Katherine has described an ever more frequent situation whereby Ross Products
or Mead Johnson salespersons remove their regular brand of formula from a
hospital and replace it with Similac Advance (Ross) or Enfamil Lipil (Mead
Johnson). This is usually done with no input from any health care professional in
the building and without bothering to inform ANYONE! One chief of pediatrics was
so angry when this happened that he threw out all of the formula salesmen
from the maternity floor and stopped giving out the formula discharge bags!
Sneaking out the regular formula now puts the companies in the driver's seat,
dictating what newborns can be fed. Because your hospital is Baby Friendly and does
not give out the commercial bags with the formula sample, the companies must
resort to sampling in another manner. Marketing research tell them that
whatever formula the baby is started on in the hospital the mothers will use when
they go home. Therefore starting them on Lipil or Similac Advance almost always
assures the company that the mother will buy the more expensive formula after
discharge.

I priced these formulas in the grocery store: Similac powder 14.1oz can was
$11.99. Similac Advance 12.9oz can was $11.99. The cans look the same size but
mothers pay 10% more for the Similac Advance. Similac regular 1 quart
ready-to-feed was $4.49. Similac Advance was $5.69 a 27% increase.

Your hospital has some options. The companies are not going to continue
making the hospital systems of formula feeding, but the regular formulas can still
be purchased. Have your purchasing department buy the regular formula from
someone else, a wholesaler or a retail establishment. The store brand formulas
(Wyeth) and Carnation have added the supplemental fatty acids so your hospital
may wish to explore the use of the new organic formula that is coming out this
fall. Martek Biosciences (the manufacturer of the fermented microalgae and
soil fungus-derived additives) has made sure that all formulas will have this
additive. The percentage of formulas with their ingredients has gone from 2% to
28% in 18 months and will continue climbing, as will their profits.

Ask your ethics department for an opinion on this. Remind your risk
management people that these new formulas are under post market surveillance and have
had a number of side effects observed. There is data showing that their use
does not make babies smarter, they do not see better, babies can make their own
DHA and ARA, that the use of these formulas interrupts the antioxidant system
in the body, and along with the fatty acid supplemented pureed baby foods, may
actually lead to overweight and obesity.

Keep a log of the increased amount of vomiting and diarrhea seen in the
babies given these formulas. Report all side effects to the manufacturer (not the
salesman) and to the FDA's MedWatch program. Advise mothers to watch for the
side effects also. It's time to stand up to these companies whose sole purpose
in adding this stuff is to make more money. How about reporting the companies
to the Better Business Bureau? How about reporting the companies to the Federal
Trade Commission for false and misleading health claims? Why add something
babies can already make, especially when the data simply does not support the
claims!

Marsha Walker, RN, IBCLC
Weston, MA

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