Bag free in the Bay State.
BACKGROUND
The deleterious effect of formula company-sponsored discharge bags on breastfeeding is well established. As of July 2012, all 49 maternity facilities in Massachusetts had banned these bags, making it the second "bag-free" state in the United States. Obstacles to changing this long-standing practice were numerous, including concerns regarding the cost of a substitute gift. This study was designed to describe what practices maternity facilities in Massachusetts have adopted in place of giving out a formula company-sponsored discharge bag.


METHODS
Maternity facilities in Massachusetts were surveyed regarding discharge gift practices. Information was collected regarding gifts given and cost.


RESULTS
The response rate was 100%. Fifty-nine percent of the facilities replaced the formula company-sponsored bag with their own gift bag carrying the hospital's logo. Bags were either given empty or contained educational materials and/or a gift such as a T-shirt, hat, or baby book. Fourteen percent of the facilities gave a gift that did not include a bag. Twenty-seven percent of facilities gave no gift. Cost of the gifts ranged from $1 to $35, with a mean cost of $10.67. The hospital budget was used to partially or fully fund 58% of gifts; 22% were covered in part by donations.


CONCLUSIONS
Although most maternity facilities surveyed replaced the formula company-sponsored discharge bag with a different gift, one-quarter gave no replacement. These data indicate that discontinuing discharge gifts can be a readily accepted, cost-neutral step toward evidence-based breastfeeding best practice.
1 Department of Pediatrics, Harvard Medical School , Cambridge Health Alliance, Cambridge, Massachusetts.
Anita Gupta
AG
Hurwitz
Phillip R
PR
Farrow
Genevieve
G
Preer
Barbara L
BL
Philipp
D000329:Advertising; D001942:Breast Feeding / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D037921:Gift Giving; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage / Q000191:economics; D007231:Infant, Newborn; D008389:Marketing of Health Services / Q000191:economics / Q000331:legislation & jurisprudence; D008404:Massachusetts / Q000453:epidemiology; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D014481:United States