When NABA completed its second round of Code monitoring this fall we found  
that in the US, formula salesmen usually have unlimited access to the maternity 
 unit. Most do not follow the hospital's vendor policy of making an 
appointment  for a specific purpose and registering with the purchasing department, 
etc. They  just show up with food, trinkets, and games to carefully court the 
nurses into  using, defending, and peddling their products. They do not have 
contact with  patients as they simply get the nurses and physicians to sell their 
formula for  them. The Ban the Bags campaign has shown that nurses are the 
single most  difficult barrier to surpass when a hospital wishes to eliminate 
discharge bags.  Many formula salespeople have a quota to meet, whereby a certain 
number of  babies from the hospitals that they cover must be fed formula one 
way or  another. Food is a way to break down the barriers between the 
professionals and  the salesmen. People will look more kindly upon the salesmen and 
come away with  closer ties to that person no matter what the salesman is saying 
or selling.  This is why maternity units should never allow these people to 
provide food. We  also found that management in many hospitals refuses to act 
in an ethical manner  and within corporate compliance when it comes to formula 
salesmen. These  salespeople have ingratiated themselves into the unit culture 
to the point where  some nurses and physicians cannot distinguish between 
salespeople as vendors or  sales people as part of the health care team. The 
salesmen are treated as if  they have a say in what and how babies are fed. Most 
of the salespeople are  hired for their persuasive abilities not because they 
have any scientific  training. 
 
Marsha Walker, RN, IBCLC
Weston, MA

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