Suzanne Bowes posted about a restaurant dinner that a formula manufacturer
is offering staff at her hospital, as an enticement to attend an
'educational inservice' about their product.
From International Baby Food Action Network you can get a pamphlet called
'Protecting Infant Health: a Health Workers' Guide to the International Code
of Marketing of Breastmilk Substitutes' (ISBN 983 9075 09 8). Baby-Friendly
institutions may not distribute formula samples, nor display or distribute
materials promoting formula or artificial feeding. They may not even hold
group teaching sessions on how to prepare formula; such teaching must be
done individually as needed, and not as part of 'general info every mother
needs' sessions.
Implicit in the Baby-Friendly certification process is respect for the
international marketing code. The Code expressly prohibits formula
companies from bestowing gifts on health workers, and dinner at a fine
restaurant would definitely qualify as a gift.
The European Union Commission published a report last year on the status of
breastfeeding in Europe, and pointed out that such activities are most
definitely in violation of the Code. For those of you who aren't acquainted
with the political and economic landscape in Europe I can tell you that the
Commission is the last place a breastfeeding supporter would expect to find
an ally, and yet, there they are, pointing out that companies circumvene the
Code in all European countries studied, by attempting to create alliances
between themselves and health workers.
Unfortunately there are still a lot of health workers who 1) are starved for
attention, so they are flattered that a company rep wants to buy them dinner
and 2) haven't ever stopped to think why a manufacturer's representative
might not be the most reliable source of information on a given product.
Judging by the strange looks I got when I turned down the offer of a coffee
cup (a really UGLY coffee cup at that!) from a manufacturer of disposable
diapers who under-bid our previous supplier in order to get the contract for
our hospital, I think I have colleagues who might say yes to a restaurant
dinner no matter who offered it. I know I have midwife colleagues who
accepted samples of powdered instant coffees in different flavors from the
Nestle rep when she was doing her usual "professional education" thing at a
perinatal medicine conference here. I still can't figure out what a public
health nurse is doing dispensing instant coffee and After Eight chocolates
when the stated purpose of her presence is to 'inform' us about Nestle's
work in infant nutrition, but that didn't bother the crowds of midwives and
other health workers clamoring for free boxes of fake espresso.
So, Suzanne, your knee-jerk reaction is right on target, but don't expect
most of your colleagues to understand. In time you may notice that they
have a grudging respect for you, and some of them will come around, but
others will find your behavior an affront. These are the ones who already
know in their hearts that accepting the dinner invitation is unethical, but
they do it anyway because they enjoy going out, and they are the ones who
actually do feel guilty, as well they ought. To spare your colleagues the
temptation, your employer should make it clear to the company that such
invitations are not wanted. It would be a good idea for the employer to
include the content of the WHO Code
(http://www.infactcanada.ca/InfactHomePage.htmas) as part of the
BFI-required training in BF support offered to all employees working with
new mothers.
Rachel Myr
Kristiansand, Norway
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