Those formula company diaper bags.

I just got home from the annual Massachusetts Breastfeeding Coalition Conference.  It was, as I expected, an informative and fun day.  I learned more about breastfeeding twins (and triplets!), communication skills, and new requirements for breastfeeding support at hospitals in the state.

But one of the most interesting presentations was on efforts to get rid of the formula company diaper bags given to new mothers at hospitals.  These are the "freebie" bags that usually contain formula and other goodies emblazoned with formula company logos.  Earlier this year Massachusetts became within a hair of becoming the first state in the nation to prohibit the distribution of these bags at hospitals, and there is a growing national movement to ban the bags, which you can read about here.

I got one of those bags when I left the hospital after having my son.  I can still tell you the exact spot on the exact shelf where that can of formula sat.  And recently, looking through my son's baby book, I found formula logos everywhere, including his crib card from the nursery and his growth chart from our pediatrician.

There is solid research showing that when hospitals give these bags away mothers are more likely to start using formula.  Even when the formula itself is removed from the bag, the bags have an effect.  This is probably why the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and many other organizations oppose the distribution of these bags.

I love freebies just as much as anyone, but I really object to the marketing of formula - or really any product - to patients at hospitals.  I trust my doctors and nurses to give me good advice to keep my family healthy, not to advertise products - especially ones which can undermine healthy choices like breastfeeding.

I know that this is a more controversial topic than those in the other posts, and I'm looking forward to hearing from you.  Did you get one of these bags?  What did you think when you got it?  What do you think of the effort to "ban the bags?"

Comments

[HK]

I don't have a problem with the free bags. I was given one in the hospital but I was so dazed I didn't even look into it until a couple of months had gone by post birth (I already had a diaper bag to use). I would however support an effort to do away with them if it is shown that they influence new mothers to use formula.

Here's my story about formula giveaways: I had a lot of trouble getting nursing going in the beginning. My baby did NOT want to wake up and nurse (I had a C section and didn't get to try until later that night) and my nipples were so sore I avoided pushing her. At week 2 the pediatrician said I had to supplement with formula and gave me a "supplementation kit" a/k/a a little free bag with a can of powdered formula in it. I was relieved to have permission to stop torturing us both, I thought.

But when I opened the bag at home, there was a little booklet in it about nursing along with the can of formula. I dutifully started to read the booklet and one of the first things it advised was to throw away any free formula given out by hospitals and doctors! It then went on to describe my exact situation (baby not gaining, doctors advising supplementation) and it said "for these mothers and babies, breastfeeding is soon over." When I read those words I started to cry (it still brings tears to my eyes). I couldn't believe my little baby was only a few weeks old and we had already failed at something together. I became determined at that moment to pull myself together and give it everything I had to try to make nursing work. What followed was a painful 4 weeks of nursing, pumping, supplementing and crying, but I am happy to say that by week 6 we were able to go off the supplementation completely and now at nearly 6 months are still nursing exclusively.

I sometimes feel bad that I used the formula at all but then I remind myself how very close we came to giving up altogether and what a huge accomplishment it was that we made it work. I am so grateful to whoever it was that managed to sneak those booklets into the free formula bag!

[Isaiah's mommy]

I too received one of the formula diaper bags from the hospital. I had to supplement with formula for about four months because I did not produce enough milk. I met with a lactation consultant the week after my son was born and she was really a BIG help (I will go back to her when I have more kids). I followed her suggestions but my son was still just not getting enough milk and gaining weight. I wish I didn't have to supplement but I needed to feed my baby and have him grow. I still nurse him and he just turned 11 months. I hope that it goes better with next babies. I wish I didn't have to use formula but I am grateful for the can of formula to get me through til we could work things out.

[MJ]

I was thankful for the free formula samples I received! They gave me the ability to relax and not worry about whether I was pumping enough, nursing right, leaving enough bottles when I went to work, or any of the other MANY things I found to worry about.

I tend to be a bit of a perfectionist. I was very worried about nursing "right." I knew being relaxed was an important component to producing enough milk but come on, who can really relax when they HAVE to?? Then I got this free formula bag as I left the hospital. I took it home and put it under a cabinet. Every time I started to worry, I thought about the formula sitting there, waiting to back me up if I wasn't "perfect."

My son is now 11 1/2 months old and we've never touched that formula!! Despite the fact that I even had to pump in a co-ed break room while serving on a jury, we've managed to persevere. I don't think we would've been so successful if I didn't have that safety net.

I think if doctors and nurses do everything they can to support breastfeeding then the bag is just a bag and the sample is just a sample. I believe that it's only when the support isn't there that a bag and a sample can have that much influence over a woman's choices.

[Jessica]

I got one of these bags when my daughter was discharged from the NICU. It contained the "special" formula for preemies. That now (10 months later) is still sitting unopened on a shelf. This along with a few cans the nurse threw in to take home. I did just fine nursing her without the use of fomrula. I now use the bag on occasion as a lunch sack, when we go on long trips (it's used for her baby food since it's insulated). I would definetly support the ban on those bags in my state as well.

[redheadmomof4]

I teach mothers about breastfeeding every day, and have had 4 children of my own. I got the formula from the hospital and was upset about it.

I also know that the mothers I work with are affected by the free formula. They have expressed that they feel that breastfeeding "might not work" and that's why the hospital gave it to them (undermining their confidence). It's also very true that this creates "brand loyalty", where moms feel that they should stick with that first brand of formula.

I totally support banning this type of advertising in the hospitals. I feel that if it's needed, stores everywhere carry it. I also feel that it is unethical for health professionals to promote or advertise formula.

[owensma]

I have an 11 week old little boy. I have made the decision to nurse him because of all the health benefits to him and to myself. However, I am an independent 27 year old woman who enjoys the ability to not worry about pumping enough for my son... if I want to go to the grocery store alone... or if I want to go get dinner with a friend... or perhaps wants to have a cocktail! Formula isn't the end of the world. I think that making the choice to breastfeed-- for an independent woman like myself is a great challenge. I am proud of my choice... but do feel that it nice to have the freedom to "escape" every now and then. I think that more women would breastfeed if they knew it was OK to give leave the baby with their husband/partner and a can of Enfamil. Instead, the breastfeeding community shuns women for even considering introducing it into their childrens' diets. That's too bad. I like my samples, thank you.

[Heather]

We should remember that breastfeeding, while best, is a choice that each individual family needs to make. It is not always the right thing for everyone. I have enjoyed breastfeeding my two children.

My daughter had occasional formula but my son has a milk and soy allergy so he has had none since the allergy was discovered. I have to attend a wedding out of state and will be gone only one night, my frozen supply is very low and this is causing alot of stress.

I have pumped now for 11 months while I work full time outside the home. I wish I had a backup at daycare just in case they spilled some or he wanted more.

Breastfeeding versus formula doesn't have to be all or nothing. Those of us who decided they wanted to breastfeed their children will do it whether or not we got a can of formula from the hospital. Let's give women a little more credit and not let the government make this decision for us.

[momof2boys]

I recently gave birth to my second son 5 weeks ago, and found something great that didn't occur with my first son 3 yrs ago. Along with the diaper bag filled with formula goodies, also came a diaper bag filled with breastfeeding mothers goodies. Included in it was several booklets of great breastfeeding reading....breastmilk storage bottles, samples of breast pads, and ice packs for storage on the go with this insulated diaper bag. This I thought was a great idea. I don't believe that the diaper bags with formula are a BAD idea, but having other things available as well are great. I can see how that alot of new mothers would get discouraged enough in the first few weeks of breastfeeding to lean on the formula samples, but sometimes this can't be helped. BUT on the other hand, it does make it easy to think that formula feeding would be much easier, especially for first time mothers. I had a rough couple weeks with this baby breastfeeding, just being very sore and things....and had it been my first baby, I may have given up on breastfeeding. Thank God I had already had the experience with my first son, which went like a dream...and I didn't let myself get too discouraged. I think breastfeeding is definately a choice, but most hospitals and doctors seem to push formula feeding more than they should.

[Jen]

I received a several freebie bags. In the mail at the hospital, and at the doctors office. I enjoyed having the peace of mind that if something happened I would have a backup. I also received a cool shirt that read "I eat at mom's" I thought this was the coolest thing!I think a women makes up her mind before she even goes in the delivery room. If we ban these bags then what about the women that can't afford formula or just didn't even think about buying any before the birth. One of the bags I received was a nursing bag it had the ice packs and a storage bag along with a manual pump. I think we should put the information out there for both and let parents decide what is best for their child.

[AlisonS]

It's great to hear from so many moms who didn't change their breastfeeding plans based on the diaper bags. Unfortunately, though, in randomized studies of hundreds of women, those who got bags were more likely to start using formula than those who didn't -- even if the formula itself was taken out of the bag.

It's also good to know that some of you got helpful info on breastfeeding from formula company gifts -- but really, shouldn't hospitals be able to pay the $7 to 8 to give you a bag w/ breastfeeding info that's not funded by a formula company?

The bags are not a great deal for bottle feeding families either. The brand of formula in the gift bags is the most expensive on the market, costing 2/3 more than store-brand generics. For bottle feeding families, that adds up to more than $700 over the course of a year. But when a nurse hands a brand-name bag to a new mom, the message is clear: "My hospital recommends Enfamil." The vast majority of families stick with it.

There's no practical reason that formula companies couldn't send the bags straight to mom's homes. When I had my first baby, 4 or 5 cans of formula arrived at my home without my even asking for them. But companies want hospitals to give out the bags because they need the endorsement from doctors and nurses to sell their product.

Ultimately, the issue is not whether families should be able to get samples, but whether hospitals should be marketing brand-name formula. And if your hospital is handing out gift bags, you can be certain that the same formula companies are treating your doctors and nurses to holiday gifts, lunches, dinners, text books, training programs, luxury weekend conferences, and endless other perks. One long-time postpartum nurse told me that Similac shipped ready-to-feed bottles of formula to her home -- free of charge -- for her son's entire first year of life. Why? Because she sees hundreds of new mothers a year, and they know she'll always recommend Similac. As one training manual put it, "A well-serviced nurse is another salesman for Ross."

Getting hospitals out of the gift-bag distibution business doesn't force mothers to breastfeed, or prevent families from keeping an emergency can of formula in the kitchen cabinet. Think of the hundreds (thousands?) of dollars we spend on baby clothes, nursery furniture, diapers, wipes, thermometers, toys, car seats, boppy pillows, nursing bras, and everything else under the sun. A can of generic formula for emergencies costs $12. Keeping marketing gimmicks out of your health care? Priceless.

-Alison (mom of 2, obstetrician, and not a fan of formula marketing tactics...)

[l-thomas]

I received a free diaper bag as well which was handy when things were really messy - but - now that Dash is 9 months I just bought a new one that I am absolutely in love with - the Casiana Mini from flotoimports.com - not sure if I am posting this link correctly but try checking it out here - http://www.flotoimports.com/CasMiniTuscan-luggage.html. It fits my laptop and I love the design - just thought I would pass it along.

[onetinkerbell]

Six years ago when I was pregnant with Maeve, I was adamant about never using formula. I remember when I was still pregnant telling a woman at a maternity store urging me to sign up for something ("You'll get free formula!!" she said) that there was no point in doing so since I planned to breastfeed. Her response was to tell me that just because I planned to do it didn't mean that it would work out. I asked her if she was trying to discourage me. I walked out of the hospital with the free diaper bag, only because I needed it to carry some extra things. I still have it but my daugher uses it as a diaper bag for her baby dolls. I've tried to throw it away but she likes the colors so I let her keep it.

This may sound like the average story but there is one difference - I'm a military wife and I got the bag in a military hospital. This means that formula marketing tactics are at work in government-run hospitals. I have a problem with this - a huge problem. And while that was six years ago I can tell you that this is still happening.

I recently gave birth to my second child, Gwyneth. I also got a diaper bag this time, but not when in the hospital - I got it at the "pregnancy orientation" class that all pregnant women (spouses and military members) are required by the military to take when they are going to give birth overseas. This class is given to women who are 10-12 weeks pregnant, thereby influencing them on their decision to breastfeed (or not) even earlier in their pregnancies. The bag we were given had a small can of powdered formula in it; I took mine out and put it on an empty chair, from which it was immediately snatched up by another woman.

I was lucky enough to give birth in a German hospital. The Germans don't give away diaper bags and they certainly don't give away formula. What they do give is much more interesting and oriented towards breastfeeding. They give little bags that are similar in size to a medium-sized cosmetic bag. In these bags are literature with lots of information on breastfeeding. The one I got came from a baby food company but had no baby food in it. In addition to the literature it had some travel-sized bottles of baby bath and lotion. The best thing was the bottle of fruit juice - for me! The Germans are very big on natural remedies and herbs that are beneficial to breastfeeding. The juice is specifically marketed toward breastfeeding moms as a way to ensure that you get all the vitamins and nutrients you need while breastfeeding. Additionally, the Germans are very big on teas and the promo bag had a few tea bags of "still tea", or nursing tea. I'm not sure exactly what is in the tea although I suspect that fennel is one of the key ingredients.

I wish that American hospitals had these kinds of items available for moms in the hospital, rather than the bags we're used to seeing. I drank the juice right away (I was thirsty!) and occasionally have a cup of the nursing tea during the day as a substitute for caffeinated tea.

My husband is an Army Physician Assistant and though the majority of his patients are male, he counsels all females to breastfeed. Most of them give up quickly after giving birth, generally because so many of them qualify for WIC overseas. From my experience, WIC is just another way to get people to use formula - at least it is here. My neighbor is a WIC couselor and an RN and says that very few of her clients are willing to stick it out with breastfeeding, even if they decide prior to delivery that they will nurse. The reason? There isn't enough support for them. What we need to do in addition to getting the free formula out of the hospital is to require WIC to have at least 1 lacataion consultant on staff and to have support groups that meet with the mothers prior to and post-delivery in order to educate them and provide the necessary assistance that many new mothers require in order to keep nursing. WIC is a government-funded program. As voters we need to have a voice in how it is run.

[Tanya Lieberman]

Onetinkerbell,

Really interesting comments - especially coming from both a military and overseas perspective.

Would you mind sending me an email so we can chat further?

Thanks!

Tanya