Soft drinks. Fast foods. Cigarettes.
Companies that market these products are well-known for targeting children and teens in order to develop “brand loyalty.”
But the campaign to capture the taste buds of future consumers begins even earlier–in the hospital nursery, where formula companies use aggressive methods to ensure that babies’ first taste of artificial milk comes early and bears the name of their company.
They know that parents are most likely to continue feeding the brand served to babies in the hospital.
What’s the problem with formula, and why is this a “green” issue?
Formula companies insist that they do not want to undermine breastfeeding–they merely want to compete for their share of the formula market for women who cannot or choose not to breastfeed. Sound familiar?
Cigarette companies have long claimed that they do not encourage smoking and only want current smokers to switch brands. Most governments reject this claim and severely restrict the way tobacco companies market their products.
Breastfeeding is an easy target. It’s free, already under attack, earns little profit for anyone and therefore has virtually no corporate funds backing it. But just one bottle of formula compromises a baby’s immune system and increases the risk of illness in the short and long term.
A bottle of formula implies that formula is endorsed by the hospital, and worse, sends the not-so-subtle message that the mother’s own milk is not good or plentiful enough. And just like it only takes a few cigarettes to become addicted, early introduction of formula can lower milk supply and is associated with early weaning.
Israel and the WHO Code
The World Health Organization (WHO) recognized the deleterious effects of formula marketing on the health of babies and mothers and its World Health Assembly passed the International Code of Marketing of Breast-milk Substitutes in 1974. The aim of the Code is to
. . . contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.
The Code prohibits companies from targeting pregnant women, parents and health-care workers with free samples and promotional and “educational” materials.
Israel is a signatory to the Code, indicating passive support. Unfortunately the Code has never been passed into law. There has been some progress: Gift bags of formula samples are no longer given out to mothers as they leave the hospital, and formula advertising and samples have largely disappeared from Tipat Halav, the government-sponsored well-baby clinics. Yet serious infractions occur with the tacit approval of the health ministry.
Formula Companies Target Public Israeli Hospitals
In January 2008, Ynet investigated the relationship between Israeli maternity wards and the two large formula importers, Materna and Similac. (A third company, Remedia, withdrew from the market after a lack of vitamin B-1 in a batch of soy formula led to the deaths of three babies.)
Despite the fact that the hospitals are publicly owned, the hospitals and the health ministry refused to release data regarding their agreements.
Ynet reported that every three years hospitals submit a tender for their supply of infant formula. Usually, an institution tries to buy a product at the lowest possible price. But in the case of formula the companies actually pay hospitals for stocking their products exclusively. Reportedly these contracts earn hundreds of thousands of dollars of shekalim for the public hospitals, and at least one hospital received valuable state-of-the-art equipment.
Others received outings for its staff, linens, and funds to hire additional “lactation consultants,” creating a serious conflict of interest. In return companies earned the right to provide a constant supply of pre-mixed bottles of formula with the company’s name and logo in large letters.
Ninety percent want to nurse, only 70% do
According to health ministry statistics, 90% of pregnant women intend to nurse, but a full 70% of babies receive their first bottle in the hospital. It’s easy for a nurse to offer a bottle to a mother who has even a mild concern about her baby’s feeding patterns. Worse, babies often receive formula against parents’ wishes. Hospitals allow a situation where overworked staff suggest formula instead of ensuring that trained staff sit with the mother, answer her questions and help her breastfeed. But Israel’s health-care system may be acting against its own interests by accepting formula money–one study showed that the it costs huge sums to treat health problems of formula-fed babies in the first year alone.
Big business must be kept out of the public health system through legislation, and Israel should not permit infant-formula companies to influence health-care decisions relating to newborns. Parents deserve accurate, unbiased information about the risks of formula. The health ministry must ensure that all mothers have easy access to instruction, information, and their babies–without input from self-interested parties.
Often there are questions about whether a newborn is getting enough to eat. The appropriate medical response is to evaluate the situation, and, if necessary, encourage the mother to express colostrum–her own antibody-rich milk. Formula should be reserved for cases when it is truly needed. Stopping formula gifts to hospitals is a critical step in ensuring that our babies get the healthy start they deserve.