Eliminating formula giveaways ("banning the bag") has been embraced as a way to reduce the influence of formula marketing in hospitals and to increase breastfeeding rates among new mothers, but the policy raises ethical concerns in the mind of some, notably because it denies a useful benefit to mothers who have trouble affording formula. Hospital policies to promote breastfeeding, including banning the bag, should be sensitive to the economic and other costs associated with breastfeeding and should be consciously designed to make breastfeeding easier and not just to make formula feeding more difficult. We recommend that hospitals evaluate the negative impacts of banning the bag on their patient population in order to ensure that families are not being negatively affected.
CaseB General Hospital has been serving its community for more than 100 years. While its patient population has changed substantially over the years to one that is more demographically diverse, the hospital is still relied upon to provide a full range of health care services despite the fact that it serves mostly patients who are poor, underinsured, or undocumented. To patients who are new mothers, B General Hospital has been distributing infant formula discharge bags for many years, and, from all accounts, this service is highly valued among community members and widely regarded as not only successful but essential. Dr X is a family physician who just started at B General Hospital 9 months ago. She saw it as a place where she could deliver good prenatal and postnatal care to a vulnerable and underserved patient population. With that in mind, she raises a concern at the next department meeting: "Given the widely documented benefits of breastfeeding, I don't think we should continue to distribute infant formula discharge bags. Continuing to distribute the formulas primarily serves the needs of the breastmilk substitute companies rather than our patients."Another physician disagrees, emphasizing, "The patients in this community appreciate and rely upon getting the infant formula. We still encourage breastfeeding, but our