I thought I would chime in with my two cents on Brenda's description of the  
commonplace practice of formula salespeople being mistaken as members of the  
health care team by managers who have more loyalty to formula companies than  
they do to patients. You owe no allegiance to formula salespeople. The ethical 
 underpinnings of health care delivery specify that our duty and obligations 
are  to the patient not to corporate interests. NABA has long had this in 
print in  its Code monitoring report Selling Out Mothers and Babies. In the 
Executive  Summary of Selling Out Mothers and Babies is a quote that I use when I  
in-service hospital nurses on this issue. This quote is from an old Ross  
employee manual that allows nurses to see how they are viewed by their  
pseudo-friends the formula salesmen. It helps them understand that they are  being used 
to peddle a product that has the potential for harm:
 
"Never underestimate the role of nurses. If they are sold and serviced  
properly, they can be strong allies. A nurse who supports Ross is like another  
salesman."
 
You may wish to share this quote with your director and the other nurses on  
your unit. The type of situation you describe cheapens the nursing profession. 
 While never sharing any information with formula salespeople, you could 
share  with your director and colleagues that the DHA supplemented formula is 
still  technically under what is called post market surveillance. That means any 
side  effects seen from the use of this formula is to be reported to the 
manufacturer  and the FDA's MedWatch program. How many of the babies on your unit 
who receive  this formula suffer diarrhea and vomiting from ingesting it? This 
should be  logged and brought to the attention of the chief of pediatrics and 
the  FDA.
 
You might wish to secure a copy of your hospital's vendor policy to make  
sure that the formula salespeople adhere to it. Verbal abuse should be reported  
to your human resources department.
 
Please consider mailing me any of the materials that were used in this  
presentation such as the handouts and the paper that stated how much the company  
paid for the presentation so that I may use them in the next round of Code  
monitoring. That $2000 came from the mothers who purchase formula, a  product 
that is vastly overpriced.
 
Marsha Walker, RN, IBCLC
Weston, MA

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