What's not to like about free stuff?
Plenty, according to Magee-Womens Hospital of UPMC, if it promotes infant formula for new mothers.
The hospital, where more than 10,000 babies are born each year, recently stopped giving away diaper bags stocked with coupons and cans of powdered formula.
"We don't want to give the mixed message that we are promoting bottle feeding when really we want to encourage breast-feeding," said Karen Ewing, director of patient care services for Magee's neonatal intensive care unit.
The hospital has stopped distributing the bags completely, whether mothers are nursing or bottle-feeding formula to their babies at discharge. The change comes as hospitals nationwide are re-evaluating their policies toward formula-sponsored diaper bags, which have been distributed for more than four decades.
Massachusetts this year became the second state in the country to ban hospitals from distributing diaper bags, following Rhode Island last year.
Earlier this week, Mayor Michael Bloomberg of New York City made news by asking New York City hospitals to comply with a whole host of new practices to promote breast-feeding, from getting rid of diaper bags to keeping formula locked up to requiring hospitals to buy all formula, rather than receiving some or all of it free from formula companies.
Other hospitals in the Pittsburgh area still give the diaper bags away.
At St. Clair Hospital in Mt. Lebanon, the staff certainly encourages breast-feeding, said Doug MacKay, an obstetrician and gynecologist at the hospital. But he sees nothing wrong with sending patients on their way with a free gift.
"I personally would like to think that people can make educated decisions on their own," he said. "Our policy is that we encourage breastfeeding, but we respect the patient's autonomy."
Furthermore, he said, formula is expensive, and getting a can of it for free might ease stress for a new mother.
"In this economy, everything helps," he said. "I don't think it makes people's minds up."
The International Formula Council says that research into whether formula bags decrease breastfeeding rates has been inconsistent. The group, which represents formula manufacturers, also says that the bags contain materials that help educate women about bottle feeding.
At West Penn Hospital in Bloomfield, diaper bags are also still being distributed. But discussions are under way to change that policy, said Sandra Porco, manager for maternal child support services.
The problem, as she sees it, is that having the formula on hand gives them an easy out if breastfeeding becomes difficult.
"Moms in those early vulnerable days that go home with formula -- rather than seek help if they're having breastfeeding problems -- they rely on formula," she said. "Moms who go home with formula are more likely to give up and give up sooner."
Ms. Porco also believes that it puts medical professionals in a strange position. "It puts the nurses in the position of being the salesperson," she said. "It's not the role of hospitals to market formula products."
West Penn is in discussions to try to figure out whether to keep the bags in some instances (such as women who are already formula feeding), replace them with another parting gift not associated with formula or get rid of them altogether.
At Magee-Womens Hospital on Wednesday, Kathryn Martinec of Robinson was recovering from the 4 a.m. birth of her fourth child, Case.
She hasn't used formula with any of her children -- not with her 3-year-old, Lane, and not even for her prematurely born 5-year-old twin daughters, Ava and Sophia, for whom she pumped milk exclusively -- but liked getting the bags to use around the house and giving the formula away to friends who needed it.
"I'm a little disappointed that they're not doing it," she said. "In my case, it didn't really sway me in either direction in terms of what was the best choice."
Magee considered replacing the diaper bags with another free gift or another type of diaper bag, said Ms. Ewing, but found that patients generally already had their own diaper bags anyway.
"When the patients were telling us that they didn't really need it, that's why we chose not to pursue anything further," she said.
Magee and West Penn hospitals are both interested in pursuing the Baby Friendly Hospital Initiative, sponsored by the World Health Organization. To receive a Baby-Friendly Hospital designation -- as Mr. Bloomberg is urging for all New York City maternity wards -- hospitals must not only give up diaper bags but also give up financial support from formula companies.
Currently, neither Magee nor West Penn are close to ending that financial relationship.
Medical professionals cite a host of benefits in encouraging breastfeeding, from lower obesity rates to fewer infections to an easier maternal bond. But while Mr. Bloomberg's "Latch On NYC" program urges a mandatory talk about the benefits of breastfeeding for mothers intent on formula feeding, Magee takes a less aggressive approach.
"If there is a patient who is on the fence, that's something where we want to talk about the benefits of breastfeeding," said Michelle Corna, unit director of a post-partum floor at Magee. "It's kind of a fine line how you interact. You don't want to come across and make them feel like a bad mother."
Anya Sostek: firstname.lastname@example.org or 412-263-1308.