BOSTON (AP) – The widespread practice of giving gift bags filled with baby formula and other freebies to new mothers has been banned at hospitals in Massachusetts in a move by state health officials to promote breast-feeding.

The ban doesn’t forbid hospitals from giving out free formula, but it ends a practice that breast-feeding advocates say was designed to turn harried new mothers toward a less healthy alternative, and also implied an endorsement of formula by hospitals.

“There’s no free lunch and there’s no free gift,” said Beth Sargent, a lactation consultant from Needham. “A gift is something given freely without the anticipation of a return. There is absolutely an anticipation of return.”

Some Massachusetts hospitals already forbid the gift bags, but Donna Rheaume, a spokeswoman for the Department of Public Health, said she believes it’s the first time a state has written such a ban into its hospital regulations.

Formula companies say their top priority is healthy mothers and babies, regardless of whether they breast-feed or use formula.

Gail Wood, a spokeswoman for Mead Johnson & Company, which makes Enfamil, said the ban was “over the top” and intrudes on the private choice about feeding a baby, which is made between mothers and their doctors. “I don’t think they’re respecting the decisions of women and the decisions of health care professionals,” she said. “I think it’s not respectful of their privacy.”

The bags are often diaper bags or backpacks with a cute mascot on the front, such as the bunny used by Enfamil. Besides a sample of formula, the bags contain coupons, information about formula feeding and breast-feeding. The “Very Best Baby” bag given out by Nestle has an ice pack for chilling breast milk, a music CD and a photo album, among other items, according to the company Web site.

Rheaume said the state was due to update regulations for maternal and newborn services, which hadn’t changed since 1989. The ban on gift bags, she said, was simply a way to encourage breast-feeding

Evidence of the benefits of breast-feeding is overwhelming, Rheaume said, including decreased ear infections, gastrointestinal illnesses and respiratory problems for babies, and lower risk of ovarian and breast cancer for mothers.

But if a woman chooses formula, she said, “that choice is going to be supported, as well.”

According to statistics from the Centers for Disease Control and Prevention, 74 percent of Massachusetts mothers breast-feed, but only 39 percent are still breast-feeding when the baby is 6 months old, below the federal goal of 50 percent. Nationally, about 36 percent of mothers breast-feed at 6 months.

Amy Branger, of Boston, the mother of a 2-year-old girl, said she was committed to breast-feeding but knew the temptation to turn to formula would be strong. One reason she chose Boston Medical Center for her delivery is because they didn’t give out the gift bags.

“In the middle of the night, when you’re tired and you want someone else to feed the baby, you want to use” the sample, said Branger, 39. “I wanted to do everything possible for (nursing) to work out.”

But not everyone chooses to breast-feed, due to work or other commitments, and not all women are physically able. Sarah Wood, 25, of Salem, said her now 15-month-old son initially had difficulty breast-feeding, so she used formula as a supplement, including the sample she got in her gift bag.

“The pressure to breast-feed is good. The problem is it doesn’t work out for everyone,” Wood said. “To make people feel guilty for doing it is the risk people run by advocating it so strongly.”

Judi McLaughlin, 36, of Medford, who gave formula and breast milk to her 2-year-old and 10-month-old girls, said the government has no business promoting a way to feed babies. All the gift bag ban does, she said, is open the door to pressure from breast-feeding advocates and increase “mother guilt.”

“My breasts, my business,” she said. “Stay out of there.”