Boston — As of July 1, 2012, all 49 Massachusetts maternity facilities have voluntarily eliminated the formula company diaper bags, traditionally given to new moms at hospital discharge. Massachusetts became the nation’s second “bag-free” state after Rhode Island’s seven hospitals eliminated the bags in 2011. The achievement will be celebrated on July 18, at 10:30 am at Nurse’s Hall at the State House, in an event that includes Dr. Lauren Smith, medical director of the Massachusetts Department of Public Health.

In 2005, nearly all maternity facilities in the state were giving out discharge bags from formula companies. The marketing technique is particularly effective in lowering breastfeeding rates in part because of the implied endorsement of the hospital and health professionals. The bags often come with a requirement that hospitals get their formula for free, which contributes greatly to unnecessary use of formula by breastfeeding mothers. Research has consistently shown that such use is one of the strongest predictors of early breastfeeding failure— with a resultant increase in formula sales.

Helping mothers reach their own breastfeeding goals, free of commercial influence, is one of the best ways to reduce health disparities. Many of the first hospitals to ban the bags served the state’s neediest populations. Due to loyalty to the pricey name-brands given in hospitals, even formula feeding mothers end up paying far more to feed their infants than they would if they simply bought store-brand formula.

Hospital staff have increasingly recognized the conflict of interest in promoting a product that can undermine their patients’ health. Unfortunately, the industry is now getting pediatricians and ultrasound offices to pass out the bags there.

Dr. Melissa Bartick, chair of the Massachusetts Breastfeeding Coalition notes, “If all Massachusetts hospitals can eliminate this conflict of interest, all health providers can certainly follow suit. We urge all professional organizations, including the American Academy of Pediatrics, to cut financial ties with the formula industry in the interest of their patients.”

Bartick is careful to emphasize that banning the bags has nothing to do with a mother’s choice to use formula—it is about how that formula is marketed. Consumers can always contact the formula companies and get samples delivered straight to them, without using health care providers as an intermediary. Due to brand-loyalty, formula feeding mothers tend to use the pricey name brand marketed to them in the hospital, which cost over $700 a year more than store brands.

Together with the Coalition, the Massachusetts Department of Public Health, Ban the Bags, and Dr. Bobbi Philipp a pediatrician from Boston Medical Center, have all helped the state lead the long process of change. “We want to set an example for the nation,” said Philipp. “Hospitals should market health and nothing else.” To this she adds, “Our professional organizations should also market health, and nothing else.”

The voluntary campaign to ban the bags accelerated in 2006, after then-governor Mitt Romney forced the Department of Public Health to rescind a proposed regulation that would have required hospitals to stop acting as marketing venues for infant formula.

Here’s the history of hospitals banning the bags in Massachusetts:

Year #banned
2002 3
2005 7
2009 22
2010 27
2011 37
2012 49