State allows gifts of formula for infants

In a victory for Governor Mitt Romney , the state's public health commissioner announced yesterday that hospital maternity wards in Massachusetts can continue to hand out gift bags with samples of infant formula. Last winter, the Public Health Council had imposed a ban on the bags, but then, at Romney's urging, it reversed its decision and ordered further study.

The five months of debate over gift bags with formula crystallized scientific and political issues regarding both breast-feeding and the Public Health Council, which governs the state Department of Public Health.

To public health specialists and powerful members of the Legislature, the episode demonstrates the perils of politics intruding into healthcare.

Last week, Romney completed a major overhaul of the nine-member council, and three members who had supported the gift-bag ban were removed. The governor's office said they had been removed because their terms had expired, but one member, Phyllis Cudmore, whose term expired a year ago, described her removal as political.

In an effort to make the Public Health Council more resistant to political overtures, the Legislature this spring included in its healthcare law a provision to radically expand the board and to alter who appoints its members. Next February, the council is scheduled to grow to 18 and to include representatives from schools of public health and interest groups.

Currently, there is no requirement for members to have expertise in public health, although the body now includes a surgeon and a psychiatrist.

``This whole flap over the formula is a case where they've been directed basically to follow a particular philosophy, and three members are no longer members because they weren't marching in step with the administration," said state Senator Richard T. Moore , an Uxbridge Democrat who championed the reconstitution of the council.

The council's unanimous decision in December made Massachusetts the first state in the nation to prohibit the giveaways.

Romney objected to the ban, saying it deprived women of the right to decide whether they wanted to breast-feed their babies or give them formula. In February, the council reversed the ban but ordered administrators at the state Department of Public Health to conduct a three-month review.

Yesterday, state Public Health Commissioner Paul Cote, who leads the department, told the council that the review showed no pressing need for a gift-bag prohibition, because regulations encourage breast-feeding.

In an interview, Cote said a prohibition ``is probably a little bit too heavy-handed for government from a regulatory perspective. We certainly counsel people and educate them toward the benefits of breast-feeding, but we don't absolutely eliminate the option for people to choose the alternative."

At the council meeting, members had little comment. A council member, Maureen Pompeo, described it as ``a good compromise."

Hundreds of research studies have found that both children and mothers benefit from breast-feeding. Infants experience fewer earaches, stomach problems, and other common maladies of childhood, and mothers later in life experience lower rates of ovarian and breast cancer.

Supporters of the ban said they would now direct their energies toward persuading hospitals to stop distributing the bags.

A review this month by The Boston Globe found that in recent months, major hospitals have increasingly stopped giving away the bags containing the formula.

Gail Wood , spokeswoman for Mead Johnson & Company , maker of Enfamil , the leading infant formula, said the decision means that mothers can decide what works best for them.

In April, Romney vetoed the proposal to change the composition of the Public Health Council, but the Legislature overrode him.

A Romney spokesman, Eric Fehrnstrom, said yesterday that the governor still objects to the future changes in the council's composition, but that the administration will leave further consideration of the issue to the next administration, which will be in place when the shift happens.

``Our view is that it is clearly unconstitutional in that it transfers the governor's appointing authority over executive branch functions to unaccountable private organizations," Fehrnstrom said in an e-mail message.

Health Care for All , which advocates equal access to medical services throughout the state, will have a seat at the council's table next year.

Its executive director, John McDonough , who spent a dozen years in the Legislature, said that starting with the administration of William F. Weld , the Public Health Council has been increasingly subject to political pressures.

``The appointees seem to have been appointed more for connections and political favors and less for the experience and talent they bring to bear," McDonough said.