> These representatives are rampant in my area(Texas).They are now offering
> CEUs  and what I interprete  as emotional support etc. They are also
> overstepping their boundaries and at least one is quoted as telling some
> nursing staff which formula to give

One way would be to print out The International Code of Marketing of
Breastmilk Substitutes
(WWW link at: http://www.io.org/~infacto/codeview.htm )
and share it (in a nice way) with colleagues - raise their
consciousness!! and professionalism!!

I start all my professional educational presentations with The
International Code and appropriate goals from Healthy People 2000,
reminding my colleagues that this nation has determined that
Breastfeeding goals are ...(etc)

Specifically, I wonder if direct comments to the formula reps -
referencing appropriate code sections, of course - might also help (but
I doubt it; I'd still try.) or at least the hospital Director of Nurses
and/or CEO.

For instance, the CEUs should not take place in the hospital or
home-health agency (a hotel would be acceptable, but then what nurse
would go?):
"NO promotion of products in health care facilities, including the
distribution of free or low-cost supplies"

The CEUs should not be free (How many nurses or physicians would attend
*formula* inservices if they had to pay for it??!!?):
"NO gifts or personal samples to health workers"

Yet at the same time, to be fair, the formula reps are supposed to
direct their advertising *to us* the healthcare folks and we should
demand scrupulous data when they do so:
"Information to health workers should be scientific and factual"

If we do not let them advertise to us - as they should - they will feel
justified to continue and increase advertising to the consumer. This is
difficult, as most nurses and physicians are not necessarily aware of
the subtle coercions inherent in clever advertising. But the next time a
formula company wants to be present at a professional conference, that
is where they are supposed to be with this activity. It doesn't mean we
have to act on the advertising.

Katharine West, BSN, MPH, IBCLC(exp)
Sherman Oaks, CA