The World Health Organization’s International Code of Marketing of Breast-Milk Substitutes, as well as most major medical authorities, opposes hospital-based distribution of free infant formula at discharge. The goal of this cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007, was to determine the extent of this practice. It was found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant (P < .001). It was concluded that most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of organizations including the US Government Accountability Office, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention.
Brennan TA, Rothman DJ, Blank L., et al. Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. JAMA. 2006;295:429-433.
2.
Brett AS, Burr W., Moloo J.Are gifts from pharmaceutical companies ethically problematic? A survey of physicians. Arch Intern Med. 2003; 163:2213-2218.
3.
Morgan MA, Dana J., Loewenstein G., Zinberg S., Schulkin J.Interactions of doctors with the pharmaceutical industry. J Med Ethics. 2006;32: 559-563.
4.
Kuehn BMReport: FDA exerts too little oversight of researchers’ conflicts of interest. JAMA. 2009;301:709-710.
5.
Rothman DJ, McDonald WJ, Berkowitz CD, et al. Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest. JAMA. 2009;301:1367-1372.
6.
Schafer A.Biomedical conflicts of interest: a defence of the sequestration thesis-learning from the cases of Nancy Olivieri and David Healy. J Med Ethics . 2004;30:8-24.
7.
Steinbrook R.A higher bar-Vermont’s new law on marketing prescribed products. N Engl J Med. 2009;361:8-9.
8.
Willyard C.Physicians fight back against disclosure rules. Nature. 2009;460:556-557.
9.
Kaiser J. Ethics .Private money, public disclosure. Science. 2009;325: 28-30.
10.
More doctors smoke Camels than any other cigarettes. Modern Science. 1946.
11.
World Health Organization.International Code of Marketing of Breast-milk Substitutes. Geneva, Switzerland: World Health Organization; 1981 .
12.
Gartner LM, Morton J., Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics . 2005;115:496-506.
13.
Centers for Disease Control and Prevention.Breastfeeding Among U.S. Children Born 1999-2005. National Immunization Survey . Atlanta, Ga: Centers for Disease Control and Prevention; 2008.
14.
Kramer MS, Chalmers B., Hodnett ED, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001 ;285:413-420.
15.
Philipp BL, Merewood A., Miller LW, et al. Baby-Friendly Hospital Initiative improves breastfeeding initiation rates in a US hospital setting. Pediatrics. 2001;108:677-681.
16.
Cattaneo A. , Buzzetti R.Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative. BMJ. 2001;323:1358-1362.
17.
Philipp BL, Malone K., Cimo S., Merewood A.Sustained breastfeeding initiation rates at a US Baby-Friendly hospital. Pediatrics. 2003;112: e234-e236.
18.
Merewood A. , Philipp BL, Chawla N., Cimo S.The Baby-Friendly Hospital Initiative increases breastfeeding rates in a US neonatal intensive care unit. J Hum Lact. 2003;19:166-171.
19.
Merewood A. , Mehta SD, Chamberlain LB, Philipp BL, Bauchner H.Breastfeeding rates in US Baby-Friendly hospitals: results of a national survey. Pediatrics. 2005;116:628-634.
20.
Kruse L., Denk L., Feldman-Winter L., Rotondo FMComparing sociodemographic and hospital influences on breastfeeding initiation . Birth. 2005;32:81-85.
21.
US Preventive Services Task Force.Behavioral interventions to promote breastfeeding: Recommendations and rationale . Rockville, Md: Agency for Healthcare Research and Quality, 2003.
22.
Bergevin Y. , Dougherty C., Kramer MSDo infant formula samples shorten the duration of breast-feeding? Lancet. 1983;1:1148-1151.
23.
Frank DACommercial discharge packs and breastfeeding counseling: summary of a study . J Hum Lact. 1989;5:7-10.
24.
Dungy CI, Christensen-Szalanski J., Losch M., Russell D.Effect of discharge samples on duration of breast-feeding. Pediatrics. 1992;90(2 pt 1):233-237.
25.
Dungy CI, Losch ME, Russell D., Romitti P., Dusdieker LBHospital infant formula discharge packages. Do they affect the duration of breast-feeding? Arch Pediatr Adolesc Med. 1997;151:724-729.
26.
Rosenberg KD , Eastham CA, Kasehagen LJ, Sandoval APMarketing infant formula through hospitals: the impact of commercial hospital discharge packs on breastfeeding. Am J Public Health. 2008;98:290-295.
27.
Shealy KR, Li R., Benton-Davis S., Grummer-Strawn L.The CDC Guide to Breastfeeding Interventions. Atlanta, Ga: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.
28.
American College of Obstetricians and Gynecologists.ACOG Educational Bulletin, Breastfeeding: Maternal and Infant Aspects. Washington, DC: American College of Obstetricians and Gynecologists; 2000 .
29.
Government Accountability Office.Some StrategiesUsed to Market Infant Formula May Discourage Breastfeeding: State Contracts Should Better Protect Against Misuse of WIC Name. Washington, DC: Government Accountability Office;2006.
30.
Merewood A. , Fonrose R., Singleton M., et al. From Maine to Mississippi: hospital distribution of formula sample packs along the Eastern Seaboard. Arch Pediatr Adolesc Med. 2008;162:823-827.
31.
National Center for Health Statistics.Total Births and Percentage of Births With Selected Demographic Characteristics, by Race and Hispanic Origin of Mother: United States, Final 2004 and Preliminary 2005. Atlanta, Ga: Centers for Disease Control and Prevention; 2009.
32.
Centers for Disease Control.Breastfeeding-related maternity practices at hospitals and birth centers. MMWR Morbid Mortal Wkly Rep. 2008; 57:621-625.
33.
Ross Products Division.Ross Mothers Survey. Cleveland, Ohio: Abbot Laboratories, 2006.
