The July/August issue of MCN (The American Journal of Maternal Child Nursing)
contained a pro and con column on the topic of nurses giving out discharge
bags with formula samples to breastfeeding mothers. Writing for the "con"
side were our own Cindy Curtis and Maurenne Griese who did a wonderful job in
a short space of getting the point across. Thanks to both of you for the work
and the passion that went into this. I could not resist writing a letter to
the editor about this practice and wanted to share it with all of you. As it
may not be printed, at least my thoughts have been put on paper.
Marsha Walker, RN, IBCLC
Weston, MA
July 10, 1999
Dr. Margaret Comerford Freda
Editor, MCN
1695 Eastchester Rd., Suite 301
Bronx, NY 10461
To the Editor:
I wish to comment on the "Second Opinion Pro & Con" columns in the
July/August 1999 issue of MCN. The question pertained to nurses offering
discharge formula samples to breastfeeding mothers. Formula discharge packs
are marketing tools designed to place a product in the hands of a consumer
(sampling for product recognition) from a respected source implying
endorsement (the nurse), to generate sales by creating brand recognition,
brand loyalty, and a need for the product. It has nothing to do with a
mother's infant feeding decision. Since mothers are seldom informed of the
side effects of infant formula, their decisions are less than truly informed
anyway. The discharge bags are usually handed out because the hospital has a
contract with a formula company stipulating this as a condition for receiving
thousands of dollars in cash, free formula, and gifts and gratuities for
staff.
The authors of the Pro column are looking at the wrong research regarding
discharge packs. Accessing the MARKETING research shows how the discharge
packs increase formula sales and elevate the market share of the sponsoring
formula company. The discharge pack is not therapeutic, contains nothing a
mother cannot find elsewhere, increases the chance of illness and allergies
in infants, and demeans the nurse to the position of an unpaid formula rep.
The formula discharge bags are designed to do one thing - cause the
breastfeeding mother to supplement with formula, decrease her milk supply,
and create the need for the product in a market that would not have existed
otherwise.
Giving out coupons and samples of disposable diapers is the exact same thing
- marketing and endorsing a product. When a nurse gives out discharge packs
of formula she violates any conflict of interest form she signed, generally
accepts gifts to do so, markets products to patients which is usually
forbidden, defeats the purpose of the hospital's mission statement, practices
outside the ethical standards of the nursing profession, and increases
commercial pressures placed on new parents. When was the last time you saw
nurses marketing Tupperware in the cardiac unit so patients had "handy,
reusable" storage containers for their lunches when they returned to work or
giving out coupons to smokers for low tar cigarettes?
The reason why hospitals continue to give out the discharge bags is that if
they stop this practice they lose the cash, gifts, food, ski trips, sporting
event tickets, coffee mugs, donuts, prizes, and gratuities that flow on
maternity units. Staff will lose the camaraderie generated by the friendly
formula rep who violates hospital vendor policy with impunity.
Let's stop beating around the bush and defending these practices. Nurses have
more integrity than this. They are strong, dedicated to good patient care,
and should not be used to further the goals of a greedy corporate America.
Thank you for your attention.
Sincerely,
Marsha Walker, RN, IBCLC
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