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Leading National Trend, 80 Percent of Births in North Carolina Occur in Infant Formula Bag-Free Facilities

Oct. 29, 2013 

Leading National Trend, 80 Percent of Births in North Carolina Occur in Infant Formula Bag-Free Facilities

Vast Majority of Top-Ranked U.S. Hospitals, Including Duke and UNC Women’s Hospital, Have Ended the Practice, New Study Shows

WASHINGTON, D.C. – The vast majority of the U.S. News and World Report’s 2013-14 “Best Hospitals” have ended or substantially limited formula marketing, according to a new study released today by Public Citizen and the Ban the Bags campaign. Duke University Hospital and UNC Women’s Hospital are the only two hospitals ranked in gynecology in North Carolina, and both have adopted the best practice.

A large majority of the hospitals ranked best in gynecology and in the Honor Roll of overall best hospitals have stopped distributing formula company-sponsored discharge bags with formula samples, the most common form of formula marketing.

The study, based on a Public Citizen survey as well as reports collected by Ban the Bags and the North Carolina Breastfeeding Coalition, shows an encouraging trend among hospitals seeking to improve mother and baby health through infant feeding support policies. It also represents progress in efforts to block companies from co-opting hospitals and using them to peddle products to new mothers with what appears to be a stamp of approval from the medical establishment.

“This report shows that prohibiting infant formula marketing is not only a recommended policy, but a best practice employed by the top hospitals,” said Public Citizen’s Executive Vice President Margrete Strand Rangnes, a mother of two. “The most reputable hospitals are realizing that marketing formula is unethical and ultimately undermines the health of mothers and babies. Now it’s time for the laggards to catch up, to protect infant health.”

“The North Carolina Breastfeeding Coalition recently celebrated that more than 80 percent of babies born in our state are born in facilities that have banned the bags. We celebrate every hospital’s triumph over the temptation to market formula by presenting them with Golden Bow Awards. We look forward to the day when we can celebrate being a bag-free state like Rhode Island and Massachusetts,” said Emily Taylor, MPH, LCCE, CD(DONA), chair of the organization.

“As in most states, women in North Carolina intend to breastfeed,” Taylor added. “Our job is to educate and support every mom to meet her goal. Research performed right here in our state has shown that infant formula advertisements lead women to doubt their ability to meet their goals. We want to empower new mothers, and in order to do that, we have to stop distributing materials that we know disempowers them.”

There is overwhelming agreement by all major healthcare professional organizations that distributing discharge bags sends the wrong message to mothers that hospitals endorse formula feeding, as compared to breastfeeding. Healthcare professionals agree that exclusive breastfeeding for the first six months after a child is born has numerous short- and long-term health benefits for both babies and mothers.

Additionally, the U.S. Department of Health and Human Services and others have estimated that women save up to $1,500 per year in formula costs if they exclusively breastfeed.

Research convincingly shows that mothers who receive infant formula samples are less likely to breastfeed exclusively and are more likely to do so for shorter durations. Accordingly, the U.S. Surgeon General’s 2011 Call to Action to Support Breastfeeding called for more enforcement of the World Health Organization (WHO) International Code of Marketing of Breast-milk Substitutes, which prohibits in-hospital formula marketing. Hospitals are increasingly seeking to become Baby Friendly, a designation that requires them to cease marketing formula to new mothers.

Public Citizen and the Ban the Bags Campaign made the following key findings on the nation’s top-ranked hospitals in gynecology:

  • Sixty-seven percent of top hospitals in gynecology (30 out of 45) reported not distributing formula company sponsored discharge bags, formula samples or other formula company promotional materials to mothers in their maternity units. Another 11 percent (5 of 45) reported limiting formula company-sponsored discharge bag and sample distribution to mothers who request them, or based on other criteria.
  • Eighty-two percent (14 of 17) of U.S. News’ Honor Roll of overall best hospitals reported having a policy or practice against distributing formula company-sponsored discharge bags or other promotional materials.
  • Eleven percent of hospitals in gynecology (5 of 45) still distribute formula company-sponsored materials, and a handful of hospitals did not respond to the survey.

“It is such wonderful news that so many of the top-ranked hospitals have eliminated the distribution of commercial infant formula discharge bags,” said Marsha Walker, RN, IBCLC, co-chair of the Ban the Bags campaign. “This demonstrates such a significant commitment to the health of their littlest patients. Our experience at the Ban the Bags campaign in Massachusetts has shown that formula marketing does not belong in the hospital, and hospitals should market health and nothing else.”

The report reaffirms other data showing that hospitals have been steadily trending toward ending formula promotion over the past decade. According to the Centers for Disease Control and Prevention (CDC) Maternity Practices in Infant Nutrition and Care (mPINC) survey, 27.4 percent of hospitals had discontinued the formula discharge bags in 2007, and by 2011, 45.5 percent had ended the practice. All hospitals in Massachusetts and Rhode Island have voluntarily banned discharge bags.

The study is part of a nationwide Public Citizen campaign aimed at both healthcare facilities and major formula makers, and the Ban the Bags campaign that grew out of the Massachusetts Breastfeeding Coalition’s successful “Ban the Bags” initiative. More than 16,500 people have signed Public Citizen’s petition calling on the three major formula companies – Abbott, Mead Johnson and Nestle – to stop marketing formula in healthcare facilities. To read Public Citizen’s report and learn more about the organization’s campaign to stop infant formula marketing in healthcare facilities, visit https://www.citizen.org/our-work/health-and-safety/infant-formula-marketing.

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