Howdy,
(This was my first post, but it didn't seem to be distributed. Sorry if
it is a duplicate.)

In regards to the recent comments about WHO code violators exhibiting at
recent breastfeeding conferences, I would like to suggest that the
decisions made by the breastfeeding organizations may have been
influenced by the arbitrary application of these guidelines in the past.
Perhaps this was a wonderful thing that will make us as professional
look at the issue more closely and come to some sort of agreement about
where we really stand! 
  
The WHO code issue is not black and white.  If a company is not code
compliant, is it a violation of the code to allow them to exhibit their
products that are not in violation of the code?  What if they are in
compliance in one part of the world but not in another? Who decides
whether a company is compliant with the code. There are many opinions
about interpretation of various parts of the code. Does marketing to
parents include displays at a retail store? (yes) Does the code apply in
the US which doesn’t have laws to support the code? (yes) What if the
company changes the name of the product and calls it milk
collection/storage containers- does that exempt that product from the
bottle designation? (no) Is a bottle that is required as part of a piece
of equipment for collection purposes violate the bottle clause?  (yes)
If a company does not advertise directly to parents, but provides
advertising with their company logo to use in advertising for a retail
establishment does this constitute direct advertising? (yes) If there is
advertising on the internet that states it is for health care
professionals only but does not block parents from viewing the site is
the information on the site intended for health care professionals in
violation of the code? (yes) What if the internet site says for US
markets only and is in violation of the code- is that company in
violation? (of course)

Making an exhibit code compliant does not negate the fact that company
is not code-compliant.  It is misleading. There is
implication/endorsement by association.  If a breastfeeding organization
supports a company by allowing them to exhibit or advertise, there is
the assumption that the company must be OK Refusing to allow a company
to exhibit, after already agreeing to it in a prior year, is a problem.
It is also loss of revenue for the conference.  A breastfeeding
organization cannot choose to apply the code discriminatorily to various
companies- allow the ones we like to exhibit and not allow those we
don’t. There is a problem with the arbitrary application of the code to
various exhibitors- there are companies that sell both bottles/nipples
and breast pumps. Breastfeeding organizations are currently not
accepting a code-compliant exhibit because of their bottle and nipple
marketing to consumers is in violation of the code from one company but
accept the other without complaint.  It is as though we are applying the
code to the companies we don’t like, but excusing the ones we do like.
There is a whole new industry developing to bottle breast milk and it is
difficult to assimilate it all. If a breastfeeding organization excludes
all of the code violators there would be very few exhibitors and it
would be difficult to learn about new products that may be helpful.
Members could be educated about products without the presence of
exhibitors   Sessions devoted to discussion of products, inclusive of
whether or not the particular company was code compliant could be a part
of the conference.  One solution is to not have exhibits, which can be a
major loss of income for the conference, plus additional loss of
advertising in publications.  Conference fees may have to be increased
with the potential loss of attendants. How many of you would attend a
conference with no exhibits and pay more to make up for the lost income?
Breastfeeding organizations need to be able to continue without
commercial revenue. Directors of breastfeeding organizations have an
obligation not to sink the ship financially.  If an organization is to
take a stand, the decision to do so must be made by the members and not
by the leadership!!!!! 

Based on article 7.4, breastfeeding organizations are within the
boundaries of the code to allow exhibits for the purposes of
professional evaluation.  In actual fact, if ILCA relies on 7.4 to
explain why one company can be there, they cannot really exclude anyone.
The article states, “samples of infant formula” etc.  Any company could
insist they be there on those grounds.  Most breastfeeding organizations
do maintain the right to refuse any exhibitor without cause or
explanation.

If breastfeeding organizations draw the line that the exhibit must be
code compliant, then  fail to provide educational opportunities for
their members- if they restrict these opportunities significantly,
members will not look to their professional organizations to learn about
new products, they will go elsewhere. So breastfeeding organizations are
caught between meeting member needs and their organizational commitment
to ethical support of the WHO code. If breastfeeding organizations only
insist that exhibits be code compliant, there is nothing to keep infant
formula manufacturers from exhibiting its human milk fortifiers (which
many members may be interested to learn about).  Nor is there anything
to keep another formula manufacturer from exhibiting Chocolate Candy to
energize our conference attendees. (Oh I can hear Marsha Walker now-
“Over my dead body…”) 

If breastfeeding organizations open the exhibits for the educational
displays for members we could theoretically exhibit all of the products
within the scope of the code- bottles, nipples, formulas etc. 
There have been changes in the economic, marketing and especially
communication environment since the time when the Code was written. Back
then, marketing to professionals was very distinct from marketing to
consumers.  Now consumers are getting information on their own and doing
their own research of the professional literature to make decisions.  We
never saw marketing of prescription drugs in the 80’s, but now it is
everywhere. Marketing works and these companies are unbelievably
creative in finding new opportunities to increase their market share and
profits. It really all does come down to money.

There is another issue of the US not supporting the code with law which
in some people’s minds makes it inapplicable here. Concern has been
raised re litigation due to anti-trust laws applicable to non-profit
organizations.  Does this not also apply to refusing ABM companies ?  In
addition, breastfeeding organizations are gaining more and more
knowledge about the implications of restraint of trade and we need to be
very careful about our legal exposure in this area. 

But remember there is endorsement by association, manipulation by
assistance and the symbiotic relationship built by taking money from
non-code compliant corporations which helps them to make more money!

Perhaps you can help answer these questions::
        Should breastfeeding organizations accept money from and provide
booth space and advertising  
        for companies  who are CODE violators?
        If so, why not accept from all code violators?
        If not, how do breastfeeding organizations decide which
companies are code compliant and 
which are not?
        What legal liabilities are associated with restricting trade?
        Do breastfeeding organizations allow non-code compliant exhibits
(members are attending as health care providers not consumers)?
        If so, why ask exhibitors to remove non-compliant items?
        If not, how do breastfeeding organizations educate our members
about these products?
        How do these policies impact their members?
        What is their obligation to their members? To their finances? To
their existence as an organization? To the broader breastfeeding
community? To maternal child health?
        Where do breastfeeding organizations draw the lines and how do
they make those decisions?
        If breastfeeding organizations can’t support the WHO code by
refusing to do business with violators, how can they expect the rest of
the world to do the same?????
	

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