Recent posts on hospital addiction to infant formula have sounded more and
more depressing in terms of how to respond to this. LCs, nurses, physicians,
etc who feel that something should be done about this have some tools to use
in their efforts to promote the health of mothers and babies.

1. accepting large sums of money may be creating a conflict of interest
situation
ACTION: inform the hospital administrators, the Board of Directors and the
chief executive officer of the hospital that the institution is taking money
in return for marketing and distributing a product that may be in direct
contradiction to the mission statement of the hospital. Administrators should
be informed of the importance of breast milk, the actual cost of purchasing
formula, that the hospital might receive more money from managed care
providers if the insurance carriers could save money elsewhere, and that the
cost of purchasing infant formula is passed on to the patient/insurer just
like mashed potatoes or other food for patients in other units

2. ACTION: Post a picture of a Trojan Horse next to the formula company
freebies with the dictionary definition: INTENDED TO UNDERMINE OR SUBVERT
FROM WITHIN

3. Consider this as an ethical problem or ethical conflict. ACTION: Contact
the person in your hospital who functions as a bioethicist (perhaps on your
human subjects review committee, the chaplain, etc) If no one in your
hospital specializes in ethics check a local university. Ask about the
ethical responsibility of both the staff and the institution in functioning
as a commercial distributor of breast milk substitutes. Does the hospital and
staff violate their ethical responsibility to patients in their care? Do they
follow the four principles in ethical decision making: beneficence
(benefitting the patient) how does free formula discharge packs benefit the
patient? nonmaleficence (do no harm) does this practice harm the
breastfeeding relationship? justice (is it fair to ask that we all pay higher
insurance premiums to take care of the increased illness from formula
feeding? autonomy (respect patients as equals in health care decisions and
encourage them to assume responsibility for their decisions (let's drop the
guilt issue as a reason of withholding infant feeding information)

4. Work on this problem from a different angle. ACTION: Contact your Quality
Improvement Committee. Identify this as a problem and ask that a task force
be formed to improve the quality of care through systematic intrvention. Do
not approach your immediate supervisor unless this person agrees with you. Go
directly to the Quality Improvement people.

5.ACTION: Write to your state Department of Health and make sure they know of
these practices. Most have a health care quality department that oversees the
hospitals licensure. Ask them how accepting free formula, cash bribes, and
free ski trips improves patient care.

6. ACTION: Contact your local TV stations. Most have a health reporter who
may like to do a segment on how health care delivery is being controlled by
commercial interests. When formula companies start to bribe maternity units
to change their breastfeeding policies in order to distribute discharge packs
it is time to blow the whistle!

7. ACTION: Contact your major newspaper and ask to speak to the people who do
investigative reporting. They may also wish to look at this practice and
publish it for all to see.