In case anyone wants to see a template for what this kind of advocacy can
look like, I'm copying & pasting the email I sent to the hospital that's
allowing the formula company to sponsor the breastfeeding webcast that
they're hosting for local professionals. (Quote it freely if anyone needs to
borrow from it in part or full!)

Understand that this comes after I initially contacted the hospital in
question via email (names redacted, though honestly, maybe I should print
them and warn people! ugh!). The Director of Maternal/Child Health contacted
me via phone today, and this is my follow-up email to her. (MANY thanks to
Lactnet-ers who helped me by offering their thoughts on the situation!)

Hi [name redacted],

Thank you so much for calling me this morning to discuss the breakfast and
webcast. I really appreciate your willingness to discuss this important
subject and change how these things are sponsored in the future.

As we discussed, here are a couple of links that I referenced during our
conversation. Of course, I'd be happy to follow up on any questions or
concerns.

*Regarding whether it is necessary to promote brand-name formulas (in
general or a specific brand) over generics: **[she claimed it was necessary
to have formula reps sponsor things like this, so that the practitioners at
the hospital can promote specific brands of formula - otherwise, "moms might
just buy whatever's on sale." I kid you not, Lactnet'ers! OY!]*

"Do "house brand" or generic infant formulas differ nutritionally from name
brand formulas?

All infant formulas marketed in the United States must meet the nutrient
specifications listed in FDA regulations. Infant formula manufacturers may
have their own proprietary formulations but they must contain at least the
minimum levels of all nutrients specified in FDA regulations without going
over the maximum levels, when maximum levels are specified."
http://www.fda.gov/Food/FoodSafety/Product-SpecificInformation/InfantFormula/ConsumerInformationAboutInfantFormula/ucm108141.htm


The safest infant formula is one that is organic and doesn't contain the
multitude of chemicals in mainstream formulas.

*In short, the primary difference in price is due to the large dollar
amounts spent on marketing by name-brands, that is not spent by generics.
 The dollars Mead-Johnson committed to this breakfast are an example of why
their product is priced higher than generics.*


*Regarding the IBCLC Code of Ethics:*

IBLCE Code of Ethics [by which all IBCLCs are bound] (Tenet 24) says:
 IBCLCs must support the WHO Code [see below], as it applies to health
workers. http://www.iblce.org/upload/downloads/CodeOfEthics.pdf

WHO Code for Marketing Breast Milk Substitutes (Article 7.3) says:
No financial or material inducements to promote products within the scope of
this Code should be offered by manufacturers or distributors to health
workers or
members of their families, nor should these be accepted by health workers or
members of their families
 http://www.who.int/nutrition/publications/code_english.pdf

Ergo, *IBCLCs are in violation of their Code of Ethics by partaking in a
breakfast sponsored by a formula company*. They are thus compromising their
credential in doing so.

So, for this particular event, any IBCLC in attendance is forbidden by their
Code of Ethics to partake in the breakfast. It's perfectly acceptable for
them to attend the webcast; they just can't have the breakfast that
accompanies it.

Given the CDC's recent announcement that* 96% of hospitals are not
adequately supporting breastfeeding*, the odds are overwhelming that
[hospital name redacted] is within the 96% that's not doing enough.  I would
hope that given this opportunity to do something to strengthen the
hospital's stance on breastfeeding support by *not allowing or inviting
formula companies to sponsor breastfeeding-related events *(for the public
or professionals), that you would seize this opportunity and forego any
sponsorship dollars from formula companies for this and future events.

Best,
Amy

So, there you have it. It's awfully discouraging to run into this level of
pushback regarding this issue, but the only way things will change is if
people speak up, and keep speaking up. I'm approaching a ridiculous level of
burnout - I feel like I'm always the one on this soap box! - but someone has
to be. If not, we certainly can't expect anything to change!

Coming back to this "home base" is a breath of fresh air...sometimes, you
need to preach to the choir to recharge your batteries!

With much gratitude,
Amy West, CLC

On Wed, Aug 3, 2011 at 12:30 PM, Elizabeth Brooks <[log in to unmask]> wrote:

> IBLCE Code of Ethics (Tenet 24) says:  IBCLCs must support the WHO Code, as
> it applies to health workers.
>
> WHO Code (Article 7.3) says:  Health workers will not accept freebies from
> manufacturers of WHO-Code-covered products who are not meeting their
> [ethical marketing] obligations under the Code marketing in compliance with
> the WHO Code.
>
> Therefore:  GO to the breakfast ... because as lactation advocates we need
> to hear what our colleagues and clients/patients are hearing.  Even if the
> webcast has speakers who are not connected to industry, you need to hear how
> that nice little free breakfast is being promoted.  But as an IBCLC or
> WHO-Code supporting attendee, do NOT accept the free food.
>
> And schedule a meeting someone in the very near future, with the hospital's
> staff education department, and/or risk managers, and/or quality
> improvement/quality compliance departments, and/or pediatric/OB/NICU
> department heads.  Come armed with a copy of the Surgeon General's Call to
> Action to Support BF, so they can see why the Nation's Public Health Doctor
> has called on *all* health workers and facilities to support BF ...
> including pointed language at Action 6 about the negative impact of formula
> marketing on BF exclusivity, and the need to be conscious of the WHO Code
> even if it is not legislated in the USA.
>
> And if everyone is acting sleepy, whisper "Joint Commission" and "exclusive
> BF"  and "perinatal care core measure" in the same sentence and see what
> happens.
>
> There is a lot in the Lactnet Archives about this topic of freebies and
> enticements to health workers by marketers who are not meeting their WHO
> Code obligations.
>
> --
> Liz Brooks JD IBCLC FILCA
> Wyndmoor, PA, USA
>

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