Mary's story is all too common. At NABA and at Ban the Bags we have noted  
that hospitals who have eliminated discharge bags have been blitzed by formula  
reps offering other goods and services, especially educational offerings. I 
just  wrote and posted a corporate compliance document at the Ban the Bags 
website, _www.banthebags.org_ (http://www.banthebags.org) , which may help in this  
situation. The May 31, 2003 issue of the British Medical Journal is full of  
articles on the relationship between pharmaceutical companies and health care  
providers, all of which is applicable to formula reps. Another good article  
is:
 
Katz D, Caplan AL, Merz JF. All gifts large and small: toward an  
understanding of the ethics of pharmaceutical industry gift giving. Am J  Bioethics 2003; 
3:39-46
 
NABA's "Selling Out Mothers and Babies: Marketing of Breast Milk  Substitutes 
in the USA" also discusses these practices.
 
This is a tactic to ingratiate themselves into a hospital maternity unit by  
appearing to offer the gift of "free" education. Nothing is free. Gift-giving 
is  a reciprocal behavior with something expected in return, usually to look  
favorably upon the gift-giver and reinstate the discharge bags. Remember that  
formula reps, as all drug company reps, are picked for their ability to 
"seduce  and persuade" rather than for their scientific knowledge. Reps carefully 
court  nurses because as an old Ross employee manual states, "Never 
underestimate the  role of nurses. If they are sold and serviced properly, they can be 
strong  allies. A nurse who supports Ross is like another salesman." Falling 
prey to  slick marketing tactics cheapens the nursing profession, places our 
patients at  risk, and allows industry to dictate health care. These educational 
offerings  may violate your own hospital's vendor policy and flirts dangerously 
 close to violating the Federal anti-kickback statute.
 
Both NABA and Ban the Bags are working to provide resources that will help  
eliminate some of this marketing. NABA is just completing its second round of  
Code monitoring in the US and will be publishing the US country report soon 
(as  soon as we can find funding to print it!). Ban the Bags is forming a 
strategic  plan for helping the nation rid hospitals units of the undue influence of 
 formula companies on clinicians and new mothers. Please let Ban the Bags 
know if  your hospital is bag free by visiting the website and filling out a 
short form.  You can see a list of all of the hospitals we know of so far that 
have  eliminated the bags. Get these reps off the maternity unit and spend the 
time  they waste with their visits and "educational" offerings on the mothers 
who need  our help.
 
Marsha Walker, RN, IBCLC
Weston, MA

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