox County Health Department, Knoxville, TN
Karen Peters, MBA RD IBCLC , Breastfeeding Task Force of Greater Los Angeles, Los Angeles, CA
Reginald Fonrose, BS , Boston Medical Center, The Breastfeeding Center, Boston, MA
Tina Navidi, BS , Boston Medical Center, The Breastfeeding Center, Boston, MA
Tony Pomales, BA , Boston Medical Center, The Breastfeeding Center, Boston, MA
John T. Cook, PhD , Department of Pediatrics, Boston University School of Medicine, Boston, MA
Background: In violation of the WHO Code for the Marketing of Breast Milk Substitutes, infant formula manufacturers distribute formula sample packs via the hospital to new mothers in the US. Samples are packaged as a diaper discharge bag, and advertised as free gifts. Our previous study described practice in the Eastern US. This study includes all US hospitals.

Objective: To determine the extent of hospital-based, formula discharge bag distribution in all 50 US states and DC.

Design: In 2006-2007 we collected data from 3,444 US maternity hospitals, representing all US birthing hospitals available from relevant state organizations and Departments of Health. Researchers called the maternity service at each hospital and, using a prepared script, asked if the hospital distributed a formula-company sponsored diaper discharge bag to new mothers. If the respondent was uncertain or said packs were not distributed, a 2nd, independent researcher called and confirmed the information. The year packs were eliminated was recorded. Data were collected in Massachusetts, Tennessee, and California.

Results: 92% of hospitals nationwide distributed formula sample packs. Rhode Island (57%), Oregon (61%), New Hampshire (63%), and New Mexico (69%) had the lowest percentage of hospitals distributing sample packs. In 9 states, 100% of hospitals distributed packs. A trend towards discontinuation of the practice was statistically significant (p<0.01).

Conclusions: Most US hospitals distribute formula sample packs. Distribution varies by state. The practice is quickly being discontinued.

Funding: Department of Health and Human Services

Learning Objectives:
1. List 3 reasons why formula sample pack distribution by hospitals is poor public health practice 2. Describe national prevalence of formula sample pack distribution by hospitals 3. Articulate regional patterns and changes over time relevant to this practice

Keywords: Breast Feeding, Ethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed and lead the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.