Do hospital freebies discourage breast-feeding?

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(CBS/AP) If "breast is best," how come hospitals often give new moms freebie packages that contain infant formula? Critics of the practice say it undermines new moms' resolve to breast-feed their babies.

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"Hospitals need to greatly improve practices to support mothers who want to breast-feed," CDC chief Dr. Thomas Frieden said last month in releasing a CDC report card on breast-feeding. It showed that less than 5 percent of U.S. infants are born in "baby-friendly" hospitals that fully support breast-feeding, and that 1 in 4 infants receive formula within hours of birth.

Routinely offering new moms free formula is among practices the CDC would like to end. In some cases, hospitals give out the freebies in exchange for getting free supplies for special-needs infants, Frieden said.

How many U.S. hospitals hand out formula? That's unclear. The American Hospital Association and the International Formula Council, a trade group for formula makers, do not keep statistics and formula companies contacted for this story declined to comment.

A nationwide study of more than 3,000 U.S. hospitals and maternity centers published last year in the Journal of Human Lactation found that 91 percent sent new moms home with free formula in 2006-07. A 2010 study of 1,239 hospitals suggests that while the practice has decreased, most hospitals - 72 percent - still offered formula. That study is being released Monday in the October edition of Pediatrics.

"I don't think hospitals are the right place to market anything and I don't think hospitals should be marketing a product that is nutritionally inferior to breast milk," said study author Anne Merewood, an associate pediatrics professor at Boston University medical school and editor of the Journal of Human Lactation.

"People do think if a doctor gives something it must be good for you," Merewood said.

Some women and activists, though, say the move to end formula freebies is part of a breast-feeding movement that has gone too far, overstating the benefits and guilt-tripping new moms who have trouble nursing or choose not to. Even some breast-feeding moms don't have a problem with the free formula.

"I think it's fine to offer freebies to any mom, especially those who are undecided or have already made up their mind not to breast-feed. We are always free to refuse," said the Rev. Camille Lebron Powell, an associate Presbyterian pastor in Little Rock, Ark.

Breast milk contains antibodies that boost babies' immune systems and help fight infections. Studies have shown that breast-fed babies have reduced chances of becoming obese or developing diabetes in childhood, and sudden infant death syndrome is less common in breast-fed infants.

The American Academy of Pediatrics and other medical groups recommend that infants get only breast milk for their first six months. The new CDC report shows that only 15 percent of new mothers achieve that goal, and only 44 percent of new moms breast-feed at all for six months.

Hospitals have been offering formula freebies for decades, but they have a new incentive to abandon the practice.

The Joint Commission hospital accrediting group last year added "exclusive breast milk feeding" during newborns' hospital stays as a measure that hospitals can be evaluated on. While formula giveaways won't be evaluated, the commission mentions monitoring that practice when it educates hospitals on how to improve their performance, said Celeste Milton, an associate project director at the commission.

The World Health Organization and the United Nations Children's Fund established the "baby friendly" designation, with 10 criteria hospitals must meet. These include allowing new moms and infants to remain together throughout the hospital stay and not giving newborns any pacifiers or formula.

Jennifer Smoter, a spokeswoman for Abbott Nutrition, makers of Similac formula, declined to disclose how many hospitals Abbott provides with formula samples and would not comment on the practice. Representatives of Mead Johnson, makers of Enfamil formula, did not respond to email and telephone requests for comment.

Haley Stevens, a scientific affairs specialist for the International Formula Council trade group, said not offering new moms formula samples "is really irresponsible."

New moms should have formula available, along with information on how to use it so they don't water it down or make other mistakes that could endanger their babies' health, Stevens said.

"We agree breast-feeding is the best, when you can do it," she said. "There's no question. But if one size doesn't fit all, it's good to have a backup."

  • David W Freeman

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