Except for Baby Friendly hospitals, almost all other hospitals accept free
infant formula for use in their nursery as a condition in contracts they have
with formula companies. In looking at a copy of such a contract, the formula
company typically gives the hospital a large amount of cash that is unrestricted
in its use. The hospital also receives specialty formula, volu-feeds, and
other equipment, help with attracting physicians to the hospital, architectural
services, water bottles, discharge bags, etc. All of this is given with the
expectation of something in return: use of the formula in the nursery (creates
brand recognition), distribution of discharge bags (creates brand loyalty),
unrestricted access of formula salespeople to the maternity unit even though they
violate the hospital's vendor policy, attendance at sales pitches that
masquerade as in-service education programs (to create loyalty to formula use and
discredit breast milk and breastfeeding).
I reported these practices to the Inspector General of the Department of
Health and Human Services who said that hospitals who engage in these practices
could be violating the federal anti-kickback statute and be placing themselves
in a position of not being able to receive Medicaid reimbursement. You can have
your corporate compliance officer check on this issue. Infant formula is a
food that can and should be part of the room and board charge, the same as
foodtrays are for any other patient in a hospital. Purchasing infant formula
amounts to about $.50 or so per feeding which comes out to about $3.00 a day. The
price tags formula companies give the hospital is not for what the formula would
cost to purchase, but the value the company places on the cash, equipment,
and supplies that they give to the hospital.
Hospitals have become dependent and addicted to formula company money. Money
buys influence which is why there is so much resistance to eliminating this
plague from our hospitals. Hospitals can easily purchase the amount of formula
they would need for non-breastfed infants, they just can't break their
addiction. Supplementation rates of breastfed infants in the US is now at 23% which
works towards formula company goals of creating the need to purchase formula.
Marsha Walker, RN, IBCLC
Weston, MA
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