Really great discussion regarding formula samples in the general pediatric office. I struggle with this a lot. My practice is associated with a large hospital system who "banned the bags" a couple of years ago in pursuit of baby-friendly status (they aren't there yet, but have made a lot of improvements overall). 

The hospital where most of our patients deliver is a small community facility, and although I am employed by the large hospital, my practice covers the nursery at the small hospital nearby.  The small hospital routinely hands out large quantities of ready to feed nursettes to all moms (FF or BF) at discharge. They have no LC on staff, only nurses who "think" they give good advice/help. There are, of course, a few excellent nurses who are good as helping moms breastfeed. 
  Consequencely, these moms see no risk in supplementing even the well-breastfeeding baby, and most often then thing I hear on the 2-3 day hospital follow up visit is "Baby is breastfeeding , but I feel like they were not satisfied so I went ahead and gave them the similac and they took the whole 2 ounces" . Hello, slipperly slope!! 

We have a high breastfeeding initiation rate, but our 2 week breastfeeding rate (even partial BF) is horribly poor in my opinion). My practice is made up of about 50/50 private and medicaid, I do not find my local WIC office supportive of breastfeeding, btw. 

Anyway, after that long background- my practice did not give out any formula bags when i started here 3 years ago.  There has always been a "sample closet" and the reps do deliver formula samples but not really a lot compared to the patient numbers we see. 

I noticed an interesting pattern. Once the large hospital initiated the "ban the bags " campaign, my office nurse mgr started getting large boxes of Nestle diaper bags. They ONLY send the ones labeled "for breastfeeding mothers". 

I immediately instructed my nurse that I would not be distributing them to my patients, but other physicians in my practice do not care (or even know) that their nurses routinely hand them out at newborn and 2 week visits. Of course we all know they are filled with mostly useless propoganda including the can of formula. I find myself very angry when I see that a nurse who is filling in with me has already given out the stupid bag to a new mom who is more often than not at least attempting breastfeeding. 

Does anybody know of a direct line to nestle to basically just order them to stop sending? I have asked the nurse mgr and she has stated that she did not request them to be sent to our office. 

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