Breastfeeding

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United States Government Accountability Office

GAO

R eport to Congressional Addressees

February 2006

BREASTFEEDING
Some Strategies Used
to Market Infant
Formula May
Discourage
Breastfeeding; State
Contracts Should
Better Protect against
Misuse of WIC Name

GAO-06-282

Contents

Letter

1

Appendix I

Briefing Slides

Appendix II

Advertising Data

36

Appendix III

Literature Review

37

Appendix IV

Studies in Literature Review

39

6

Abbreviations
CDC
FNS
NIS
USDA
WIC

Centers for Disease Control and Prevention
Food and Nutrition Service
National Immunization Survey
United States Department of Agriculture
Special Supplemental Nutrition Program for Women,
Infants, and Children

This is a work of the U.S. government and is not subject to copyright protection in the United States. It may be reproduced and distributed in its entirety without further permission from GAO. However, because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately.

Page i

GAO-06-282 Breastfeeding

United States Government Accountability Office
Washington, DC 20548

February 8, 2006
The Honorable Robert Bennett
Chairman
The Honorable Herb Kohl
Ranking Minority Member
Subcommittee on Agriculture, Rural Development,
and Related Agencies
Committee on Appropriations
United States Senate
The Honorable Henry Bonilla
Chairman
The Honorable Rosa L. DeLauro
Ranking Minority Member
Subcommittee on Agriculture, Rural Development,
Food and Drug Administration, and Related Agencies
Committee on Appropriations
United States House of Representatives
The Honorable Tom Harkin
Ranking Minority Member
Committee on Agriculture, Nutrition, and Forestry
United States Senate
Millions of U.S. mothers and infants each year forgo the health benefits of breastfeeding and rely on infant formula. Infants who are breastfed are less likely to develop infectious diseases and chronic health problems, such as diabetes and asthma, while breastfeeding mothers are less likely to develop certain types of cancer. Recognizing the health benefits of breastfeeding for infants and mothers, the U.S. Department of Health and Human Services’ Healthy People 2010 campaign has recommended that more U.S. infants be breastfed and that babies be breastfed for longer periods of time. According to the U.S. Department of Agriculture (USDA), the U.S. would save a minimum of $3.6 billion in health care costs and indirect costs, such as parents’ lost wages, if breastfeeding increased to meet these Healthy People goals.

Breastfeeding rates are particularly low among infants who participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). WIC is administered by the USDA’s Food and Nutrition

Page 1

GAO-06-282 Breastfeeding

Service (FNS) in cooperation with state and local agencies. The program provides free food and infant formula to improve the health and nutritional well-being of low-income women, infants, and young children. Nearly half of infants born in the U.S. receive benefits through WIC.

Although formula manufacturers agree that breastfeeding is best, they market infant formula as an alternative for mothers who do not exclusively breastfeed. A congressional committee asked us to review the potential impact of infant formula marketing on breastfeeding rates, especially for infants in the WIC program.1 We answered the following questions: 1) What are the estimated breastfeeding rates for infants in the general population and for infants on WIC, and how do these rates compare to recommended breastfeeding rates? 2) How is infant formula marketed to women in general and to women on WIC in particular? 3) What is known about the impact of infant formula marketing on the breastfeeding rates of women in the general population and women on WIC?

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