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Samples are never free, but who pays?

May 2021

Giving away samples of human milk substitutes from infant formula to commercial baby foods and bottles is a common practice, while prohibited in some countries and local jurisdictions such as US states. In general, where restrictions exist outside of a comprehensive Code law, they have primarily focussed on infant formula samples given to families through the health care system, particularly birthing hospitals.


The argument in favour of these practices is that it provides a benefit for parents who have chosen to use human milk substitutes by saving them money. This is sometimes extended to include the concept that parents who use these products are being unfairly disadvantaged when the Code is implemented.

This is a straw man argument - and the first hint to that is in the term “sample”. Sample means that you’re getting to try out the product before you buy it. It is a pretty effective sales technique, though an expensive one reserved for products that have a big profit margin and high rates of brand loyalty.

The Code contemplates that there will be situations where an infant or child requires a commercial product that their family cannot afford - and requires that having initiated the use of a commercial product such as infant formula, the health care provider ensure that the child has access to a supply of that product for as long as it is needed.

A quick calculation of how much “savings” is created by samples, using some quick numbers from a Canadian retailer and a common major brand of ready-to-use infant formula. This is for illustrative purposes only but can be pretty easily calculated from online sources.

Price per 100ml: $1.00
Average daily intake at discharge: 240ml (8 X 30ml) Cost: $2.40 / day
Average daily intake month 1-6: 720ml (8 X 90ml) Cost: $7.20 / day or $216/month
Savings from a 6-pack sample of 69ml bottles: -$4.14

The cost of a ‘gift’ that interrupts breastfeeding: $1,291.86 in the first 6 months

By the time a child is taking full feeds, the well-meaning ‘gift’ they received in the hospital barely gets them to lunchtime on a single day, while they need to divert family resources to either paying for or otherwise obtaining a safe and consistent supply of formula.

Infant formula is an easy example that is familiar in the world of birthing hospitals, but the use of samples to incent parents to try out breastmilk substitutes can be detrimental across the spectrum of Code-covered products. “Free samples” of commercial baby foods and toddler milks are also common in pediatric primary care, leading to a reliance on these unnecessary foods, while displacing more appropriate ones. While this reliance is nutritionally not required, once a child has become dependent on them or their parents believe that they have, the ethical obligation is all the same.


Michelle Pensa Branco MPH IBCLC
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Last Updated: September 2018