Dear Mira Leibovich, MD and Lactnetters:

Remember the thread in the last week on the International Code of the
Marketing of Breastmilk Substitutes!  This is why we need this!!!

Dr. Mira, I assume you are very supportive of breastfeeding in your
practice.  Do you collect data on differing health care utilization
between the breastfed and the formula-fed babies?  If the health
insurance plan has to spend less money on health care for breastfed
babies, then they MAKE MONEY.

If you don't collect this data in your clinical practice, START TODAY!!!
You have to have HARD DATA to show the insurance company how
breastfeeding benefits THEIR BOTTOM LINE.

<< In the past I was told by the health insurance that they do this
because the company manufacturing these products donates "fun days" for
nurses, or something of the kind.>>

Does the health insurance company have this kind of agreement with any
other product manufacturer?  Would they consider entering into such an
agreement with a tobacco manufacturer or a chemical manufacturer or some
other industry linked with health problems? This is DIRECTLY ADDRESSED
in the Code.  Have YOUR nurses ever participated in this 'Fun Day'?
Does the company consider it ethical to receive such kickbacks, and do
they receive them from any other company (eg. Aspirin manufacturers)?
Do you HAVE to use these things in your clinic?

If you can demonstrate, at least in your clinical practice, that
breastfed babies have lower health care utilization, you may be able to
estimate company savings IN EXCESS of the amount of kickback they
receive -- wouldn't it be great if healthy breastfed babies sponsored
the "Fun Day"?  Then the company would see that participating in this
relationship is NOT IN THE BEST INTERESTS OF THEIR BOTTOM LINE.

<<I feel helpless, but I also feel SO angry.>>

Mira, you're a DOCTOR.  I bet there are lots of Lactnetters out there
who would give their eyeteeth to have a DOCTOR go to bat with them. So,
here's a strategy:
1.  COLLECT YOUR DATA
2.  Get a copy of the Code RIGHT NOW (if you don't already have one)
at:<http://www.gn.apc.org/ibfan/fullcode.html>  Find out if there are
any legal statues in Israel concerning this.
3.  Discuss this informally with other doctors of like mind under this
insurance company; see if the group of you can come to some consensus.
You may also want to do the same with hospital staff.
4.  Find alternatives for patient education (even if you have to make or
buy them. -- I know there are a lot of Israeli LC's out there who could
probably work with you).
5.  Take this consensus to the Medical Director or Committee for the
insurance company.  Point out how distribution of this material violates
your medical oath to do no harm.  Point out how the distribution of this
material makes the insurance company look hypocritical and lessens the
members trust in their physicians and plan.  Point out how the plan can
develop or distribute other material of equal print quality with better
information, funded through the savings they would generate on improved
health outcomes through bf.
6.  Do something for World Breastfeeding Week -- analyze the content of
the magazines and point out to clients how much money they would waste
if they bought into this stuff.

Okay Dr. Mira -- here's your mission (if you choose to accept it).

Good Luck!

--Doraine Bailey, MA
ILCA World Breastfeeding Week Coordinator
WBW 1998:  Breastfeeding: The Best Investment

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