Cathy, you make a clear appeal for understanding of the ethical 
dilemmas thrown up by researchers working with industry, and ask the 
important question 'if industry does not fund the research, who 
will?'. I don't have the answer to that, but while we have 
industry-funded research, it is *imperative* we have world-wide 
protections for breastfeeding ans breastfeeding women and children 
vis a vis the *marketing* of any results.

Yet you raise the possibility of removing a major part of this protection:

>
>Much is often said about "code violations" in regard to the advertising of
>bottle and teats for the administration of EBM. Given the ever increasing
>numbers of women needing to use these aids to give their babies breastmilk
>(esp mothers returning to work) should we consider changing this part of the
>code?

The Code is the only thing that stands in the way of unethical 
marketing of infant feeding products to mothers.

We can't rely on researchers to prevent unethical marketing - they 
have little control over how the results of their work are presented, 
anyway. We have also seen an example of how the usual thanks and 
acknowledgement of industry-backing can become more than the 
formality it should remain, in Rachel Myr's account.

We certainly can't rely on the medical profession - in the UK  HCPs 
are banned by law from giving out free samples of formula (for 
instance), but in countries where this law is not in place (eg the 
USA), mothers frequently get samples either from or via their 
doctor's office.

Sadly, actually heart-breakingly, we can't even rely on breastfeeding 
supporters/breastfeeding professionals to stand in the way of 
unethical marketing. Nursing and other journals throughout the world 
take misleading advertisements from industry; midwives get help with 
their education; HCPs are offered 'free training' and seminars. On 
this very list, some posters *persist* in confusing the criticism of 
marketing with criticism of a product (which may or may not be 
useful) and end up defending the usefulness of a product.  It's crazy 
that some people cannot even see that the complaint is about 
*marketing*  - but it sure as anything plays into the hands of the 
marketeers.  If people can't even see when something is unethical and 
undermining to breastfeeding, or think it somehow doesn't matter 
because the product is/might be good, then the marketeers have won.


>  I have seen the view that business shouldn't be allowed to advertise
>directly to mothers for this purpose and that they could advertise to us
>only, who would then make the decisions about what is best for a mother to
>choose. This struck me as being very paternalistic, I would be interested to
>hear what others have to say on this.

  Under the Code, advertising to HCPs *is* permitted of an 
informational nature - in fact, a lot of advertising is very far from 
that (another post could explain why but I hope most people here 
would know what I mean). Professional ethics would demand we share 
information with parents.  I think parents should have as much 
*information* as they want - unfiltered by someone who is trying to 
sell them something.

What you are asking for is a removal of protection for all mothers 
and babies, actually, including formula/bottle feeding mothers and 
babies. Advertising is not information - now this does not matter if 
we are talking about washing powder, or cars, or breakfast cereals. 
But when we are talking about something that undermines 
breastfeeding, and bf is socially and culturally *fragile*, we need 
to take more care.

The Code is also the only international benchmark for ethical 
marketing, and is a major part of international public health - it 
allows HCPs and lay organisations to work together, to speak with a 
unified voice, on what constitutes protection of breastfeeding.

The suggestion that it should be watered down, and to permit a 
free-for-all marketing fest, uncriticised by the breastfeeding 
support community, would leave mothers and babies at the mercy of 
'businesses' - and actually far less well-informed than they should 
be.

Heather Welford Neil
NCT bc, tutor, UK
-- 
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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