Boston, Feb. 22, 2006
In a surprise setback for Governor Mitt Romney, the Public Health Council yesterday decided to study the proposed ban on formula gift bags for three more months, rather than completely rescind it, as Romney had requested. Yesterday, the Massachusetts Breastfeeding Coalition continued to make its strong case for the ban to PHC members, two of whom openly voiced their support for the ban.

Romney views the ban as the “heavy arm of government” being used to influence health choices. Instead, he wants the heavy arm of corporate America to peddle bottles of formula in mothers’ hospital room as they recover from childbirth.

The governor also demonstrated his ignorance of the importance of breastfeeding. He likened formula gifts to “Q-tips and baby lotion,” failing to understand that formula is linked with adverse health outcomes, unlike other baby products. Other comments on weaning indicated a lack of understanding that public health authorities recommend 6 months of exclusive breastfeeding, followed by at least 1-2 years of continued breastfeeding.

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) have both called for an end to the distribution of formula-company sponsored bags. No other unit in a hospital engages in a marketing campaign for a product that is known to be deleterious to the health of its patients. MBC considers the practice akin to other aggressive marketing practices that adversely affect the health of children, such as the intrusion of soft-drink industry into schools.

Internal documents from the formula industry illustrate that the bags are an effective marketing tool, increasing sales of formula at the expense of breastfeeding. This finding is consistently shown by medical research, and confirmed in a recent GAO report. Key to the bags’ success is that health care providers give them out, providing implicit endorsement of bottle-feeding. In fact, the sales training manual for formula-maker Ross states that “a nurse who supports Ross is like another salesman.”

Also key to the bags’ success is the perception that they will save families money, an argument which the governor has also bought into. Poor women are at the highest risk of poor health outcomes that can be prevented by breastfeeding. The formula in a gift bag contains less than a week’s worth of feedings and will hardly help stretch the budget of low income families. Boston Medical Center, which cares for a high proportion of low income women, stopped distributing these bags almost a decade ago because they consider the practice unethical. Every container of formula lists a toll-free number which families can call to receive free bags, coupons, or samples.

Research shows that mothers make their feeding choice during pregnancy, not as they are leaving the hospital with a formula bag. In fact, women deserve to be free from aggressive marketing tactics during the vulnerable time following childbirth. Feeding choice is between a mother and her doctor, and marketing practices intrude upon the privacy of the doctor-patient relationship. Formula marketing parallels marketing efforts by the pharmaceutical industry to gain undue access to our patients and influence medical decisions.

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) have both called for an end to this practice.

Massachusetts lags behind 17 other states in the percentage of women who even try to breastfeed. A quarter of our birthing hospitals have given breastfed babies formula without a medical reason. One in four do not require postpartum nurses to have formal breastfeeding training. “We have plenty of barriers to breastfeeding without the governor adding one more,” say MBC Board member Dr. Alison Stuebe, a Boston obstetrician.