AMERICAN ACADEMY OF PEDIATRICS
SECTION ON BREASTFEEDING
Date: December 20, 2002
To: Members, AAP Board of Directors
Eileen M. Ouellette, M.D., J.D
Robert M. Corwin, M.D.
Alan E. Kohrt, M.D.
David T. Tayloe, M.D.
Ellen Plummer Buerk, M.D.
Kathryn Piziali Nichol, M.D.
Gary Q. Peck, M.D.
Jon R. Almquist, M.D.
Burton F. Willis, M.D.
Charles W. Linder, M.D.
President: E. Steven Edwards, M.D.
Executive Director: Joe M. Sanders, M.D.
CC: Carden Johnson, M.D.
Louis Cooper, M.D.
Roger Suchyta, M.D.
From: AAP Section on Breastfeeding - Executive Committee & Leadership Group
Subject: New Mother's Guide to Breastfeeding
While we appreciate the opportunity of meeting with Dr. Sanders, Dr.
Suchyta and members of the Board of Directors at our Section Executive
Committee session in Boston, we must express our disappointment with the
content of the discussion, the outcome of the meeting and lack of clear
resolution of the issues. Considerable discontent remains among not only the
Executive Committee and Committee Chairs, but section members and members of
the breastfeeding community within and outside of the AAP membership. We
feel that you were not responsive to our concerns and did not fully
understand the depth of concern that we have with how this matter was handled
and continues to be handled. You have not demonstrated an understanding or
concern that the reputations of the editor of the book, Dr. Joan Meek, and
those of us who are contributors to the book have been compromised. No
apology or effort at remediation has been forthcoming from the Academy
leadership to us or to the breastfeeding community. Similarly, there seems
to be little recognition of the harm that has come to the Academy's
reputation as a leader in the field of breastfeeding and child health nor any
effort to repair that sullied image of the Academy.
The plan presented to us for the next set of books to be purchased by
Ross, if they choose to do so, with their name and logo again on the front
cover, albeit with a statement that the book is a "gift from Ross" was made
without any input from the authors or members of the section and is not
acceptable. We request the opportunity to enter into open discussions about
other ways in which Ross could be acknowledged. This dialogue is consistent
with the "first step in establishing a collaborative relationship…" as stated
in the AAP Policy Manual Chapter V, Page 6. The same policy manual
recommends that the name or logo of the commercial organization "be placed,
when possible, either on the inside cover or the back cover of a
publication." (Page 4) Negotiations that include Ross (or other commercial
enterprises), our leadership group, and Academy leadership may produce
alternatives upon which we can all agree, such as a book wrapper. The AAP
Policy Manual also states that "When the product (in this case infant
formula) is relevant to the program (breastfeeding) special care must be
exercised in the recognition language and placement to avoid any implied AAP
recommendation or endorsement of the product."
At this time, we would appreciate receiving in writing:
1) a description of the plan for future sales of the New Mother's Guide to
Breastfeeding to Ross or any other commercial purchasers.
2) a plan regarding commercial sales of all publications which the Section
on Breastfeeding would produce in the future. Two of these publications (the
Physicians' Handbook and the Slide Set for Teaching) are underway, but will
not be finalized until we know how the issue of sales will be handled.
These statements in writing would provide an opportunity for discussion, not
final decisions. We feel strongly that this is a matter which should be
decided through discussion with the Section leadership and the authors of the
publications. This document may serve as a model for other committees and
sections of the Academy, many of whom have similar concerns and have
expressed support for our position in this matter.
Many members of the Section on Breastfeeding, and others within and
outside of the Academy, have expressed sufficient concern about this issue
that they have said they are considering resigning from the Academy. We have
urged them not to take that path, but to remain in the Academy as an active
force for breastfeeding advocacy. Overt actions on the part of AAP
leadership to demonstrate a commitment to the principles of ethics in
marketing and responsible collaborative relationships with corporate sponsors
are needed now to reassure our membership.
We were encouraged to hear from several board members that there was
discussion of preparing a general document on commercial relations for member
and public use. We urge that this new document be developed with open input
from all interested AAP members.
Each of us looks forward to receiving more information from each of you
regarding these issues and to meeting with you for discussion of these
matters. We want the American Academy of Pediatrics remain a respected
advocate for breastfeeding and we are prepared to make every effort to work
with all of you to assure that this occurs.
Leadership Group - Section on Breastfeeding
American Academy of Pediatrics
Executive Committee
Lawrence M. Gartner, M.D., Chair
Audrey J. Naylor, M.D., Dr.PH
Linda Sue Black, M.D.
Ruth A. Lawrence, M.D.
Donna O'Hare, M.D.
Richard J. Schanler, M.D.
Liaisons
Nancy F. Krebs, M.D.
(Committee On Nutrition)
Alice Lenihan, MPH, RD, LDN
(National Assoc. of WIC Directors)
John Queenan, M.D.
(Am. College of Obsteticians & Gynecologists)
Committee Chairs
Mary Dobbins, M.D.
Arthur I. Eidelman, M.D.
Lori Feldman-Winter, M.D.
Larry Pickering, M.D.
Susan Landers, M.d.
Yvette Piovanetti, M.D.
Nancy Powers, M.D.
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA
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