Office prenatal formula advertising and its effect on breast-feeding patterns

Objective: To compare the effect of formula company-produced materials abou t infant feeding to breast-feeding promotion materials without formula adve rtising on breastfeeding initiation and duration. Methods: Five hundred forty-seven pregnant women were randomized to receive either formula company (commercial; n = 277) or specially designed (resear ch; 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 2 4 weeks. Survival analyses were used to evaluate continuous outcomes, and c hi(2) and logistic regression analyses were used to evaluate discrete outco mes. 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, 9 5% CI 0.86, 1.64) were not affected. Women in the commercial group were mor e 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 1.0 2, 3.55). In subgroup analyses, women with uncertain goals for breast-feedi ng or goals of 12 weeks or less experienced shortened exclusive (hazard rat io 1.53, 95% CI 1.06, 2.21), full (hazard ratio 1.70, 95% CI 1.18, 2.48), a nd overall (hazard ratio 1.75, 95% CI 1.16, 2.64) breast-feeding duration w hen exposed to the commercial intervention. Conclusion: Although breast-feeding initiation and longterm duration were n ot affected, exposure to formula promotion materials increased significantl y 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 mat erials about infant feeding should support unequivocally breast-feeding as optimal nutrition for infants; formula promotion products should be elimina ted from prenatal settings. (Obstet Gynecol 2000;95: 296-303. (C) 2000 by T he American College of Obstetricians and Gynecologists.).