To comment on this story, read more about breast-feeding vs. formula feeding or to read what local moms are saying, visit momaha.com, the World-Herald's website for moms.
Nearly all metropolitan-area hospitals have stopped handing out free infant formula to new moms at discharge time.
» Its use took off a century later with modernization, improvements and a decline in formula-related infection.
» In 1950, as more women entered the workforce, more than half of U.S. babies were formula-fed. Formula was perceived to be healthier than breast milk.
» Breast-feeding became more widely practiced in the United States in the 1970s. Since then, the federal government and various health institutions have heavily promoted it.
» Breast-feeding recommendations now call for its use exclusively for an infant's first six months, then breast-feeding with baby food supplements through an infant's first year.
And the last one to still do it in Omaha, Creighton University Medical Center, is being acquired by Alegent Health. Whether Creighton would fall in line with other Alegent hospitals that ended the practice in January is uncertain.
The Nebraska Medical Center ended the practice three years ago. Methodist Health System, whose women's hospital in Omaha delivers more babies each year than any other facility in the city, ended formula handouts 14 years ago. All cited the same reason: A preference to encourage breast-feeding.
That makes Omaha somewhat unique. Nationwide, about two-thirds of the nation's hospitals still give infant formula samples, according to a national group trying to ban the formula handouts in this breast-is-best era.
Citing health and marketing concerns, the Washington, D.C.-based Public Citizen is leading a petition effort to end formula freebies at hospitals. The petition does not extend to doctors, who give formula samples at their discretion. The American Academy of Pediatrics recently issued a statement discouraging handouts and formula marketing in doctors' offices.
Public Citizen said a nationwide ban on formula handouts would bring U.S. hospitals more in line with a 31-year-old World Health Organization international code calling for limits on marketing of breast milk substitutes, saying such marketing eats into breast-feeding rates.
The International Formula Council, a trade group representing the $8 billion global industry, said formula is the healthiest alternative to breast-feeding. The council presents its own research saying most mothers would like the samples.
Some mothers would like to breast-feed but cannot for physical or lifestyle reasons. And some like the samples because formula is pricey.
It is a subject that can be emotional for mothers, and it splits opinion among women. Some see the samples as a helpful and cheap last resort if breast-feeding doesn't work out; others echo an Omaha pediatrician who likened formula handouts to cigarettes.
“It's no different than a hospital offering cigarettes to its smokers,” said Dr. Laura Wilwerding, who is on the faculty of both of Omaha's medical schools and serves as the American Academy of Pediatrics' state breast-feeding coordinator in Nebraska.
Wilwerding said hospitals wouldn't dream of giving away tobacco and shouldn't give formula, because health data support the merits of breast-feeding over formula.
Some moms who intended to breast-feed saw the formula freebies as lifesavers when they needed baby food in a pinch.
Kathy Gorczyca of Omaha said years ago she had planned to breast-feed her newborn but had to supplement with formula soon after going home because she wasn't producing enough milk.
“Thank God I had the free formula from the hospital to give him some nourishment until I could get him to the (doctor) the next day,” she said.
She breast-fed until her babies were 10 months and supplemented with formula.
Other moms, however, agreed with the formula sample ban. These mothers said the handout of a particular brand could get a mother or baby hooked on name-brand formula, which is substantially more expensive than generic counterparts. Formula for an average infant can cost from $75 to $100 a month. The cost can go much higher — over $200 a month — for infants with special needs, such as those with allergies.
Jennifer Penick, a 32-year-old La Vista mom expecting her fifth child, said the free samples provide easy temptation and do interfere.
“I really think if there's not that kind of temptation there, a lot more moms would work through it,” she said.
Mardi Mountford, a trade group official, called infant formula “the only safe, nutritious and recommended feeding option for non-breast-fed infants.” Without education and information, she said, parents can make feeding mistakes.
Kelsey Archer, a spokeswoman for Creighton Medical Center, said the hospital will provide formula samples for mothers who choose not to breast-feed. She said the hospital offers breast-feeding education classes and said some formula companies offer kits with formula in them.
“We do offer it to the moms,” Archer said. “If they are truly not wanting formula, we can take that out and give them the rest of the kit.”
When asked if the Alegent acquisition would change this, Archer said not “at this current time.”
In the region, St. Elizabeth Regional Medical Center and BryanLGH in Lincoln and Mercy Hospital in Council Bluffs have ended formula handouts as well. Jennie Edmundson Hospital in Council Bluffs still provides samples to mothers who want them.
Breast-feeding benefits were reinforced in a 2007 review of 9,000 studies. Infant benefits can include fewer ear and respiratory infections and a lowered risk of sudden infant death syndrome, said the Joint Commission, an independent, nonprofit hospital accreditation entity. Breast-feeding benefits for mothers include less postpartum depression and lower rates of breast and ovarian cancers.
Infant formula has become so verboten that some hospitals require a pediatrician's order to dole it out.
Methodist Women's Hospital has formula on hand but acts on what a pediatrician says and what the parents want.
“It goes down a line we don't want to go down,” said Sue Korth, vice president and chief operating officer.
Hospitals are facing increasing pressure to advocate for breast-feeding. In 2009, the federal Centers for Disease Control and Prevention found that a third of hospitals nationwide had stopped handing out formula samples.
Wilwerding said any amount of breast-feeding is better than none.
“It starts in the hospital,” she said. “When you receive a formula sample, that gives an innate endorsement by that doctor or hospital that not only formula is good, but that brand is. You're basically endorsing it even if you didn't mean to. There's no money in breast-feeding. There's plenty of money in formula.”
Contact the writer:
Click tabs below to read breast-feeding statistics
Nation: 74.6 percent
Iowa: 78 percent
Nebraska: 72.8 percent
Exclusive breast-feeding at 3 months
Nation: 35 percent
Iowa: 37.2 percent
Nebraska: 37.9 percent
Exclusive breast-feeding at 6 months
Nation: 14.8 percent
Iowa: 17 percent
Nebraska: 13.4 percent
Breast-feeding at 6 months (with supplementation)
Nation: 44.3 percent
Iowa: 51.9 percent
Nebraska: 44.4 percent
Breast-feeding at 12 months
Nation: 23.8 percent
Iowa: 28.8 percent
Nebraska: 25.5 percent
Source: Breast-feeding Report Card, 2011 using Centers for Disease Control and Prevention data on 2008 births