Barbara informed us of her letter to the ethics committee in her hospital
regarding the practice of giving breastfeeding mothers formula-containing
discharge bags. One of the things to investigate is whether your hospital has
a contract with the formula company that specifies giving out these bags in
return for the cash given to the hospital. The cash typically goes to the
chief of OB or pediatrics. In your situation, probably the Nursery Chief.
These contracts obligate the hospital to accept the cash, accept free formula
on an exclusive basis, accept other supplies like sugar water, artificial
nipples, special formula, etc. The hospital is also obligated by the contract
agreement to give out the formula bags. Some hospitals engage in a joint
purchasing contract where the purchasing of supplies and equipment is
discounted if the hospital also agrees to give out the formula bags. You need
to check if your hospital participates in this agreement.

Formula bags are designed to cause breastfeeding mothers to supplement so
that their milk supply never increases enough to fully breastfeed their baby.
Supplementation at home decreases milk production leading to the need to buy
more formula, thus creating a market where none would have existed. Formula
company reps have unprecedented access to maternity staff. No other vendor in
the hospital feeds staff, conducts contests and bribes the unit into
marketing a product with known adverse health effects on patients. Look at
your hospital's vendor policy and see if the formula companies ever follow it.

Formula companies use the hospital as a marketing conduit that sanctions the
use of formula, models its use at a vulnerable time, and generally overlooks
the ethics of what it is doing because the money is so powerful! One also has
the option of reporting a hospital to the state department of health's
Department of Health Care Quality that regulates hospitals in the state.

I have a handout on how to rid your hospital of infant formula that I am
happy to share. Barbara is to be congratulated and supported for taking a
stand and for having the courage to do the right thing. If I can be of help,
please let me know.

Marsha Walker, RN, IBCLC
Weston, MA

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