title: The Impact of Mailed Samples of Infant Formula on Breastfeeding Rates.
abstract: BACKGROUND
  Decades of research supports the health benefits of breastfeeding. Prior studies have shown that hospital discharge bags containing free samples of infant formula are associated with decreased breastfeeding exclusivity. This study aims to determine if receiving a free sample of infant formula in the mail has an impact on breastfeeding duration and exclusivity.
  
  
  METHODS
  This was a cohort study analyzing data from the Infant Feeding Practices Study II. The main outcomes of interest were any breastfeeding through 12 months of age and exclusive breastfeeding through 6 months of age. The main predictor of interest was receipt of a free sample of infant formula in the mail around the time of the infant's birth. Logistic regression models were developed to evaluate the association between the outcomes and predictor of interest at each month.
  
  
  RESULTS
  This study included 3,031 infants; mothers of 1,741 (57.4%) received a sample of infant formula in the mail. There was no difference in the likelihood of any breastfeeding at each month among those who received formula in the mail compared with those who did not. There was also no difference in exclusive breastfeeding through 5 months; however, by 6 months of age infants whose mothers received formula in the mail were less likely to be exclusively breastfed (odds ratio = 0.57; 95% confidence interval, 0.37, 0.89).
  
  
  CONCLUSIONS
  Receiving infant formula in the mail decreases the likelihood of exclusive breastfeeding by 6 months of age while having no impact on the duration of any breastfeeding.
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, University of Washington , Seattle, Washington.
authors.forename: Whitney M
authors.initials: WM
authors.lastname: Waite
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, University of Washington , Seattle, Washington.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Christakis
mesh_terms: D000328:Adult; D000329:Advertising; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D002755:Choice Behavior; D015331:Cohort Studies; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008425:Maternal Behavior; D009035:Mothers / Q000523:psychology*; D016017:Odds Ratio; D012959:Socioeconomic Factors