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From:
Angela Hartfelder <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 21 Feb 2012 13:25:51 -0500
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Liz D - I hear and understand what you are saying, and I have good news for you; it can be done with relatively little pain!

Over the last twenty years in pediatrics and obstetrics, I have watched with interest just how large practices handle infant formula. It starts in the obstetrics office with giant boxes of free magazines and “important” information arriving for distribution in the obstetric goody bags given at the first visit. Into the bag these things go, chock full of endless formula, diaper, and childcare product coupons, samples, and hand outs; along with the physicians handouts on handling things such as morning sickness, intolerance to vitamins, Braxton-hicks, headaches, colds, and the numerous other things pregnant women have over the course of 40 weeks. I can remember when cases and cases of formula were delivered to the OB’s offices to be included in the bags. Not that OB’s really had any vested interest in what formula a baby would be put on, but everyone would coo with delight that they had yet another goody to throw in the bag. Of course, there were special congratulatory cases for any OB who became pregnant, or had a wife who was expecting. (And to anyone who thinks this doesn’t still happen, I had a consult recently in which the mother dumped out her goody bag from the OB’s office onto the coffee table and I counted no less than 5 different samples of types of formula!)

There is no less marketing to pedi’s, and yes mothers have been known to outright demand samples, even suggest that a pediatric office is substandard for not providing them. After all, how are they supposed to feed their baby if we don’t provide them with formula? (Yes, I’ve actually been asked this question.) But it can be done! The pediatric practice I work with serves a couple thousand patients who range from normal to intensive special needs, so it is not exactly a small practice. Not too long ago, we made the switch to stop carrying samples of any kind, be it medication, formula, or dosing spoons. What we found was that generally, there was very little fuss about it at all. There were certainly some who had been accustomed to receiving their supply of whatever in the form of samples, but they were simply answered with the statement that we no longer carry any samples at all. When discussing formula changes for intolerance or other issues, etc., we simply tell them the type, ie: soy. We do not specify brand names, or can colors. We also do not generally make recommendations for super special formulas such as added rice, or diarrhea formulas. We do discuss that there is really little difference between formula brands and no one brand is superior to any other. We also do a lot of discussion about normal baby behaviors, and ways to soothe baby’s other than with a bottle. If they are having difficulty providing formula, they are given a list of community resources to assist them. It is actually somewhat freeing for the office! There are no expiration dates to watch, no finding storage space for bulky packaging, no sample logs, no bags of things people left, or that they forgot to come pick up. Going cold turkey and making sure we knew what we were going to say, seemed to be the best plan and the transition was relatively painless.

Angela Hartfelder IBCLC, RLC

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