Infant Formula Marketing Can Discourage U.S. Breastfeeding: Low-income Moms are at Higher Risk

Donya C. Arias

Nations Health. 2006;36(3) 

Infant formula marketing in the United States can discourage breastfeeding, especially among low-income mothers, according to a recent federal report.

While little is known about the impact of most types of marketing on breastfeeding rates, a U.S. Government Accountability Office review of numerous studies found that giving free formula samples to mothers as they are discharged from a hospital after childbirth reduces breastfeeding rates. The report also found breastfeeding rates for mothers were below national goals, especially among those participating in the federal Women, Infants and Children nutrition program.

The GAO review also found some infant formula marketing efforts use the trademarked WIC acronym in promotional materials, which is barred by federal regulations. Yet most states don't enforce the regulations in their WIC contracts.

"Too few U.S. infants breastfeed, according to national recommendations, and breastfeeding rates are even lower for infants on WIC," the report said. "If rates do not increase, many mothers and infants will continue to miss out on the health benefits of breastfeeding. This is particularly important for low-income children, who often have less access to health care and poorer health. The United States will also spend billions of dollars more in avoidable health care costs."

Healthy People 2010 breastfeeding goals call for 75 percent of infants to be breastfed at birth, 50 percent at 6 months of age and 25 percent by 12 months. The goals also call for 60 percent of infants exclusively breastfed at 3 months and 25 percent at 6 months. Average breastfeeding rates between 1999 and 2002 remained constant but were much lower than those Healthy People 2010 targets, with only about 22 percent of non-WIC infants and 10 percent of WIC infants exclusively breastfed at 6 months. In 2004, only 64 percent of WIC infants had ever breastfed, compared to 78 percent of non-WIC infants. By 12 months of age, a mere 14 percent of WIC infants were breastfed, compared to 23 percent of non-WIC infants.

The GAO report found that both WIC and non-WIC infants were more likely to breastfeed if their mothers were married, older than 20 and college graduates. For WIC infants, breastfeeding rates were higher among Hispanic infants and lower among black infants.

One main concern outlined in the GAO report was that companies have used the WIC trademark to market infant formula. Some examples of that marketing strategy included glossy posters for health care providers promoting formula as "WIC-eligible" in big letters and depicting a flag with the WIC acronym as well as an advertisement and coupons indicating a formula designed for babies with colic is "WIC-approved in all 50 states." Companies have also printed prescription pads with the words "WIC Program Prescription for Special Formula" and a "Dear Health Care Provider" letter noting that a formula for babies with special medical needs is "approved for use by WIC patients in all 50 states" and that recommending the formula to patients "may save your state money."

The report urged that the U.S. secretary of agriculture educate states on WIC acronym and logo restrictions and ensure that all state contracts restrict the use of those trademarks in infant formula advertisements.

To read the full report, visit and search for GAO-06-282. For more news from The Nation's Health, visit

— Donya C. Arias


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