NYC hospitals (see latest blog post)

I am glad to see that for one mom, the sample didn't end her breastfeeding relationship and that she was able to get back to exclusive nursing. But this is an exception and not the rule. More women who rely on the samples end up with more breastfeeding problems (lower supply, nipple confusion, colicky baby who is intolerant of the cow's milk proteins in the formula), and the research shows this... which is why the samples have been banned.
I can't speak for the majority but I was given samples of formula by none other than a lactation consultant, since my milk had not yet come in (I ended up having a cesarean and as you may know that is a common result of the surgery). I was grateful for the samples as I was exhausted and, having expected to breastfeed, had done absolutely no research on what kind of formula would be best to supplement with. I was also shown how to supplement properly so that she would get fed and at the same time help my milk to come in. So I have to say I disagree; samples of formula are not all bad in all cases and banning them outright may cause more harm than good. Does the law allow the hospital to give out samples in a case like mine? Or do they leave a first-time mother to founder and wonder how she'll feed her child when her milk supply is not sufficient? I'd rather the hospital staff be able to help a mother feed her baby then leave us guessing on what to do next.

No, I wasn't charged for it. I didn't ask for it either, so for all intents and purposes I was given a sample of formula by the hospital without asking for it. I'm not sure I agree that a mother who is at "an exhausted and frustrating moment" is less entitled to feed her baby with a sample of unasked for formula than I was. That frustrating moment is still a problem--a medical problem if it means her baby isn't being fed, or a mental health issue if it means she will slide into depression. Rather than ban the giving of unasked for formula samples outright and bind the medical profession in a black and white scenario, the law should be more aware of these lactating issues and provide the support hospitals need to help first-time moms out. I have a hard time believing that formula samples are at the heart of the issue-- I suspect that what's really happening is that there isn't enough support for the mother who wants to breastfeed. The hospital I gave birth in had that support, and along with the formula samples, they allowed me to continue breastfeeding. If the support hadn't been there I would have turned to formula for good, regardless of whether they gave me sample formula or not.

I am not, by the way, all for aggressive marketing campaigns by companies trying to sell their products when the product has been found to be less than optimal. But I'm also aware that if we want to live in a capitalistic society then we have to take the bad with the good. I'd rather spend my energy on the root issue (not enough breastfeeding) than on a peripheral one (formula company advertising), and help the medical profession make a positive transition (more breastfeeding support) rather than a negative one (no more formula samples). For one thing the negative route doesn't get the general public on your side, and you need that support to make breastfeeding the "popular" choice. For another the negative route takes away an option but doesn't provide an alternative.

I'm not sure it's an either-or issue. Certainly, there is more to supporting breastfeeding than removing formula marketing from hospitals, but I think it's easy to underestimate the influence of formula sales reps on hospital practice. This issue really isn't "peripheral." Formula representatives spend their entire careers cozying up to maternity nurses, buying them meals, handing out tickets to sports events, and showering them with supplies of free formula when they have babies of their own. Moms today have 48 hours after delivery to learn how to breastfeed, and it takes enormous dedication for maternity nurses to make sure they get the help they need and get plugged in with the right resources after discharge. If that nurse is taking notes with a Similac pen, and spent last night at a Major League baseball game courtesy of Similac, and is a long-time pal of the Similac sales rep, she's going to feel a little less enthusiastic about spending an hour teaching mom and baby how to latch -- and a little less hesitant to suggest mom try some formula. The formula companies know that -- the training manual sales reps for Ross Pediatrics, that makes Similac, puts it plainly:

“Never underestimate the importance of nurses. If they are sold and serviced properly, they can be strong allies. A nurse who supports Ross is like an extra salesperson.†(Abbott Labs v. Segura, 1995)

Getting those sales reps out of hospitals goes hand in hand with banning formula marketing bags -- and it can't happen a moment too soon. What would you prefer? A nurse who is regularly "sold and serviced" by an industry that profits ever time a mother fails at breastfeeding? Or a nurse whose priority is to help you and your baby follow medical recommendations to successfully breastfeed?

Beyond the influence of sales reps, there is the evidence from multiple randomized trials that formula sample packs undermine women who want to breastfeed. None of us want to believe that marketing works. We all want to be "too smart for that." But when nursing mothers are randomly assigned to non-commercial bags vs. formula marketing bags, the mothers who get formula bags are less likely to breastfeed successfully. The bottom line: any hospital that hands out the bags is ignoring strong medical evidence that their policies undermine breastfeeding -- and that's frankly unethical.

As tomboymom points out, there are many other issues facing new mothers. It would be great to provide every new mom and baby with a home visit from a maternity nurse to help settle in the first few days. There should be insurance coverage for lactation consults, paid maternity leave, comfortable places to breastfeed in malls and shopping centers, workplace accommodation, and a slew of other supports. I've testified to legislators and lobbied my state and federal representatives on those issues, and I intend to keep doing so. But a lot of breastfeeding success (or failure) starts in the hospital. And if the hospital staff is more committed to marketing baby formula than taking care of mothers and babies, families lose out. The bags are a central part of the problem, and it's time for them to go. Hospitals should market health, and nothing else.

I've honestly never met a nurse who didn't have my best interests at heart, either at a hospital or elsewhere. Maybe there are some but I daresay they don't work at hospitals. They work at insurance companies and other places where they actually make a living salary and value their salary over their work.

I've only seen one study and of the study I've only seen the abstract. Do you have links to the actual studies you are referring to? I'd like to see the evidence, method of how the studies were conducted, etc. So far I've just seen the concluding opinion of the researcher (necessarily biased) and a lot of people referring to a study.

Speaking of grocery stores, I get coupons for formula every time I buy diapers. I notice the coupon (obviously) but it hasn't persuaded me to buy formula. You're saying that's because it didn't come from someone I trust and that I'd make a connection between the diaper bag and all of its myriad contents and an endorsement from the doctor. I'm not sure I buy that argument but I can see where you're coming from. Would you also consider it unethical for the formula company to set up their samples of formula right next to the breast pump accessories? In this scenario they would be deliberately undermining breastfeeding by targeting moms who are trying to breastfeed their infants while away from their infants for long periods of time. What if they handed out literature that said, to the effect, "breast milk is better, but this is much easier!"?

Admittedly I'm not a formula aficionado, but all the formulas I've ever seen (and even this website) start out with "breast is best. But..." I'm not sure what kind of misinformation you are referring to since I've not been marketed to in that fashion (or I wasn't paying attention: I even forget what the t-shirt I'm wearing says. We dropped the diaper bag on the floor with a bunch of other stuff and it got chucked two days later. I've not a clue what was in it). I have some friends in the advertising business and I know that they aren't allowed to misrepresent their product--although obviously there's leeway in that statement.

As far as misinformation goes, that fault lies on both sides of the aisle. I've already taken issue with the breastfeeding mantra "Breastfeeding is more convenient than formula," as I've personally found that it isn't. My pediatrician pussy-footed her way around the Vitamin D issue, not wanting to admit that my milk might not have enough of the vitamin to prevent rickets but also not wanting to admit that formula was actually good in this regard. There's a piece by Dr. Sears on formula feeding in which he goes on about how formula is no where near as good as breastmilk, not the least of which is because "formula has no DHA." He then goes on to mention that if you have to feed with formula than you should choose one with DHA in it (a direct contradiction), but never mentions that if you don't eat enough foods with DHA your milk won't have enough of this in it either. And lactivists like to cite recalls and poisons in formula but never talk about the toxins (mercury, BPA, flame retardents, cleaning fluids, etc) we adults have bio-accumulated and then feed to our infants through our milk. In short, even "hard" evidence can be distorted and/or omitted in the quest to bring people onto "your side." I'm not saying formula companies aren't guilty of aggrandizing their products (I'd almost expect them to) but I'm not sure breastfeeding activists are telling the whole truth either.