Melissa Bartick, MD

    The Real View of Free Formula Samples—Open Your Eyes

    Posted April 18th, 2012 by

    Whoopi Goldberg and friends on The View just threw a Molotov cocktail of ignorance into the middle of the Mommy Wars.  This time it’s about whether hospitals have the right to market formula to new moms with free samples. The women of The View give a unanimous, “Yes.”  But the proposed ban on marketing is not about women being bullied into breastfeeding.  It’s about standing up for our freedom to make our own feeding choices, freedom from commercial influences in the one place where they certainly don’t belong—the hospital.

    Let’s be clear. Formula companies distribute free samples in hospitals for one reason: to sell more formula. Specifically, to sell more high-priced brand-name formula. Abundant market research shows that women stick to the brand of formula they got in the hospital.  Knowing that babies often don’t tolerate formula well, moms wisely stick to a brand that’s worked for them. That’s why the makers of those pricey brands compete, often viciously, to be the brand a hospital uses. These brands will cost a family at least $700 more per year than store-brand formula, which may be every bit as good, since the government regulates what ingredients must be included.

    Those free samples to moms come with a hitch. They are not just “free” to the moms. Formula companies want your business so badly that they will vie for the privilege of supplying most of the hospital’s formula for free. Yep, you heard that right. Unlike any other product, the formula company representatives bypass all hospital purchasing policies and quality control, and wheel their cache right up to the maternity ward, in the hopes that nurses will dole it out like confetti.

    It’s a brilliant strategy. It helps make the United States the biggest single consumer of infant formula in a $10 billion a year global market. Hospital staff love to be helpful. They went into health care to help people. The formula companies are well aware of this instinct for well-meaning nurses to rain freebies down on moms.

    Think you’ll get more sleep if that helpful nurse takes your baby to the nursery? That’s another myth the formula companies prey on. One nurse may be looking after 5 or six babies. It’s no wonder research shows that babies do better next to their moms, and moms get just as much sleep whether their babies are with them or not.

    For moms who chose to breastfeed, the abundant supply of free formula is even more problematic than it is for moms who choose formula. Research shows that one of the biggest predictors of breastfeeding failure is giving babies formula in the early days when there is no medical reason for it. (For more information on these issues, check out these sites: http://www.ncbi.nlm.nih.gov/pubmed/18563999http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5723a1.htm)

    This interferes greatly with the mom’s ability to establish an early and abundant milk supply, and interferes with the well-choreographed dance between baby’s hunger and mom’s body. As many moms will tell you, one bottle then leads to another, and pretty soon mom’s milk supply dwindles to nothing.

    When that happens, moms have to buy formula for the rest of their baby’s first year, just as surely as the diabetic has to buy insulin. Formula companies sell a product with only one market, babies, and there are only so many babies born every year. So the only way to sell more formula is to sell less breastfeeding. It’s as simple as that.

    Those free bottles of formula come in handy at home, when a mom is at her wits’ end in the middle of the night. And that’s the whole point of them.  If breastfeeding doesn’t get off to a good start in the hospital, we know that it’s much more likely that a mom will go home and struggle.  A bottle of premixed, ready to use formula is awfully tempting, even for those of superhuman willpower. Then that mother-baby dance is interrupted, and for most babies, breastfeeding is likely to go from bad to worse.

    Contrary to popular belief, breastfeeding doesn’t tend to go badly because of maternal factors. It tends to go badly because of hospital factors. The Centers for Disease Control and Prevention conducts a biannual survey of how well hospitals conform to evidence-based maternity practices around infant nutrition and care, the mPINC survey. Out of 100 possible points, the average US hospital scored just 65, a solid D. Even average hospital the top scoring states were only in the low 80s.These evidence-based practices, the Ten Steps to Successful Breastfeeding, make a huge difference to long-term breastfeeding rates. What happens in the hospital is crucial for breastfeeding success.

    When there’s abundant free formula around, it’s a lot harder for hospitals to change their long-established routines and implement the WHO’s Ten Steps to Successful Breastfeeding, the protocol upon which the mPINC survey is based. So, why are hospitals marketing baby formula instead of implementing the Ten Steps? That’s the question we should all be asking.

    We would find it absurd if hospitals’ cardiac units gave out coupons for Big Macs. Commercial marketing doesn’t belong in hospitals. No matter how you feed your babies.

    For more information, go to www.banthebags.org

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    23 Comments

    April 19, 2012 at 9:14 am by Jamie Budak

    The real problem isn’t the samples, it’s the steady stream of misinformation about breastfeeding and the dietary needs of a newborn. Healthy newborn babies can go more than 24 hours after birth before they actually need to eat! There is no reason to supplement with formula because your milk hasn’t come in yet at this point. Your body is producing colostrum at this point, with is very beneficial to the baby, maybe even more so than actual milk! And a baby’s stomach can only hold a tablespoon or do of liquid at this point- not the OUNCES of formula they are sometimes fed!

    My son had a very rough start to breastfeeding. He had kind of a rough entry into the world and was too sleepy to nurse for a full day. I did feel pressured into supplementing with formula. The nurses were concerned and his blood sugar and dehydration because he wasn’t latching. I supplemented once with formula, about 1 tablespoon. But I kept trying with breastfeeding, got help from a lactation consultant, and a few days later he was nursing like a champ. 8 months later we’re still going strong!

    A few more misconceptions about breastfeeding:

    1. You can’t drink alcohol. False. You can have a drink or 2 occasionally. The amount of alcohol from 1 drink that gets into your breastmilk is extremely small and unlikely to affect a healthy full term baby. If you feel tipsy, wait until you don’t anymore before breastfeeding.

    2. Breastfeeding is painful. FALSE. If it hurts, you’re doing it wrong! The most common reason for discomfort is a bad latch. Here is my foolproof method for a good latch: squeeze your areola gently so that your nipple extends a little. Wait for baby to open as wide as possible and get as much of your breast into the mouth as you can. Position baby so his head is facing your breast directly, his chin presses into the breast, and the tip of his nose just barely touches. Presto. Perfect latch.

    3. The only way to tell how much milk you’re producing is to pump. False, false, false. Pumping is not nearly as effective at removing milk from a breast as a baby’s suction. You may be producing even twice as much as you are able to pump! If you have no other option but to pump, the more frequently you do it, the more milk you’ll produce. Also, you’re breasts are never actually empty. They’re always at work producing milk.

    I do not judge women who choose to feed their babies formula for whatever reason. Formula is FINE. It’s not poison, save for the occasional tainted batch. :/ I was a formula-fed baby and I grew up to be a relatively well-adjusted happy adult. Chances are your child will too. It just makes me sad to hear that someone isn’t having the same wonderful experience with breastfeeding that I’ve had. I want every mom to feel that!

    [Reply]

    Jennifer J in MN Reply:

    @Jamie Budak, I agree with everything here, except concerning breastfeeding hurting. It can be quite painful at the beginning even if you are ‘doing it right’. Let’s be totally honest with women. If it continues to hurt or you have cracked and bleeding nipples or painful lumps, you do need some help. Generally the pain will pass, but with all 7 of my children there has been about 1 week of pain or discomfort–I’m pretty sure I was ‘doing it right’ and know how to get a good latch. It just not always as sun shine and roses as some would have you believe. It can be hard work.

    [Reply]

    Jamie Budak Reply:

    @Jennifer J in MN, I should have said sure, some discomfort is normal at first, but it shouldn’t be excrutiating. It’s a new sensation so I see your point about it being uncomfortable. And yeah, it can be ”work” at times, especially during growth sorts when babies wanna nurse CONSTANTLY (talk about feeling drained. Literally.). But those times when it’s hard work or hurts are a tiny fraction of the time spent nursing overall. I guess it’s kinda like childbirth- yeah, it hurts and it’s hard work,.but only for a little while and the good far outweighs the bad. :) I don’t feel like I’m sugar coating it to say breastfeeding is 99% great once you get the rhythm. <3

    [Reply]

    M. Reply:

    @Jennifer J in MN, But that’s exactly it. If it does hurt then Mom needs help. She does not need to be told that it’s normal to have excruciating pain, cracked and bleeding nipples, etc. She needs to know that it’s NOT normal and then she needs to be given help by her doctors directly or else sent to a lactation specialist who -can- help her. She doesn’t need to be dismissed as a whiner, and that’s what happens when people think breastfeeding is painful.

    [Reply]

    April 19, 2012 at 7:59 am by Victoria

    I do appreciate this article as well. Watching this video clip made me cringe. The overall ignorance on the issue as a whole makes me sad. As a mom who had to supplement some with my son I understand their is a need at times to use formula. But as a nurse in the maternal child health field most a lot of the patients that I encounter hold the same views as the women of the view even before they are even offered the free formula in the hospital. A lot of the women who come in and say they want to breastfeed are willing to offer a bottle even by the first night when it gets tough. A lack of overall education regarding the details of breastfeeding is the bigger issue. This is something that is very difficult to provide in the thick of things. It’s a very challenging topic to provide awareness on.

    [Reply]

    April 19, 2012 at 6:17 am by Liz Brooks

    Well said, Melissa Bartick, and hear hear.

    Public Citizen — a highly-esteemed and well-respected non-profit organization — has recently begun an initiative to raise awareness of the public health impact of predatory marketing practices by formula manufacturers. To learn more about this project (and to sign a petition if you choose) See: http://action.citizen.org/p/dia/action/public/?action_KEY=10062

    Ban the Bags also has a Facebook page:
    https://www.facebook.com/BanTheBags

    The United States Breastfeeding Committee is the multi-organization assn (of govt and non-profit groups) that seeks to promote and protect breastfeeding in the USA. One can learn a lot — and find opportunities to help — at: http://www.usbreastfeeding.org/

    [Reply]

    April 18, 2012 at 8:20 pm by Rhonda

    Shame on this entire show for throwing more ignorance into the wind. If they spent a day with me at the WIC office, they would see just how “free” formula really was.

    [Reply]

    April 18, 2012 at 5:27 pm by Jim

    Let me guess: The formula company or its lead company is a sponsor of “The View”?

    [Reply]

    April 18, 2012 at 5:00 pm by terry g

    i got free formula. and used it. because my milk had not come in and my son was starving. i was dedicated and once it came in he nursed exclusively for 1 year. i can see it being an easier way out for some moms but if you really want to nurse- you will not give in to formula. and in my case a jaundice starved child needed something! so i see both sides.

    [Reply]

    Amanda Reply:

    @terry g, you are the exception to the rule in your dedication to breastfeed after a rough start. You probably also would not have hesitated to go buy a small amount of formula if you really felt your baby needed it. You didn’t need the freebie.

    This is such an excellent article — I want to make copies and stick them in front of all the formula ads in my dr’s office baby magazines!

    [Reply]

    April 18, 2012 at 4:36 pm by Janice Reynolds

    Here’s the clip on the show from last week. Plus some other clips where The View takes on breastfeeding.

    http://www.youtube.com/watch?v=Ma9_IF57374&feature=plcp&context=C47caf3bVDvjVQa1PpcFNjUsiqFJMsuH7enHar_qVHw-OCN15k01w=

    [Reply]

    April 18, 2012 at 4:36 pm by Megan

    I agree 100%. This is precisely what happened to me with 3 out of my 5.

    [Reply]

    April 18, 2012 at 4:00 pm by stacy h

    Wonderfully written. Here here!

    [Reply]

    April 18, 2012 at 4:00 pm by Amber Magyari

    Love It! Great job.

    [Reply]

    Trackbacks

    1. The Real View of Free Formula Samples - Open Your Eyes | Care2 Causes
    2. Celebrating Mother’s Day, Networked Moms & Powerful Writing « MomsRising Blog
    3. Breasts On Our Minds | Our Milky Way

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