Elle eating her sleeve!
There is a lot of talk about the Baby Friendly initiative lately on the news, talk shows, Twitter and Facebook. While the term is becoming more common, many people aren’t quite sure of what it means in terms of hospitals and giving birth. Today a fellow LC and I talked breastfeeding with our fellow nurses and many of them were unfamiliar with the term as well.
The Baby-Friendly initiative was started by WHO (World Health Organization) and UNICEF and is becoming pretty popular in the US. Simply put it is an accreditation that is given to hospitals and birthing centers that meet certain requirements. Requirements such as skin-to-skin following birth (with well babies of course, and this is not forced on the mother, just normal hospital policy that it happens. Moms can refuse skin-to-skin), bathing and assessments of baby done in the room with parents so they can ask questions and learn basic infant care, breastfeeding education given to all staff (including doctors), no formula bags given out and a goal of having baby in room with mom 23 out of 24 hours. There are more things of course, but those are the highlights.
The AAP (American Academy of Pediatrics) and the CDC are behind hospitals attaining this certification and for a general change in practice as far as mom’s and babies. The hospital I work at is laying the foundations of obtaining certification as well.
So what is all the hullabaloo about, you may ask? Why are people fighting it? Change is hard and can be scary sometimes, we all know that. People are afraid they will be force-fed to breastfeed if they don’t want to. That is not what Baby Friendly is about. Baby Friendly hospitals do have better breast-feeding rates for sure and they are very encouraging with education and getting parents to be informed about what is best for their babies. Will you be forced to breastfeed, no. Will you have better information to make an informed decision, yes.
So why can the formula bags? Simple. Giving out free formula or “gift bags” has demonstrated itself in lower breastfeeding rates. I have heard so many arguments over why it is unjust to remove the bags, but I urge people to look at the bigger picture. No where else in hospitals*, NO WHERE, does marketing and business have direct power over the consumer than on the obstetrics unit. When a hospital allows a brand to give away promotional items that hospital is saying “We recommend this, it is good.” to the consumer. In reality the formula companies are giving the hospitals free formula, nipples and feeding supplies. The hospital and the local WIC normally choose the same brand of formula so the babies stay on the same stuff from hospital to home. WIC has contracts based on bidding systems. The lowest price is what they go for. So your free hospital bag of formula is the lowest bidder, not necessarily the best choice for your baby. That said, save for a few changes for allergies and digestive issues, most formula is all the same. What costs is the advertising, the product cost pennies an ounce. The formula companies are buying their way into homes through the hospital.
Some people still say “who cares, I like free stuff.” Well I like free stuff as well, but you have to go back to ethics. Does the Coronary Care Unit give out McDonald’s Coupons? No, they don’t want you eating fast food, and most of us don’t eat the salads when we go anyway! Does the stroke unit, give out literature about preventing strokes with cigarette ads on the top of the education papers? No. It would be contraindicated. Yet, formula companies have been allowed to market their sub-par product for decades. Formula-fed babies have higher rates of infections, bowel issues, obesity, allergies, auto-immune diseases and so on and so forth. I’m not saying that all formula-fed babies are sickly. I was formula fed and have been very healthy (though a few more IQ points may have been lovely to have;) I’m saying that statistically they have more medical problems.
If you have worked with me or know me on a personally level, you will know that I would never make anyone feel bad for giving their baby formula. It’s not about making people feel bad. It’s about getting the right information out there, and not letting big business and the formula lobby choose what your baby eats. The whole mommy-wars things is tiring and gets us no where. We are blaming each other, when if we worked together we would be so much healthier and stronger.
Baby Friendly hospitals are a great step in getting our birth experience. I wholeheartedly want our health care systems to be family oriented and less medical, unless medical is needed of course. When looking at our country and society as a whole, if we want healthier babies and higher breastfeeding rates, we need more than Baby Friendly though. We need our country to recognize how important young families are. How do we do this? Better maternity leave benefits, insurance companies paying for breastpumps, employers who have pump rooms for mom (bathrooms are not pump rooms) and don’t penalize or ridicule moms who pump milk for their babies. How do we pay for this you may ask? By breastfeeding. It save a lot of money. The AAP has estimated in the millions of dollars of financial savings if at least 75% of babies were breastfed for six months. MILLIONS of dollars. Less sick babies, less time off work, less visits to the doctor and emergency rooms.
My rant on Baby Friendly Hospitals is done for now. I almost hit 1000 words, oh my. I must go trim some stuff! Please ask me questions if you have them. Please don’t accuse me of being mean to formula feeding moms, because I am not ;)
*Edited post publishing from Health Care to Hosptials and power to direct power over the consumer. Thanks Robyn for pointing out my blunder.
Hospitals and health care are FULL of marketing. Pharmaceutical companies are all over the place with it. I’ve known hospitals/doctors to give out coupons for restaurants and products. I’ve received tons of coupons for drugs from doctors.
Then there’s also the issues that, if a mom’s milk hasn’t come in, and baby’s crying and hungry, it’s not always easy to run to the corner store for some formula.
That said, regarding formula, I’d compromise with: have the formula available for families who ask. Some families, even if they formula feed, would rather not use the hospital’s brand (like us), and wouldn’t ask for it. Some families would.
Formula isn’t McDonald’s. It’s not cigarettes. Formula is like conventional food as opposed to organic – that might be a better analogy.
I’m also not sure that studies of breastmilk v. formula are controlled enough for other factors. There’s one heck of a lot going on in an infant’s life. But that’s another story…
Robyn, After looking at my post I realize I should have written Hospitals, not healthcare. I will be changing that, thank you for pointing it out. It was late and my editing skills are poor at the best of times!
As far as hosptials being full of marketing, I agree – to the doctors, nurses and administrators they are full of pharmacutical marketing, coupons, free lunchs. What I mean is marketing to the direct patient/consumer. I have worked at three different hospitals on CCU, Ortho, Nuero and Med-Surg. In three different parts of the country and I have never seen direct marketing to the patient from the hospital itself – except in OB.
Formula is not ciggarettes or McDonalds, but formula companies ARE big business. Big business does not belong on the OB floor.
Formula is not evil. I’ve told this to mom’s time and time again. I’ve been the one to tell mom when it is time to stop trying to breastfeed and to go to formula, I’ve been there to help with supplements. My own daughter (Elle) got a few ozs here and there when my pathetic pumping got the best of me and I was at work.
We live in a country where most of our water supply is plentiful and safe and we have resources for moms to help them buy food for thier kids. Not all countries have this. The same companies that market us are marketing the poor in Peru telling thier moms that they need to formula feed, it’s better. I have personally seen Peruvian babies get condensed milk to eat because thier moms got free formula in the hospital, then couldn’t afford to buy it on thier own and then had no milk supply. I will never support these companies.
I know that there will always be a need for formula. There are adoptive babies, sick babies, moms (1%) who cannot produce milk, moms (7%) who have a small milk supply, medications that contraindicate breastfeeding. There will be mothers who choose not to breastfeed for many, many reasons. While there is a need for it for some, it doesn’t mean we have to give it to everyone or subject them to marketing.
In my seven years of working OB I have only seen three moms bring thier own formula because they didn’t like the brand the hospital have. Statisitcally they are going to use what the hosptial gives them, if the hospitals are not in the pocket of the formula companies we can have better ethics shown.
I totally support breastfeeding even though I didn’t since we adopted. I must admit I loved the formula bag. Not because of the formula per se but the bag itself! It turned out to be my favorite diaper bag ever.
We had bought formula for Charlie but only 1 can since I wasn’t sure if he’d react well to it or not. It was the same the hospital provided (I called and asked what they gave).
Although the hospital where Charlie was born did not give out formula bags unless asked or prearranged. I remember that because when I called I was questioned and told to breastfeed before I could say “we’re adopting!”.
I think the hospitals should have some handy for parents who chose not to breastfeed but not solicit or promote formula. I know formula is promoted everywhere, not just the OB floor but coupons are handed out in Lamaze classes, parenting classes, etc.
You should totally hook up with Christine Moers. She promotes breastfeeding with a “Magical Milk of the Week” photo. There is a backstory to that on her website, welcometomybrain.net . http://www.welcometomybrain.net/2012/06/magical-milk-pic-o-week_19.html
The bags are nice for sure, the companies have the money to give these away as their product costs are miniscule. It’s the propaganda that comes with them is unacceptable and not worth a nice bag. The way they send out large discounted coupons for a couple of weeks,then start sending 50 cent off coupons is so mom’s don’t feel the pinch of formula costs until they have a much harder chance of getting a full milk supply in. Then at around 5 weeks post-partum in the mail they get info on how to wean, knowing full well that most mom’s only have 6 weeks off work and will be going back to work and have to struggle with the “am I going to continue breastfeeding” dilema that many moms have because of unsupportive work enviroments.
Most hospitals in the US have the formula that the babies eat in house, and parents don’t have to bring there own formula (some don’t, many other countries do not offer the formula at all unless infant needs medical supplementing. If the hospitals purchase this formula they are not in the pockets of big business as much. As it stands now, most pharmacutical companies give hospitals all the formula and nipples for free so they can have the chance of getting their brand to families in the hospitals. The whole thing is so big business and behind closed doors it reaks of unethical practices.
If a formula-feeding mom wants bags and gifts they are easy enough to get them through the baby magizines, WIC and stores. When I say OB floor that means the childbirth education department and yes they give out the freebies and coupons as well. The advertising is everywhere and that is our society. It just does not belong in the hospitals and that is why Baby Friendly hospitals take a stand against the unethical practices of formula companies.
I’ll check out the site you recommended! Thanks for reading.
Not everyone has immediate access to WIC or even a store. I remember getting into this debate previously, and one woman lived in a very rural area, where the closest store was more than 20 miles away. Her milk didn’t come in very quickly, and her baby wouldn’t stop crying, so the formula samples were a lifesaver for her. She did end up successfully breastfeeding, if I remember correctly.
I don’t like that the drug companies market the way they do either. I just don’t have a problem with the hospital asking “Do you want some formula?”
I have no problem with patients asking for formula, or hospitals giving them formula at their request. It’s the massive everyone getting the free bags with advertising that is the problem. If the hospital buys the formula and then gives it out by a case by case basis, the hospital is working along ethical lines. Formula only though, not fancy free bags with teddy bears and “strong babies” labels that give society a skewed look at baby food.
I personally have sent mom’s home with formula if we are using it with breastfeeding, doctors have ordered supplements or the mom requests it for back up. It is given with honest education, a pep talk and support though, not free marketing. I live in a rural area where many of my moms are many miles away from a store, this is taken under consideration when they are discharged. I often talk to moms and help them through those early days that can be tough. Most of the time a supportive ear and some sound advice is what they need, not a can of formula.
I think we all agree with the need for ethics with baby feedings. It’s important that people have the facts, and that is what I hoped my post would do.
Your comments and questions have been so helpful in getting my message across :) Thanks.