New mothers in our area of Madison, Wisconsin, USA have been
receiving boxes of Enfamil (Mead Johnson) powdered formula, delivered
unsolicited at home via first class mail. The packaging shows a
swaddled newborn baby. In large print, the box says "I am not a
baby. I am a newborn." Additional text in smaller print says, "As
the makers of Enfamil, we understand that newborns are different from
older infants - and different from toddlers, too. That's why we
created Enfamil Premium Newborn, the first stage of Enfamil Staged
Formulas."
The side of the box says "Designed specifically for newborns through
3 months, Enfamil Premium Newborn provides:
400 IU of Vitamin D in 27 fl oz. The American Academy of Pediatrics
recommends 400 IU of vitamin D daily.
An easy-to-digest protein blend
Natural Defense Dual Prebiotics designed to help support baby's own
defenses"
The back of the box says, "Discover Enfamil Staged Formulas. Expertly
designed to meet your baby's changing nutritional needs" and pictures
containers of Enfamil Infant (6 - 12 months), Enfamil Newborn
(through 1 month) and Enfamil Toddler (10 - 36 months).
Marsha Walker and others have posted in the past on the risks of
using powdered infant formula with preterm babies or infants under 4
weeks of age due to the fact that it is not sterile, and there have
been incidents of contamination and illness due to enterobacter
sakazakii (see, for example, Marsha's post of March 4, 2006). She
stated then that the European Food Safety Authority recommended that
no infant under the age of 4 weeks received powdered infant formula.
Now powdered formula is being mailed specifically to households with
infants under 4 weeks of age, including those who are exclusively
breastfeeding and with premature babies. This mailing campaign is
accompanied by similar, full-page advertisements in magazines for new
parents, such as "American Baby." And "American Baby" is sent to La
Leche League leaders, IBCLCs, childbirth class teaches, and others
who work with now mothers and babies, in hopes that they will
encourage them to subscribe.
Some mothers are bringing these unopened packages of formula to
mother-baby classes and support groups for new mothers with infants 0
- 3 months of age. They think it is helpful to share these packages
with the formula feeding mothers. But when these boxes are put out
on the table of "free - help yourself" items, it looks like the
sponsor of the class (in this case, a hospital) is endorsing the
product. It was suggested that the formula be given to a food pantry
instead. But this formula is not good for babies whose mothers have
to rely on Food Pantries for a source of food either. What do you
all think should be done with it? Maybe glue the box to a heavy
brick and mark it "refused," and take it back to the post office so
that it is returned to Mead Johnson, at a cost to them?
There is much to criticize in this campaign, including the misleading
information aimed directly at new parents and failure to disclose
pertinent facts. In the US, the WHO International Code of Marketing
of Breast Milk Substitutes is not law, and therefore it is not
illegal to advertise in this way. How do we combat this campaign?
Anne Altshuler, RN, MS, IBCLC, LLL Leader
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