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Conflicting results have been reported regarding the association of formula samples given at hospital discharge with breastfeeding duration. This study investigated the relationship between the distribution of formula samples and breastfeeding duration in low-income Hispanic women. A gift pack of formula was distributed randomly to 88 breastfeeding women. All women received a telephone call at one and three weeks to collect information about infant feeding. Chi-square analysis revealed no significant difference in the proportion of women exclusively breastfeeding at one week. However, fewer women were exclusively breastfeeding in the gift pack group at three weeks (p less than .004). Gift packs given to Hispanic breastfeeding women are associated with a decrease in exclusively breastfeeding during the first three weeks postpartum.

The first 20 months of experience with a university-based, freestanding birthing center suggests that this alternative is safe for delivering obstetric and newborn care to low-risk patients.

This article describes the philosophy of public health as it relates to the work of pharmacists. Individual patient care provided by pharmacists when supplying medicines is placed within a public health framework and existing public health roles performed by pharmacists are presented. Newly emerging public health roles and public health opportunities for pharmacists in developing countries are outlined. Education relevant to the practice of public health is discussed both as a component of pharmacy training and as a specific field of postgraduate education that pharmacists may pursue.

Vaginal bleeding occurs in 15% to 25% of early pregnancies. While 50% of women who have vaginal bleeding in the first trimester of pregnancy will continue to have a viable pregnancy, the event creates significant anxiety for the woman and can be managed in a multitude of ways. The 3 main differential diagnoses associated with vaginal bleeding are spontaneous abortion, ectopic pregnancy, and gestational trophoblastic disease. This article reviews early pregnancy development, etiologies of vaginal bleeding in the first trimester, strategies for evaluation, and recognition and management of the main diagnostic considerations. Case study examples illustrating the complexity of the assessment and management of vaginal bleeding in early pregnancy are presented.