Marketing to Moms Affects Breastfeeding
Feb. 16, 2000 (Lake Tahoe, Calif.) -- Despite the World Health
Organization's prohibition on the distribution of free formula samples and the
promotion of formula in health care facilities, such materials are widely
available in the U.S. and are often distributed directly through obstetricians'
offices. This conveys a mixed message that formula feeding is as healthy as
breastfeeding and significantly affects the number of women who stop nursing
during the first two weeks after childbirth, according the author of a study in
the February issue of the journal Obstetrics & Gynecology.
Previous studies have shown that distribution of materials and formula
samples by hospitals in the period after birth decreases breastfeeding
duration. But Cynthia R. Howard, MD, MPH, tells WebMD that this is the first
study that looks at the effects of distribution of commercially produced
breastfeeding promotional materials at prenatal visits to the doctor. Howard,
who is associate professor of pediatrics at the University of Rochester School
of Medicine in New York, points out that while the material clearly states that
breastfeeding is preferable to formula, the packs do contain coupons and
advertisements for formula and statements about its use in a variety of
situations, such as when a mother returns to work.
Howard and her colleagues found that while the decision to breastfeed and
the duration of nursing beyond two weeks was not significantly affected by
receiving a commercial pack, there was a fivefold increase in the number of
those women who quit breastfeeding while still in the hospital. There was
nearly a twofold increase in quitting early -- that is during the first two
weeks after birth -- in those who received the commercial packs.
"After two weeks, there were no long-term differences in breastfeeding.
But we did see that among a subgroup of women who were undecided about how long
they wanted to breastfeed or who had goals that were less than three months
(about 43% of the study group), those who received commercial packs breastfed
five weeks less [than those who didn't]." Howard tells WebMD. Those having
their first child or breastfeeding for the first time and women who planned to
return to work within six months were more likely to have uncertain goals.
"It may be that women with short-term goals have less commitment," says
Howard, adding that breastfeeding may require at least three to four weeks to
be successfully established.
The study, which was supported by a grant from the Maternal and Child Health
Bureau, involved 444 women at six obstetric offices. On the first prenatal
visit, the participants were randomly assigned to one of two groups: 235
received a commercial pack consisting of a diaper bag, commercially produced
educational material, a can of powdered formula, a business reply card to join
a so-called baby club, a coupon redeemable for a case of infant formula, and
formula discount coupons. Another group of 209 women received the research pack
containing a diaper bag, noncommercial educational materials, a coupon for
infant items from a local department store, and a package of electric outlet
covers. Interviews were conducted after delivery, and the breastfeeding women
were contacted by telephone at two, six, 12, and 24 weeks after birth.