Why should a mother refuse formula samples and formula company diaper bags from the hospital? Does it actually affect breastfeeding?

by Karen P. Roeske, RN, IBCLC
belliesbabiesbreasts.com

Checklists of the "need to have" items for motherhood and your new baby can be found in every nook and cranny these days. One of the items on these lists is inevitably some type of bag so that you can cart around all the items listed on the checklists. Shopping for a bag can be both fun and overwhelming. Searching the malls and internet reveals the possibility of spending upwards of $200-400, especially if you want a pink leather couture bag. Of course, we all know you must have something fashionable and hip to carry around so you can look cute while changing poopy diapers! Then you find out that one of the formula companies claim that they have the "Mom-approved #1 diaper bag." ^IOh, and by the way, it's free! Wow. No more shopping needed. No more stress about which diaper bag to choose. This one is already approved by mothers. All you have to do is ask for your stylish, tone on tone print, free formula company diaper bag at the hospital. Even if you are a committed breastfeeding mother the zero price tag sounds like a great deal, especially with gas prices these days. What's the big deal about receiving a free bag that contains formula samples, formula coupons, a cooler pack and a nifty key/pacifier holder? Well, let's explore that question. To begin, since free actually infers a price of $0.00, let's boil everything down to numbers. You might not realize it, but numbers are extremely important (hence your desire for the free bag).

Here are a few numbers you focus on in pregnancy:

• Blood pressure
• Weight gain
• Weeks gestation
• Due date
• Number of babies you are expecting

Here are a few numbers you focus on immediately after you deliver your baby:

• Time of baby's birth
• Baby's weight
• Baby's length

Here are a few numbers that formula companies are interested in:

• $7 or less The cost to the formula company to create the diaper bag and contents for marketing^II
• $2000 One year cost to purchase name brand formula^III
• $700 The additional cost to purchase name brand formula per year versus generic^IV
• 224 The number of U.S. hospitals and birth centers that do not distribute formula diaper bags. ^VThere are thousands of facilities, so this number is very small.

Here are a few numbers that hospitals might be interested in:

• $0 The number formula companies market to hospitals. Formula companies may provide free formula for utilization during an infant's hospital stay, free educational programs for staff, free supplies or equipment, discounts on drugs or even cash and in return they provide the diaper bags to the hospitals to give out to mothers prior to discharge.^VI

Here are a few numbers that show how accepting that free formula bag comes with a price:

• 39% The number of women in Oregon who are more likely to supplement with formula prior to 10 weeks who were given the free diaper bag at the hospital^VII
• 24% The number of facilities (out of a total of 2,690 responding facilities) that reported that supplements were given as a general practice to more than half of healthy, term newborns^VIII
• (78% vs. 84%, p=0.07) Breastfeeding mothers who received free formula samples at discharge were less likely to still be breastfeeding at one month^IX
• 70% of 2,690 facilities reported giving formula diaper bags to mothers^X
• GAO-06-282 The number of a 2006 report by the Government Accountability Office that found in the majority of studies it reviewed that women who are given free formula bags at hospital discharge had lower breastfeeding rates^XI
• 2,033 excess number of physician visits for every 1,000 babies not breastfed^XII
• 212 days in the hospital for every 1,000 babies not breastfed^XIII
• 609 prescriptions for every 1,000 babies not breastfed^XIV

Decline formula samples and formula company diaper bags when you have your baby. Exclusive breastfeeding was reduced at all time points in the presence of distribution of commercial hospital discharge packs. The numbers speak for themselves. Go ahead and spend that money on a couture diaper bag knowing that there is a cost to the free diaper bag and free samples: free isn't always what it seems.