The recent discussion on the relationship between hospitals and infant formula companies is one of my favorites. Many of us are baffled as to why a hospital insists on giving out discharge packs and has such difficulty with the concept of purchasing formula. Every other unit buys food for its patients. The Dairy Council does not drive up with free milk for the orthopedic unit. The orthopedic unit does not give cartons of milk and yogurt to its patients when they are discharged. Formula companies pay hospitals large sums of money for the right to give them free formula. Many hospitals and formula companies have a contract which stipulates that anywhere from $50,000 to more than $1 million will be given in cash for "educational" purposes. This money is administered by the chief of pediatrics or one of the other chiefs. It is not accounted for anywhere and seldom leads to any direct benefits for patients. How much of this money have any of you seen? In addition to the outright cash, these contracts also state what will be given to the hospital in terms of supplies and equipment (IV set ups, vol-u-feeds, infant feeding videos, pamphlets, etc). Some also provide help recruiting physicians and provide the attending physicians and their offices with free supplies and equipment. Some contracts also state that every breastfeeding patient is to receive a discharge pack containing formula. This is why administrators get so upset when you want to stop giving these out. If you do, the hospital might lose all the free stuff that it has come to depend on. The states of New York and Massachusetts have perinatal regulations which forbid new breastfeeding mothers from receiving discharge packs containing formula unless requested by the mother or ordered by the physician. Thus the cards that are given to mothers reminding them not to forget to ask for their free gift from the hospital, and the physicians who order that their mothers receive these gifts. There are many hospitals that purchase formula-- military hospitals, inner city public hospitals (because most of the mothers receive WIC formula and are not a profitable market to advertise to with the discharge packs, a few other hospitals who are ready to become Baby Friendly have also started to purchase formula. How much does it cost? Probably about $.50 a feeding for formula-fed babies. Hardly enough to break the piggy bank. Hospitals have the money to purchase formula. It is where they choose to spend their money that is the issue. If they buy formula, then they lose all the freebies which can translate into a considerable amount of money. Formula companies have created a dependency that is hard to break. Money talks. Getting the product into the customer's hand (sampling) is one of the most effective marketing strategies around. Besides which, all that marketing and advertising is tax deductable, so formula companies can make even more profit while we get to help them with our higher taxes. All the bribes that are given to health care professionals buy good will and the feeling that we should not pick on these companies that do so much good. This is rubbish. Many of the parents who buy formula could not afford to pay for the types of meals and food that the formula companies are dropping off at hospitals during the holiday season. Just say no!