CHAPEL HILL, N.C. (MCT) — Mothers delivering at some local hospitals may be saying good-bye to those free diaper bags filled with goodies.

Both UNC Hospitals and WakeMed are working toward adopting guidelines to encourage breast-feeding that would make the bags — freebies from infant formula companies — a no-no.

“Everybody likes to get the bags. When you’ve got someone hoping to get a free surprise, it’s hard to say no,” said Elizabeth Rice, manager of mother-baby/women’s care and lactation services at WakeMed’s Raleigh campus. “Even though (the bags) are subtle advertising, if you’re going to take the stance that we 100 percent support breast-feeding as the best way to feed a baby, you really have to take yourself out of that advertising mode.”

The plans are part of the Baby-Friendly Hospital Initiative, created by the World Health Organization and UNICEF. Fifty-five hospitals across the country have adopted the initiative’s 10 steps and been certified as baby-friendly, though none so far in North Carolina.

In addition to requiring hospitals to stop accepting formula-company freebies, the guidelines support breast-feeding in other ways, such as allowing moms to remain with their babies 24 hours a day, giving breast-feeding moms a chance to nurse their babies within one hour of birth, and training staff on how to assist breast-feeding moms.

The U.S. Surgeon General recommends that babies drink breast milk only for their first six months. It provides better nutrition for infants than formula, and it passes on antibodies that help babies stay healthy.

Mary Rose Tully, UNC Hospitals’ director of lactation services, said the guidelines aren’t about forcing women to breast-feed, but rather “removing the barriers” for women who choose to do so.

“When at least 85 percent of moms come in with the intention of breast-feeding, shouldn’t we help them meet their objective?” Tully asked.

While refusing formula freebies is just one of the baby-friendly requirements, it can be one of the most difficult for hospitals to adopt, in part because they don’t want to take on the cost of paying for formula or risk disappointing moms who expect to bring home a diaper bag, the contents of which often include free formula, ice packs, coupons and advertisements. But breast-feeding advocates say the availability of free formula discourages breast-feeding.

When free formula is available in a maternity unit, said Cindy Turner-Maffei, the national coordinator of Baby-Friendly USA, hospital staff may turn to using it more quickly, rather than spending more time working with a mom who is having trouble feeding. Women also are more likely to ask about formula when it’s visible, Turner-Maffei said.

Acceptance of formula samples also can present an ethical dilemma for hospitals.

“None of our other food comes free or low cost. Our medicine doesn’t come free or low cost, either,” Tully said. “There’s an implied endorsement (of formula).”

But Gail Wood, a spokeswoman for Enfamil formula maker Mead Johnson Nutritionals, said the diaper bags and other freebies are aimed at getting moms who use formula to choose their brand, not at encouraging moms to chose formula over breast-feeding. Most new moms already know that breast-feeding is best, Wood said, and prohibiting free formula samples would make little difference in getting more moms to breast-feed or to breast feed longer.

In North Carolina, about 70 percent of moms start off breast-feeding their infants, but only 47 percent continue to do so past eight weeks.

“We think that moms deserve the right to have as much access to information about how to feed their babies as possible,” Wood said. “These are all very personal decisions. I think with a hospital that does go baby-friendly, they’re shortchanging their moms.”

Pitt County Memorial Hospital in Greenville, N.C., is in the middle of the baby-friendly application process, and is the state’s only hospital to have received a certificate of intent from Baby-Friendly USA. Angela Still, the hospital’s administrator for women’s services, said the decision was part of an initiative to fight childhood obesity, but the hospital still wants moms to make their own decisions on what’s best for them.

“We are not here to mandate that everybody breast-feed. Do we want our breast-feeding rates to increase? No doubt,” Still said. “But do we understand this might not be right for everybody? Absolutely.”