Many parents and care providers don’t perceive the effects of formula marketing strategies, and say that they are too smart to be manipulated. But multiple studies show an association between distribution of free commercial formula discharge bags and decreased breastfeeding.

Title: Do infant formula samples shorten the duration of breastfeeding?

Source: Lancet

• Breastfeeding mothers who received free formula samples at discharge were less likely to still be breastfeeding at one month (78% vs. 84%, p=0.07)
• Breastfeeding mothers who received free formula samples at discharge were more likely to introduce solid foods by 2 months (18% vs. 10%, p=0.01)
• The above trends were more significant among less educated mothers, first time mothers, and mothers who had been ill post partum.

Bergevin et al., Do infant formula samples shorten the duration of breast-feeding? Lancet. 1983 May 21;1(8334):1148-51

Title: Commercial hospital discharge packs for breastfeeding women

Source: Cochrane Database Systematic Review

• Meta-Analysis shows that giving breastfeeding women a commercial formula discharge pack decreased exclusive rates of breastfeeding at any point in time, from 0–6 months postpartum

Donnelly et al., Commercial hospital discharge packs for breastfeeding women. Cochrane Database Syst Rev. 2000;(2):CD002075

Title: Infant formula marketing through hospitals: The impact of discharge bags containing formula on breastfeeding.

Source: American Public Health Association Meeting and Conference

• Women who did not receive discharge packs containing formula were more likely to be exclusively breastfeeding at 3 weeks postpartum (OR 1.52, 95%CI 1.12-2.05).

Eastham et al., Differential effect of formula discharge packs on breastfeeding by maternal race/ethnicity. APHA 133rd annual meeting and exposition 2005, Philadelphia.

Title: Commercial discharge packs and breast-feeding counseling: effects in infant-feeding practices in a randomized trial

Source: Pediatrics

• Mothers who received a discharge pack that did not contain formula breastfed exclusively for longer (p=.04), and were more likely to be breastfeeding at 4 months postpartum (p=.04)

Frank et al., Commercial discharge packs and breast-feeding counseling: Effects on infant-feeding practices in a randomized trial. Pediatrics, 1987 Dec;80(6):845-54

Title: Effect of discharge samples on duration of breast-feeding

Source: Pediatrics

• Women who received a discharge pack with a manual breast pump but no formula breastfed longer (mean = 4.18 weeks) than women who received infant formula in their discharge package (mean=2.78 weeks) p<0.05

Dungy et al., Effect of discharge samples on duration of breast-feeding. Pediatrics, 1992 Aug;90(2 Pt 1):233-7.

Title: Infant feeding policies in maternity wards and their effect on breast-feeding success: An analytical overview

Source: American Journal of Public Health

• Meta-Analysis found that free commercial discharge bags had an adverse effect on lactation performance

Perez-Escamilla et al., Infant feeding policies in maternity wards and their effect on breast-feeding success: An analytical overview. Am J Public Health. 1994 Jan;84(1):89-97.

The effects of free commercial formula discharge bags on WIC-participants

Title: WIC-based interventions to promote breastfeeding among African-American women in Baltimore: Effects on breastfeeding initiation and continuation

Source: Journal of Human Lactation

• Women who received free commercial formula were less likely to begin breastfeeding and less likely to still be breastfeeding at 7-10 days

Caulfield et al., WIC-based interventions to promote breastfeeding among African-American women in Baltimore: Effects on breastfeeding initiation and continuation. J Human Lactation 1998:15-22

Title: Breast-feeding patterns among Indochinese Immigrants in Northern California

Source: American Journal of Diseases of Children

• Mothers who received free formula samples at discharge were 2 times more likely to formula-feed their infants

Romero-Gwynn E. Breast-feeding pattern among Indochinese immigrants in northern California. Am J of Diseases of Children 1989 July;143:804-808.

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