"Good friends, good books, and a sleepy conscience: this is the ideal life."
- Mark Twain
In the new mother business, my specialty is postpartum house calls to smooth out those inevitable bumps along the breastfeeding road for new mothers. So you can well imagine my surprise when at the end of a recent call, as I exited the home, a smiling U.S. mail carrier thrust into my hands the obligatory "free" infant formula packet sent to almost all new American mothers.
In a flash I was thrust back 20 years when such packets had mysteriously landed on my front stoop after the birth of my daughter. At that time, I was mystified as to the source of these unsolicited items. Over the ensuing years, I have come to understand the power of formula marketing.
In spite of all the wonderful research in support of breastfeeding, the perceived convenience of formula feeding is still strongly supported by our system of free enterprise. Expectant mothers are routinely checked by health care professionals whose offices carry popular magazines with fancy advertisements by infant formula manufacturers.
Discussions of infant feeding between doctors and pregnant women usually begin with the benefits of breast milk, but diplomatically deviate to the prospects of formula feeding, just in case the mother may find that she "cannot" breast feed, or "chooses not to breastfeed" for personal reasons. After delivery, most new mothers receive very colorful, very practical diaper bags with infant formula samples as a "going-home gift" provided by their hospital.
And then, the mail carrier brings more free infant formula to the new mother's doorstep timed to arrive during that bumpy breastfeeding period about a week after delivery. Are all these gifts really "free"? What actually might be happening?
To understand the complexity of this question, one must first look at the high cost of infant formula feeding. Anyone who has used infant formula knows that it is an on-going expense to the new family. One bottle of pre-mixed infant formula costs the manufacturer under a dollar to prepare, yet the new parents typically shell out several thousands of dollars each year to feed the exclusive formula baby.
These dollars are then directed back into further promotion for the formula company. This is good, simple, common sense American marketing.What is not discussed as the new mother journeys through this gamut of product promotion is the hidden health cost of formula feeding. For the first time, the Department of Health and Human Services has begun to address this question.
In a landmark public relations campaign launched this year, the DHHS used evidence-based, scientific studies to discourage formula feeding. Departmental posters and brochures sent to medical doctors nationwide state, "Recent studies show that babies who are breastfed are less likely to develop ear infections, respiratory illness and diarrhea."
To be more precise, Wendy Slusser, MD, MS, at the UCLA Center for Healthier Children, Family and Communities, has calculated that within Los Angeles County, "if just 5% of new mothers exclusively breastfeed for six months, $4,099,400 would be saved in family health care costs and lost wages due to fewer ear infections." That's over four million dollars saved in six months for ear infections alone.
Imagine if the public were to recoup the personal expense of repeated visits to their pediatricians for their children's respiratory illnesses and diarrhea. Suddenly, breast feeding is not so much a life style choice anymore, but a serious choice for the future health of one's children, as well as one's family financial integrity.
Imagine, if rather than spending those hard earned dollars on infant formula, as well as sick baby visits to the pediatrician, new parents might deposit the costs of infant formula into a college savings account for their new babies. So the true issue is whether formula companies should market their product "free" to new mothers when health experts and government officials now agree that breast-feeding is healthier, and saves long-term health care costs for our children.Breast feeding is truly free to the practicing mother and baby, but therein lies the catch.
Because it is the biological norm, it does not receive the funding needed for mass marketing. In 1981, the World Health Organization developed the Universal Code for Infant Marketing to protect developing countries from being inundated with formula products that discouraged breastfeeding. The United States signed the Code, but never enacted laws to restrict formula marketing.
Nestle, Abbott Laboratories and Bristol-Myers Squibb, have since enjoyed an inside track in pushing their products because of their ties to the medical establishment. Each year, these companies donate millions of dollars to many hospitals nationwide in exchange for the right to distribute free samples of their products to mothers of newborns at discharge.
Simultaneously, conscientious health professionals have voiced the concerns about this practice and supported the research that led to the DHHS campaign to promote breastfeeding.
So where do we go from here? As the American marketplace continues to struggle with these ethical issues, it is clear that the medical establishment finally supports breastfeeding. To draw an analogy, much like the rise in awareness about the dangers of cigarette smoking, the DHHS has chosen to increase awareness about the risks of formula feeding.
Their future focus includes DHHS breastfeeding promotional campaigns to inform the public about the additional risks of formula feeding, including chronic illness, juvenile diabetes, asthma and allergies, as well as childhood cancers.