EUGENE (AP) - It has long been just one more item in the gift bag new mothers take home from the hospital, along with coupons, magazines and parenting pamphlets - a sample of infant formula.

But some hospitals, including many in Oregon, are leaving it out, fearing that it undermines the medical consensus that breast milk is best.

Formula companies are fighting back, saying mothers should have the right to choose.

A group opposed to the bags, banthebags.org, lists 152 hospitals in 37 states that have phased them out, less than 3 percent of the country's 5,756 hospitals.

Oregon has the highest breast-feeding rate in the country and is the only state with an exclusive breast-feeding rate of more than 25 percent at 6 months.

The American Academy of Pediatrics which recommends that infants be breast-fed exclusively for six months and up to a year, opposes the gift bags.

Eugene's Sacred Heart Medical Center dropped them nearly a decade ago, partly because of research on benefits of breast feeding and because it did not want to become a promotional arm of formula companies, said Debbie Jensen, coordinator of Sacred Heart's breast-feeding program.

“It's an incredible marketing tool that in a sense the hospital provides free to formula companies,” she said.

McKenzie-Willamette Medical Center in Springfield still provides the gift bags to new mothers who want one, hospital officials said, but minus the formula for mothers who have chosen to breast-feed.

Providence Health Systems stopped giving out the gift bags at its seven Oregon hospitals last may including the Providence St. Vincent Medical Center in Portland, which delivers one of every eight babies born in Oregon, spokesman Gary Walker said.

“We support breast-feeding, so when you're sending formula home that's sending a different message,” he said.

Legacy Health System, which operates six hospitals in Portland and Vancouver, Wash., stopped giving out gift bags several years ago but keeps a few for mothers who say they prefer formula feeding, spokeswoman Lise Harwin said.

Oregon Health & Science University provides free samples of formulas to new mothers, but is ending the practice, spokeswoman Tamara Hargens said.

Proponents of breast-feeding cite research showing that infants who are breast-fed are less likely to get, or be severely sickened by, diarrhea, ear infections and bacterial meningitis.

Other studies suggest that breast-feeding can help protect against sudden infant death syndrome, diabetes, asthma and obesity. Research also has found that breast-feeding benefits mothers, reducing the risk of ovarian and breast cancer.

Gail Wood, a spokeswoman for Mead Johnson Nutritionals, maker of the best-selling Enfamil formula, said hospitals that eliminating the samples are taking away mothers' rights and a vital source of information on infant formula.

“We're here for babies,” she said. “It would be unethical for us to interfere with a mother's decision to breast-feed or formula-feed. We would never discourage a mother to breast-feed.”

According to the American Academy of Pediatrics, increased breast-feeding has the potential to decrease annual health costs by $3.6 billion in the United States.

In 2005 the American Academy of Pediatrics cited “commercial promotion of infant formula through distribution of hospital discharge packs” as one of the obstacles to breast-feeding. It urged pediatricians to “work actively” to eliminate such programs.

“There is very good evidence that these marketing bags are extremely effective at doing two things: Reducing the rate of exclusive breast-feeding and making sure, if a mother choose to switch to formula, that she chooses the brand the hospital gave her,” said Dr. Nancy Wight, a neonatologist at Sharp Mary Birch Hospital for Women in San Diego.