> Diane writes:
> She had Linda Smith's fact calendar over her desk, and one month it said
> something like, "Formula-feeding is linked to an increase in otitis
media."
> One of her docs walked by, saw it, and said, "What *is* this crap?"

To make sense of this you have to stop and think about how people assimilate
information.

The same message repeated over and over and over and over tends to take on a
life of its own - consider urban legends for an example.
"Formula is just as good as breastmilk" is one of my favorites.  This legend
is reinforced by the carefully worded formula advertisements that are in
journals and regular magazines. It's no wonder we find so many parents
thinking there's no difference now that they've added ARA and DHA to
formula.  It goes like this:   (a.) breastmilk has ARA & DHA in it   (b.)
formula has ARA & DHA in it just like breastmilk does --- therefore (c.)
formula is like breastmilk

Now naturally, the formula companies are not going to point out the
differences, that wouldn't be good for business. Can you imagine? "Our
formula doesn't have any antibodies or anti-infective properties for your
baby's health, buy some today!"  Not too likely.

I think people tend to trust in people who they perceive are like them.
Doctors in particular see themselves as professionals and therefore put more
stake in what people in suits tell them.  Especially nice people in suits.
Especially nice people in suits that we know because we've seen them every
other week for the past three years when they come to do something nice for
us like bring samples and donuts. That's how this drug rep thing works. As
we gain familiarity with the rep, the rep gains credibility with us.

There is an old quote about "an expert is someone from far away with slides"
[although nowadays it should probably be a PowerPoint presentation instead].
My amendment to this is that it's someone from far away that confirms what
you already know.  Doesn't sound rational? It's not. The doctor who saw the
"Formula-feeding is linked to an increase in otitis media" and labeled it
"crap" was (1)probably seeing that info for the first time   (2) not used to
"Wiessingerized" presentation of information  (3)using formula fed baby
health as the "norm" (4) in the "I don't see the breastfed babies as often
so I don't realize they're actually healthier" situation and (5) on some
unconscious level saying - the formula rep didn't mention this, they're my
expert on formula so it must not be true.

I think in the last 5 years medical schools and residencies have gotten
better at educating future physicians about breastfeeding vs. formula
feeding - which down the road will make physicians as a group a bit more
savvy to what's really going on.

Gail S. Hertz MD, IBCLC
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