Your editorial about the formula gift bag controversy misses the point (“Breastfeeding by coercion,” Feb. 23, p.6). The proposed ban on gift bags has nothing to do with forcing women to choose breastfeeding; it is simply about holding maternity units to the same marketing standards as the other units in hospitals. This policy was created by a large number of caring health professionals, using research on the effects of the gift bags. It was not created by so-called “hard-line breastfeeders.”

Internal documents from the formula industry, as well as medical research, note that the bags are an extremely effective marketing tool, increasing sales of formula at the expense of breastfeeding. One of the reasons the bags work so well is because health care professionals give them out, implying an endorsement of bottle-feeding. Says the staff-training manual for formula-maker Ross, “A nurse who supports Ross is like another salesman.”

Two of the country’s largest formula makers are pharmaceutical companies, an industry with a long track record of unethical marketing and interference with the doctor-patient relationship. This formula bag issue is just part of this pattern.

The Department of Public Health has made it abundantly clear that every woman’s feeding choice will be supported, no matter what it is. Aggressive marketing with the gift bags only serves to undermine the efforts of the 72 percent of Massachusetts women who choose breastfeeding. Multiple scientific studies show that this marketing effect is very powerful, and that women who get the bags stop exclusive breastfeeding sooner.

No one would tolerate hospital nurses handing out coupons for Big Mac’s to heart attack patients. Maternity wards simply need to be held to the same standard.

Melissa Bartick, MD, MS