After giving birth in the United States, a woman is likely to leave the hospital with the message that breast-feeding is best for her baby - and a free sample of baby formula, as well as discount coupons to buy formula for her newborn.
That's despite the fact that federal health officials at the Centres for Disease Control and Prevention are opposed to giving new mothers free formula samples when they leave the hospital, as are the American Academy of Pediatrics, American College of Obstetricians and Gynaecologists and the World Health Organisation.
In a report released this week, Anne Merewood of Boston University School of Medicine and colleagues say the prevalence of sample formula pack distribution is "disturbing and incongruous given extensive opposition, but encouraging trends suggest that the practice may be curtailed in the future."
Although the American Academy of Pediatrics recommends exclusive breast-feeding for the first six months, it's estimated that only 11 percent of infants in the US are exclusively breast-fed for six months. Formula sample packs, which are typically given free to hospitals by formula manufacturers and distributed by hospital staff, have been shown to undermine breastfeeding.
However, there are signs that more and more hospitals are doing away with the practice of giving new mothers free formula samples upon discharge.
Between October 2006 and March 2007, Merewood and her colleagues surveyed 1 295 hospitals in 21 Eastern states and the District of Columbia about their free formula sample policy.
Roughly 94 percent of hospitals acknowledged distributing formula sample packs. In New Hampshire, about 70 percent of hospital distributed formula samples, while all of the hospitals in New Jersey, Maryland, Mississippi, West Virginia, and the District of Columbia did so.
The good news, the researchers say, is that the number of hospitals not giving out formula samples rose significantly between 1979 and 2006. Among 80 hospitals that did not hand out formula samples, 20 eliminated the practice before the year 2000 and 60 after the year 2000.