Dear all:

I just reread several posts --- those asking for tolerance ---- not the entire stream which 
would take quite a while and I think there is something I am still not understanding.  I'm 
not sure if the "tolerance" means respecting a company that is offering misleading 
advertising or it means respecting women's choices.  I still see that the Code provides not 
only for us learning about alternative feeding devices and using these feeding devices 
appropriately and teaching mothers how to use these devices even when they may not be 
appropriate after we've given mothers informed evidence-based information. So, clearly I 
am missing something here.  

So, moving away from the flaws in marketing that I see causing harm to breastfeeding 
and nonbreastfeeding mother alike regardless of whether they are putting human milk, 
cow's milk or coca cola into those devices, I think we have a very rare opportunity with 
the economic crisis to try to make a difference.  We may not succeed, but why blow the 
opportunity.

When I started my graduate studies there were much tighter regulations on prescription 
medications.  HIV actually loosened up the regulations because the deaths that were 
occurring was used as leverage to get drugs to market faster --- and probably at that 
time appropriately so.  The regulations on marketing are so loose now that you can find 
commercials on TV claiming that cereal containing mini candy bars are marketing as 
being "part of a good breakfast".

I think the time is ripe to start advocating for more stringent regulations on bottle 
advertising. We have the "BPA" crisis that could be used as leverage. It is ironic to me 
that the "BPA" crisis prompted the only complaints to me about "well if someone had told 
me about BPA I wouldn't have poisoned my baby, while I haven't heard the same 
complaints about formula.  Because BPA is a chemical, because it is an "unknown risk" it 
carries far more emotional weight than "risk of aspiration" or "risk of overfeeding" or 
"risk of flow preference".  

Furthermore, there appears to be an opening for scientific research again. We really need 
independent research --- at good funding levels.  Lisa Sandori clearly did a great job with 
very little money.  Had some consumer research group expanded that research we could 
have a solid system of appropriate bottle labeling.

The reason why I say this is that the last time lactation consultants tried to evaluate 
breast pumps on their own, it resulted in law suits against the lactation consultants.  
Since everyone involved in these lawsuits was scarred by the economic impact on what is 
a low income profession, we will never publicly have the real details of either the function 
of that pump or the damage done by the lawsuits.  

I kept thinking of egg cartons when I met that wall of bottles. Eggs have "grades" and 
standardized sizes.  An egg labeled "large" is within the same range regardless of the 
distributor unless you have the good fortune to buy them direct from the farm, which I 
actually was able to do recently from a tiny little convenience store in the middle of the 
Poconos that bought them from the small little farm next door. I enjoyed the variety of 
those eggs.  When it comes to bottles, it is unfair to the consumer when a company can 
slap a label for flow rates on their bottles however they choose. There is no 
comparability.

Ditto for claims about pumps being new and improved when really the new and improved 
are just "beta tests" that women are having to test for the company for free. No one 
should have to buy a beta test version and suffer through sending it back in again and 
again just like we shouldn't have to beta test software either.  It used to be that beta 
testers were paid and were fully informed that they were beta-testers.  Now certain 
software companies put out their product before the bugs are worked out and it is 
definitely creeping into feeding devices and breast pumps.  

Similarly, I don't know how one could achieve this, but promotional samples of anything 
really shouldn't be a part of the health care industry.  EVEN MY DENTIST complains about 
the negative effect this has had on providing good care.  She struggles to figure out what 
products are good because there is no regulation and her peer-reviewed journals are also 
rife with research that has conflict of interest and the promotional samples do not work 
well for really figuring out what works.  It turns all patients into beta-testers. This should 
NOT happen with any products that might be necessary for health care.  People who take 
place in research trials are subject to informed consent.  If inadequate research has been 
done before these products are allowed to go to market, we all become beta-testers 
without being informed.  How many times have we heard a new report about a product 
that was not sufficiently tested?  

It seems to me that now is the time for the pendulum to swing back in the other direction 
and start fighting for ourselves and our clients to stop being subjected to beta-testing.  
We should also start fighting against the monopoly of "promotional samples".  These 
promotional samples are actually "anti"choice.

Best, Susan Burger

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