Fact Number One: Exclusive breastfeeding for at least six months is best for infants and new mothers.
Fact Number Two: Hospital giveaways of infant formula samples to new mothers reduce the amount and length of breastfeeding.
Given these two facts, why would hospitals serve as marketing agents for infant formula companies by giving away free samples of infant formula? Why do the formula companies -- Nestle, Abbott and Mead Johnson -- think they can get away with practices that undermine public health?
The first of these two questions is more mystifying. There is unanimity among health professionals on the key importance of breastfeeding. Many hospitals that encourage breastfeeding by new mothers simultaneously subvert their own health messaging by giving away formula samples, as well as discount coupons and other formula advertising.
If hospitals started out with the simple proposition that they shouldn't be marketing commercial products, the infant formula giveaway problem wouldn't exist. In the absence of a commercial-free hospital culture, hospitals take on a duty to be very self-conscious about the ways that they market or tout commercial products. When it comes to infant formula, most are failing to fulfill this duty.
The good news is that hospitals can be persuaded to do better. A Centers for Disease Control study finds that in 2009, 34.9 percent of hospitals had stopped distributing infant formula samples, up from 27.4 percent in 2007. The change follows advocacy campaigns from groups like the Boston-based Ban the Bags campaign and a stronger push for breastfeeding support from national public health agencies.
Now a new initiative by Public Citizen and more than 100 health and consumer organizations aims to up the pressure. The groups have sent letters to 2600 hospitals urging them to end giveaways, and more advocacy will follow. There's just no excuse for hospitals to market infant formula.
Despite recent gains, American society is not sufficiently supportive of breastfeeding, and the everyday realities of many new mothers' lives make exclusive breastfeeding very challenging. Giveaways of free samples directly undercut hospital efforts to support breastfeeding and sends exactly the wrong message to new mothers.
Mitzi Rose, a new mother from Rochester, New York, explains the issue perfectly: "By the time I had my second child, I was adamantly determined to breastfeed. I was not influenced to purchase formula by the bags, but I do see how the presence of a "sample" of formula can be appealing to an exhausted and discouraged new mom. I could understand how a mother could feel driven to try it as just another way to appease a baby. The act of a hospital handing a new mom a sample of formula is the same as the hospital telling the mom that she can't breastfeed exclusively, or that she shouldn't breastfeed exclusively. The choice of formula, if it is necessary, should be made in consultation with a baby's pediatrician, not determined by a contract with a formula company."
One possible explanation for the persistence of hospital formula giveaways is the power of "free." But the samples aren't really free. Not only do they undermine a healthier means of nourishing infants -- breastfeeding -- they end up costing new parents in strictly monetary terms. Using formula is expensive. Samples are costly even for formula-feeding parents. Mothers who receive a particular brand in the hospital are likely to stick with it, costing them up to $700 extra per year as against cheaper alternative brands.
Now as to that second question -- why do the infant formula makers think it's OK to pursue unhealthy practices? -- the answer is more straightforward: They are looking for profits, and they'll do what they can get away with.
This is an industry with a record of employing horribly aggressive and deceptive marketing practices in poor countries -- where breastfeeding is even more important than rich countries, because formula may be mixed with contaminated water, and because the economic costs of formula can overwhelm family budgets (or where mothers may use nutritionally inadequate amounts of powder, because they can't afford enough). The infant formula companies still violate the terms of the World Health Organization's formula marketing guidelines, but abuses are less severe than they once were, thanks to global campaigning by groups like the International Baby Food Action Network.
So, a last question: Are we going to let the formula makers get away with dangerous marketing practices that harm babies?
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