----- Original Message -----
From: Renee Hefti
To: [log in to unmask]
Sent: Saturday, February 03, 2007 7:34 PM
Subject: "free" formula and bribes to hospitals
In British Columbia in 1993, the largest maternity in Canada, (7,000 deliveries a year) was offered $500,000.00 and free formula if the hospital would sign an exclusive contract.
I wrote to the hospital president saying that accepting this "gift" was unethical and against the rules of the Baby Friendly Hospital Initiative which the hospital was working towards. His response was that the hospital needed the money and free formula and if rejected 10, of my colleages would lose their jobs.
So I did the math. If 100% of the babies were formula feeding and they stayed an average of 1.8 days in hospital and the babies were each fed 12 feeds at $.50 per feed, (could be less), the formula to feed ALL 7,000 babies would cost approximately $75,600 a year. BUT 80% of the women were breastfeeding (in 1995) and only 20% were formula feeding. If you factored in that maybe 5% of the breastfeeding babies (likely high) needed supplementing for medical reasons the cost to purchase the formula required, now dropped to under $20,000. I did not factor in the costs for special formulas in the special care unit but the president (and the press / public) got the message.
The media were more than willing to give front page headlines to the information the breastfeeding advocates supplied (especially that it was unethical for the hospital to accept free formula and money) and along with a letter writing campaign to the hospital, (for further pressure), the hospital announced that they were not going to accept the $500,000 but would accept free formula for 18 months - disappointing but some progress.
In 1995 the hospital was again offered free formula, plus this time, 1.5 million dollars. After a presentation to the Board of Directors, media attention and a letter writing campaign the hospital announced it would stop accepting free formula. The breastfeeding advocates immediately notified the Executive Director of UNICEF who immediately faxed the hosptial with congratualtions. The media headlines now portrayed the hospital as being a leader in Canada with UNICEF applauding their decision.
However, this battle was not over. In 1999 a health region, (also in British Columbia) with 3 hospitals (approximatley 6,000 deliveries per year) were offered 5 million dollars plus free formula. After press releases / media attention, a presentation to the Board of Directors and a letter writing campaign the health region turned down the "gifts".
I believe all hospitals In British Columbia now pay for their formula and no hospital, public health department or drug store distribute formula gifts packs (the way we got rid of those is a story for another day!)
In British Columbia, approximatley 97% of women now enter hospital wanting to breastfeed . Our duration rate is still not what we want but we are slowly getting "there".
The work to protect breastfeeding from the commercial pressures to artificially feed is very difficult. The meetings to determine which formula company gets the contract have historically been held in secret with no staff input. The purchasing agent at a hospital told me that the formula negotiations were a "blood bath" with each company trying to out do the other. Hospital are strapped for funds but when their unethical relationship with the companies are exposed, (and how this impacts health) they will hopefully do the right thing.
Renee Hefti - Graham
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