Spotlight
Pediatric politics stalls Ad Council campaign
Breastfeeding public awareness advertisements on hold
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Dave C. Arendt/La Leche League International
Breastfeeding through the first six months provides great health
benefits. For breastfeeding information contact La Leche League at (800)
La-Leche.
Federal officials are putting on hold a planned multi-million-dollar Ad
Council public service campaign to promote breastfeeding. And if formula
makers have their way, the current campaign, two years in development, may
be scrapped altogether.
The companies, Ross Products, the unit of Chicago-based Abbott Laboratories
that makes Similac and Isomil, and Mead Johnson, the Bristol-Myers Squibb
subsidiary that makes Enfamil, say the Ad Council uses "scare tactics" to
persuade new moms to nurse their babies for at least six months.
Even top officials of t
he American Academy of Pediatrics say they are concerned the commercials
make scientifically-suspect claims. But other breastfeeding advocates
suggest that the real issue is money-lower revenues to formula makers and
lower donations to the American Academy of Pediatrics.
The commercials, aimed at all new mothers but with an emphasis on
underserved minority communities, begin by showing pregnant women engaging
in risky behavior-logging, roller blading and bull riding-followed by the
message: "You'd never take risks while you're pregnant. Why start when the
baby's born?"
The preliminary ads say babies that are not breastfed through six months are
more likely to contract ear infections and other illnesses, even diabetes
and cancer.
It is the claims about increasing a child's chance of contracting diabetes
and cancer that caused the Academy's Executive Director Dr. Joe Sanders and
President Dr. Carden Johnston to send a cautionary letter to Health and
Human Services Secretary Tommy Thompson. "The concern we had was that the
focus was going to be on the dangers rather than the benefits of
breastfeeding," Sanders says. "We simply asked [Thompson] to think about
couching the message in a more positive way: 'If you nurse your baby, these
are the things you are protecting him or her from.'"
Dr. Lawrence Gartner, who heads the Academy's executive committee on
breastfeeding, however, supports the ad campaign. He has speculated that the
Academy's stand is based on fear of losing large donations from formula
manufacturers. "There's a lot of money involved," Gartner told the New York
Times last month.
A spokesman for the largest formula manufacturers refused to address
Gartner's charges directly. Instead, Tracey Noe, Ross' public affairs
director, says, "We believe that moving forward with this particular
campaign is inconsistent to good health policy and alarming to America's
moms. We think focusing on negative messages will incite fear and guilt and
do nothing to address real issues behind the low breastfeeding rates."
She adds: "Doing the right thing for moms is a way of doing the right thing
for our business."
The original plan
Advocates originally expected the ad campaign to debut in early December.
But Christina Pearson, spokeswoman for the U.S. Department of Health and
Human Services, says the date has been pushed back indefinitely.
"We need to make sure when we put something out that all participants of the
U.S. health department agree that the science supports it," she says. "This
is too important a cause not to get right."
While the debate continues, information about the health benefits of
breastfeeding for at least six months is not getting to enough new mothers.
Past Ad Council public service campaigns have been credited with changing
societal attitudes. Advocates say it can have the same success in increasing
breastfeeding rates.
Ceal Bacom, a certified nurse-midwife in Oak Park, says: "It's high time for
something like this. In many communities, breastfeeding is not visible and
not part of the culture. I've lived through a lot of similar
campaigns-smoking, seat belts-and seen dramatic changes in the social norms.
I think this is worth a try."
By 2010, the government wants to raise breastfeeding rates to 75 percent and
see 50 percent continue nursing beyond six months. In 2000, the most recent
year for which numbers are available, 69 percent began nursing, but only 33
percent continued for six months. Among African-American mothers, the number
is lower-21 percent are still breastfeeding at six months.
The Ad Council, a non-profit agency developing the ads pro bono, released
drafts of the ads in mid-November. Formula makers immediately took
exception. "Some [of the materials] weren't grounded in solid science," says
Noe. "The overall approach and context is like a scare tactic. At a time
when new moms are vulnerable, the claims made will incite guilt and fear."
But Carol Kolar, director of education and member services for
Schaumburg-based La Leche League International, disagrees.
"Forty-six [government] focus groups showed that mothers, fathers and
grandparents never thought about the risks of breastfeeding," Kolar says.
"When they find out it would have made a difference [in their child's
health], they're angry they didn't have all the knowledge to help them make
the right choice, not guilty."
Kolar also is vice chair of the U.S. Breastfeeding Committee, a coalition of
41 advocacy, academic, medical and governmental organizations including
Health and Human Services and the FDA.
The initial versions of the TV, radio and print ads say babies not breastfed
exclusively for at least six months are more susceptible to ear infections
and respiratory illnesses, and more likely to contract asthma, allergies,
diabetes, even cancer.
After a Dec. 4 meeting, advocates agreed to drop the claims about diabetes
and cancer, but to keep the information about ear infections and respiratory
illness. "When you get into diabetes, obesity and leukemia, I'm not sure the
data is as strong," Sanders says. "We just didn't want the message to get
out and then down the line lose credibility if it's found that breastfeeding
doesn't affect [those diseases]."
This is in line with federal government guidelines that say breast milk is
best for at least six months-longer if possible.
Unlike the formula makers, the government has no problem with a campaign
that emphasizes the risks.
The dollars and sense
Formula companies stand to lose a lot of money if the government meets its
goals of raising breastfeeding rates. Noe declined to give specific figures,
but with Ross Products and Mead Johnson cornering 80 percent of the market,
formula sales constitute a major portion of the nearly $2.1 billion
generated by Ross' adult and infant nutrition division in 2002.
The companies also hold lucrative state contracts to provide formula to 7.5
million mothers enrolled in the federal and state Supplemental Nutrition
Program for Women, Infants and Children, known as WIC. Women served by WIC
are low-income and minority-the same women targeted by the campaign.
Noe insists, however, that Ross advocates breast milk as the best option for
optimal infant health. "We would support a positive, proactive campaign that
would focus on two things: First, we'd like to see a campaign that would
address the challenges of breastfeeding for women in the workplace, and
second, focus on increasing education and support for women in the WIC
program."
Kolar says she feels the government is committed to doing more to make
families aware of the potential risks in choosing not to nurse and the
benefits of choosing to nurse. She is optimistic the ads may begin running
as early as the end of January.
Eryn McGary is a Chicago-based writer.
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