title: Office prenatal formula advertising and its effect on breast-feeding patterns.
abstract: OBJECTIVE
  To compare the effect of formula company-produced materials about infant feeding to breast-feeding promotion materials without formula advertising on breast-feeding initiation and duration.
  
  
  METHODS
  Five hundred forty-seven pregnant women were randomized to receive either formula company (commercial; n = 277) or specially designed (research; n = 270) educational packs about infant feeding at their first prenatal visit. Feeding method was determined at delivery. Breast-feeding duration of the 294 women who chose to breast-feed was ascertained at 2, 6, 12, and 24 weeks. Survival analyses were used to evaluate continuous outcomes, and chi2 and logistic regression analyses were used to evaluate discrete outcomes.
  
  
  RESULTS
  Breast-feeding initiation (relative risk [RR] 0.93, 95% confidence interval [CI] 0.61, 1.43) and duration after 2 weeks (hazard ratio 1.19, 95% CI 0.86, 1.64) were not affected. Women in the commercial group were more likely to cease breast-feeding before hospital discharge (RR 5.80, 95% CI 1.25, 54.01) and before 2 weeks (adjusted odds ratio [OR] 1.91, 95% CI 1.02, 3.55). In subgroup analyses, women with uncertain goals for breast-feeding or goals of 12 weeks or less experienced shortened exclusive (hazard ratio 1.53, 95% CI 1.06, 2.21), full (hazard ratio 1.70, 95% CI 1.18, 2.48), and overall (hazard ratio 1.75, 95% CI 1.16, 2.64) breast-feeding duration when exposed to the commercial intervention.
  
  
  CONCLUSIONS
  Although breast-feeding initiation and long-term duration were not affected, exposure to formula promotion materials increased significantly breast-feeding cessation in the first 2 weeks. Additionally, among women with uncertain goals or breast-feeding goals of 12 weeks or less, exclusive, full, and overall breast-feeding duration were shortened. Educational materials about infant feeding should support unequivocally breast-feeding as optimal nutrition for infants; formula promotion products should be eliminated from prenatal settings.
authors.affiliation: Department of Pediatrics, University of Rochester School of Medicine, New York, USA. cindy.howard@viahealth.org
authors.forename: C
authors.initials: C
authors.lastname: Howard
authors.forename: F
authors.initials: F
authors.lastname: Howard
authors.forename: R
authors.initials: R
authors.lastname: Lawrence
authors.forename: E
authors.initials: E
authors.lastname: Andresen
authors.forename: E
authors.initials: E
authors.lastname: DeBlieck
authors.forename: M
authors.initials: M
authors.lastname: Weitzman
mesh_terms: D000328:Adult; D000329:Advertising; D001942:Breast Feeding / Q000523:psychology*; D003657:Decision Making; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D016015:Logistic Models; D009518:New York; D010353:Patient Education as Topic; D011247:Pregnancy; D011295:Prenatal Care; D013664:Teaching Materials / Q000592:standards*; D013997:Time Factors