I appreciated Janice Reynolds' advice to Brenda, and I agree that it's
better to attend the rep's talk and hear what she or he has to say than to
stay away. Getting information doesn't stain your ethical purity, but
ignorance would put you at a disadvantage if you join in any discussion with
your colleagues later on.

I also agree about not trying to debate the rep's points while attending the
talk. However, one reason we might want to speak up is if the presentation
strays from the "scientific and factual." According to the Code, baby milk
companies are allowed to market to health professionals (and that's what
this lecture is. . .marketing) provided that the information is scientific
and factual. They are not allowed to market to parents no matter what kind
of information they present.

A formula rep is ostensibly presenting information to the health
professionals about why his/her product is better than a rival product from
another company. They generally say the human milk is best and that their
product is not meant to replace human milk, only to be used when human milk
is not available. (I have to admit that I actually agree with that position.
In a case where human milk is not available for a baby--from the breast, or
expressed by the mother, or from a donor, a milk bank, or a
culturally-appropriate wet-nurse, then that is the reason to feed artificial
baby milks. I just think that in a well-run world where women had the
resources--time, information, food, support, and appropriate care--that they
need, there would be precious few babies with no access to human milk.) 

What we have to guard against--and this is why the LCs need to attend the
formula reps' presentations--is the claim that formula is BETTER than human
milk. This is how premie formulas have been marketed for years, and now I
see baby milk companies coming out with all kinds of "special" concoctions
for healthy babies' common infant feeding complaints: colic, apparent
lactose intolerance, reflux. Just as with the premie formulas, the LCs have
to to be there to monitor whether the evidence being presented is truly
scientific and factual. We need to do our best to be ready (at the next
opportunity) to present our own evidence-based recommendations, and where
the evidence doesn't exist, to make recommendations based on our experience
and our understanding of basic lactation science.  

Actually, we are at a disadvantage. So much of the basic research in
lactation management is lacking. An example would be Joan Fisher's expertise
in babies with lactose intolerance. We understand the theoretical basis for
her recommendations; we accept her "testimony" as an expert in the form of
case presentations. But when we suggest management changes to a mom based on
what we heard Joan say in an ILCA presentation, we don't have stacks of
articles to back up what we recommend. And I bet the formula rep can waltz
in to a hospital with a "lactose-free" formula and a bunch of studies that
show the efficacy of her product.

Ours is a tough job. We are not only trying to re-build a breastfeeding
culture and re-discover what our great-great grandmothers knew about how to
breastfeed normal, healthy babies, but we also are trying to figure out how
to make breastfeeding work for the challenging babies that probably would
have died in our great-great grandmothers' day. And we are doing this
without the huge financial resources that the baby milk companies can devote
to developing new products that displace breastfeeding. I think we are an
awesome group of health-care revolutionaries!

Cheers,
Chris 


Chris Mulford, RN, IBCLC
LLL Leader Reserve
working for WIC in South Jersey (Eastern USA)
Co-coordinator, Women & Work Task Force, WABA
 
 

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