For decades, hospitals sent newborns home with gift bags stuffed with free samples of infant formula — a move that anti-obesity advocates consider a not-so-subtle hint that moms didn’t need to go to the trouble of breastfeeding.

Such gift bags are being opposed by a growing international movement, strongly endorsed by American anti-obesity forces, to stop the free samples, one of a series of steps to encourage more moms to breastfeed as soon as the baby is born.

Tatiana Quintero is grateful. She gave birth to twins last month at West Kendall Baptist, which has joined the national effort to stop free formula.

“I always wanted to do it,” Quintero said of breastfeeding, “but you kind of wonder if you can,” especially with twins. She said doctors and staff were encouraging as she went through the pre-natal process and then talked to a lactation consultant in the hospital after the births. “There was definitely a lot of cheering. It’s comforting.”

Studies by the Centers for Disease Control and Prevention show breastfed children are less likely to become obese. “A baby’s risk of becoming an overweight child goes down with each month of breastfeeding... For women who intend to breastfeed, the hospital experience is critical.”

One major factor: A newborn is more likely to take to breastfeeding if the baby stays in the hospital room with the mother, rather than in a remote nursery. West Kendall Baptist, which opened last year, has designed its birthing center rooms so there is space for mother and child.

The International Formula Council, which speaks for the $8 billion industry, has a policy statement on its website that says there’s nothing nefarious about the gift bags, which have been given away for 40 years by formula manufacturers, who include not only free formula, but also items such as “bottles of water, nipples, educational materials, infant vitamins and lotions for mothers’ use.”

The council says breastfeeding is “the ideal” but adds that “mothers should be trusted to make the best choices for their babies according to their life circumstances and the needs of their families.”

The council was responding to repeated criticism of the gift bags, including one major onslaught in March when Public Citizen, a Washington consumer advocacy group, sent letters to 2,600 hospitals urging them to stop the formula gift bags.

“Multiple studies have shown that women who receive commercial hospital discharge packs stop breastfeeding sooner than those who do not,” the Public Citizen letter said. While hospitals endorse breastfeeding, “research shows that bag distribution sends a message more powerful than any verbal messages. New mothers who at first experience difficulty breastfeeding are apt to choose to use free formula samples... instead of seeking out assistance with breastfeeding.”

Linda Quick, president of the South Florida Hospital and Healthcare Association, said she’s not certain how many local hospitals distribute the gift bags, but her organization received $125,000 from a federal grant to assist hospitals and employers in encouraging breastfeeding.

Joyita Garg, a hospital association staffer, said she worked with nine Miami-Dade hospitals to help make them “Baby Friendly,” an official designation of the World Health Organization and the CDC. Garg said that during the two-year grant, breastfeeding among the new moms was reported to increase 40 percent at participating hospitals.

The program included providing 1,500 gift bags to new moms that were stuffed with plenty of helpful items — but not formula.

“When the baby is nursing, the baby gets tired and stops,” said Garg. “With a bottle, the formula keeps dripping in even after the baby’s tummy is full,” starting habits of overeating that can last a lifetime.

Garg’s work helped some Miami-Dade hospitals, including Baptist Health South Florida facilities, to begin the complex process of becoming an officially designated Baby Friendly.

Liz Westwater of Baby Friendly USA said some Broward hospitals are also working toward Baby Friendly status under a separate grant. Only three hospitals in Florida — none of them in South Florida — have been granted the status, which involves 10 steps, including hospitals paying for formula (most facilities now get free formula) and having rooms in which mother and newborn can sleep together.

Sonya Clayton, a lactation consultant at West Kendall Baptist, said doctors who use the hospital are on board with the Baby Friendly initiative. Breastfeeding discussions start with pre-natal care, continue with breastfeeding classes and end with moms leaving the hospital with new gift bags that include a T-shirt: “I’m a breastfed baby.”