Thank you to everyone who has kindly answered my questions. I especially loved the suggestion to require the nurses to write down the lot number and expiration date of formula given out. That would definitely deter free formula. My understanding is that formula cannot be given out at all under any circumstance in a BFHI hospital, even for those women who are unable to breastfeed and say that they cannot afford formula, in the first place because us giving out a days worth of formula is not going to fix that problem. WIC does not give out a full supply of formula. If formula feeding is her preferred method, she is going to need to buy a certain percentage of it. But I just wanted to make sure that what I'm saying is correct. I heard an IBCLC speak at a conference who worked at a BFHI hospital, and that seemed to be what she was saying. For women who can bfd but elect formula, they encourage them to get formula before delivery, make their wic appoint early
 and if all else fails she encourages them to bfd until their wic appointment. If they cannot breastfeed because it's contraindicated, again they try to get them into wic quickly, and then give a referral to an emergency food pantry. 
 
One of the problems with giving out formula to FF moms, is then where do you draw the line? Are we going to say yes to them, but no to the women who are partly bfding? Are we then going to give it out to the exclusive bfding moms? Also, giving out even a little formula to exclusive FF moms or any patient, I think, is a violation of BFHI policy. And once women who are FF or doing mixed feeds hear that we give out formula to women who say they are in need, what is everyone going to say? Of course, they will say that they don't have any money and they need formula and then we are right back where we started.
 
My opinion is that the best way to handle it, is just an across the board policy that no patient is going to go home with formula given out by our hospital. All patients should be notified of this on admission or preferably at a prenatal appt so it's not a surprise and they have time to plan. And those women who truly say they have no money should be encouraged to breastfeed until their wic appointment if possible, or given information about local emergency food pantries. Thank you again for your help.
 
Tricia Shamblin, RN, IBCLC

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