Does Free Baby Formula Discourage Breast-feeding?

While it has been a common practice since the beginning of time, breast-feeding has also been a source of constant debate and discussion. The latest controversy is no exception.

A new study by the Government Accountability Office suggests that a federal program designed to aid low-income mothers may inadvertently discourage them from breast-feeding because it provides them with free infant formula in hospitals.

While the U.S. government encourages mothers to breast-feed their infants, the study reports that low-income mothers who participate in the federal Women, Infants and Children health and nutrition program have significantly lower breast-feeding rates than the rest of the population.

The thought is that mothers -- particularly those in low-income brackets -- take the baby formula freebies as an endorsement for formula. These new mothers, according to the report, presume their doctors support baby formula nutrition over breast-feeding.

"It truly is a strong, powerful message to mothers about breast-feeding, when you are most vulnerable and you are handed a bottle of formula by a medical professional," said Judy Hopkinson, assistant professor at Baylor College of Medicine. "That's a pretty strong message."

The Federal Government's Perspective

The U.S. government wants more mothers to breast-feed because of it benefits. It reduces infant diabetes, ear infections and asthma, according to the GAO report. Women who breast-feed, said the report, are less likely to get certain types of cancers.

There's a financial benefit for the government, too. The report claims the government could save at least $3.6 billion in direct and indirect health care costs if its breast-feeding goals are met.

One of the U.S. Healthy People 2010 breast-feeding goals is to get 75 percent of mothers to breast-feed for the first six months of their baby's life. The Centers for Disease Control and Prevention reports that about 70 percent of U.S. women in 2003 breast-fed at least once after bearing a child.

Massachusetts Considers Ban

The controversy doesn't stop there.

The state of Massachusetts is close to becoming the first state to impose a ban preventing hospitals from handing out free samples of infant formula to new mothers. The governor has asked the state's health agency to tread carefully.

"I'm not enthusiastic about the heavy arm of government coming in and saying, 'We think we know better than the mothers and we are going to decide that they can't get free formula when it comes as a welcome home kit from the suppliers of formula with Q-tips, baby lotion and so forth,' " said Gov. Mitt Romney. "Let's let the moms decide."

The state's Public Health Council has pursued a three-month study and is expected to decide in May whether the ban should be put in place.

Fair to Advertise to New Moms?

Doctors around the country insist that deciding whether or not to breast-feed an infant should be solely a medical decision. Hopkinson is suspicious of efforts to give infant formula to new mothers and has called it advertising

"You don't just give these things out for free. There needs to be a medical reason before you do something like this," said Hopkinson. "You have to be careful what you are advertising, because physicians and nurses have a big influence on what mothers do."

The baby formula producers defend their right to distribute formula to new mothers, saying they doubt that the numbers of mothers who breast-feed would rise if they were forced to stop, according to a Reuters report.

"These are brand-name products from the hospital. It looks like the hospital is endorsing it. It's like putting Pepsi-Cola machines in the schools," said Anne Merewood, an assistant professor of pediatrics at Boston University School of Medicine.