Becoming Baby-Friendly: overcoming the issue of accepting free formula.

Although, in the current financial climate, paying for formula is a difficult step for US hospitals, demystifying the process helps. Actual formula costs may be lower than perceived costs because agreements with formula companies may list unnecessary or unused products and services. Fair market value is difficult to define, but by contacting other hospitals with Baby-Friendly status, those costs can be determined. While we do not recommend that other institutions forge ahead on the track to Baby-Friendly designation without considering the formula issue, we would encourage them to apply for the certificate of intent and begin work, even if it is not immediately clear how the hospital will pay for formula. Each of the Ten Steps takes the hospital along an important course, is never wasted effort, and increases the number of breastfeeding mothers (thereby reducing formula costs). Demonstrating a willingness to invest time and energy for the benefit of patients and the institution as a whole is valuable when requesting support for formula payment. Hospital administrators, who may make the final decision regarding formula payment, will be more willing to listen to breastfeeding advocates if they have already accomplished significant goals within the institution and have collected supporting data. The authors conclude that although for BMC not accepting free formula was the most difficult barrier to overcome on the path to Baby-Friendly designation, it was not insurmountable, and we hope other institutions will be helped by learning how we dealt with this problem.