News article

Massachusetts Becomes First State to Prohibit Formula Marketing in Hospitals

December 20, 2005

(Boston) In a groundbreaking step for mothers and babies, Massachusetts became the first state to prohibit hospitals from giving out free formula company diaper bags to new parents. Giving out these bags reduces the duration and exclusivity of breastfeeding and is considered unethical by many national and international groups, including the World Health Organization. Multiple studies, even from prestigious medical journals such as the Lancet, have shown that the bags interfere with breastfeeding, causing moms to switch to formula sooner, or quit nursing altogether– even when the bags do not contain formula samples. (See references below)

For decades, formula companies used hospitals to hand out diaper bags stocked with coupons and free samples. Most parents see these as a “free gift,” but the bags are a marketing technique that implies that the hospital endorses the product, successfully boosting sales of formula at the expense of breastfeeding. “One day, formula marketing in hospitals will go the way of cigarette ads on TV,” said Melissa Bartick, MD, Chair of the Massachusetts Breastfeeding Coalition.

The new rules on formula marketing are part of a much larger update of existing perinatal regulations written by the Department of Public Health and today approved by the Public Health Council. Hospitals must follow DPH regulations in order to be allowed to operate in the state. The regulations contain many other mandates that help promote and support breastfeeding and otherwise limit formula marketing.

In banning the distribution of these items, the DPH acknowledges that there is no medical justification for the institutional marketing of formula products to new parents. The vast majority of hospitals in Massachusetts and the US give out free diaper bags containing formula to new moms, and also accept free formula for in-hospital use. This marketing practice deviates from the standards followed by health care providers and hospitals in every other respect. For example, hospitals do not give out coupons for name-brand clothing, name-brand foods outside of maternity. “Wed never tolerate the thought of hospitals giving out coupons for Big Macs on the cardiac unit,” said Dr. Bartick, an internist. Since lack of breastfeeding is clearly associated with multiple adverse health outcomes in children and mothers, distribution of formula marketing materials by hospitals and health care providers has been recognized as unethical since at least 1981, when the World Health Organization approved the International Code of Marketing of Breastmilk Substitutes.

Members of MBC on the taskforce that drafted the new regulations helped make the case for eliminating the diaper bags. The formula bags may actually cost families money: “Not only is there the expense of formula, but parents and society end up paying for medications and time lost from work to care for a sick child,” says Dr. Kimberly Lee, a neonatologist at Beth Israel Deaconess Medical Center in Boston.

As proof of the companies influence, Dr. Lee notes that parents almost always continue to use the brand of formula their baby got in the hospital – and those formulas are typically the most expensive. These new regulations will go far in improving the quality of care to mothers and their newborns.

See How We Did It (click here)
(Click here to view the DPH summary of the formula marketing testimony.)

Read the relevant sections of the new regulations, and DPHs memorandum about them to the Public Health Council.