Hi everyone,
Thank you for all of your great input. I am in agreement about not marketing to patients, and I have the opportunity to present research to my staff. So I have been doing some research and trying to put a presentation together for RNs and MDs, including the research from JAMA that showed that MDs are susceptible to marketing practices and they are influenced by feelings of obligation. I was looking for opinions/research to help me when I speak to them. I would prefer to make a policy of no freebies/handouts, etc. from any commercial company. But I'm just saying that's going to be a hard sell, I need to be very clear and logical in my arguments before I try to tell them that they can't take baby shampoo samples from Johnson & Johnson anymore. If I'm not backing this up with research, they are just going to shoot me down. 

As far as why we don't use other materials made by Lactation Consultants. Yes, I am finding some of these as I can, but I have to be honest, it's not that easy to find resource materials for women who have a low literacy level. I have found several excellent website of breastfeeding materials made by IBCLCs. However, I think we tend to write things at a high literacy level. These brochures often contain many words, and if there are pictures they are usually of white women. It's much harder to find materials that are simple, basic, have pictures of minority women breastfeeding, or are available in Spanish. It tends to send the message that only educated, white women breastfeed, I think. Sorry, don't mean to offend, I don't think people are doing this on purpose. We are just writing what we would want to know.

I think the LER website is a perfect example. I don't mean to pick on anyone here, there are many similar websites. But after reviewing those materials, they won't work for many of my patients. If you are working with educated women those are great resources. But of maybe 40 pages of handouts only 4 are in Spanish. I frequently work with 14 year olds with no prenatal care, most of my patients have a 6th grade reading level. I'm not going to be able to use these materials with them. I need materials that have few words, many pictures, preferably with women of color and every flyer must be in Spanish, too. Oh, and FYI, I have no budget. 

Someone asked why I would want to give a handout from Medela when I'm there to teach them. I like to teach them, but then give a handout as reinforcement. It's especially handy for women who are pumping to have written information about breastmilk storage. Finding a real lack of resources for our patients, I have written several on my own. But it's not so easy to get them translated. Our interpreters are incredibly busy and do not have time to translate. One of the best websites I've found so far is the government publications through DHHS, US Womens Office of Health. After the Surgeon Generals Call to Action last year, they printed some new publications about breastfeeding. But of course this year - budget cuts, so no more brochures. But they can be downloaded from their website so that is mainly what I'm using now.

I thought that the post was very informative about how Medela's purpose is really to sell breastpumps and other products, not promote breastfeeding. That is an excellent point.But I agree that there is a definite push towards pumping lately. In our journey to become BFHI, I spoke at the OB committee meeting, a new OB was there and the first thing she said to me sarcastically afterwards was, "Well, I hope you are giving all of these patients a breastpump!" So that's our main concern now? That everyone should have a breastpump? We need to be very supportive of pumping moms, but I agree there is a definite shift in the culture towards the assumption that everyone must pump. It's usually the first questions people ask about in the hospital now. Not how to getting breastfeeding off to a good start, it's lots of questions about pumping right off the bat. Even if they aren't going back to work.

Thanks again for all your informative posts,

Tricia Shamblin, RN, IBCLC

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