Keep Infant Formula Marketing Out Of Healthcare Facilities: Action Day

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Guest Post by Jodine Chase

In 2012 Jennie Bever Babendure, PhD, IBCLC, a mother, IBCLC in private practice and breastfeeding research scientist, became an overnight advocate for the protection of mothers and children from predatory marketing practices. It happened after she learned that the representative for the World Health Organization (WHO) in the Americas, the Pan American Health Organization, had accepted $150,000 from infant food manufacturers Nestlé.

Jennie spearheaded a social media campaign that drew global attention to the need for all who work in maternal and infant health to speak out about predatory marketing practices that erode breastfeeding.

[editor’s note: We often hear confusion at Lactation Matters between the marketing of infant breastmilk substitutes and the availability of these substitutes for families who, for whatever reason, need them. Jennie’s work, and that of others who uphold the WHO’s  International Code of Marketing of Breastmilk Substitutesfocuses exclusively on marketing. To learn more about the impact of predatory marketing on families, check out this piece by Norma Escobar here or this video from Public Citizen here.]

Shortly after Jennie’s campaign drew attention to Nestlé’s involvement in funding health campaigns in the Americas, IBFAN Latin America denounced Nestlé’s sponsorship of the hiring of 15,000 women to give nutritional advice on infant feeding in Mexico. The IBFAN action comes on the heels of a successful move in the US to curb infant formula advertising in hospitals by banning the distribution of infant formula giveaways to new moms.

The success of these efforts, such as those in New York City and the state of Massachusetts, means moms in those states are no longer exposed to formula gift packs in hospitals. A 2012 survey by Best for Babes found the practice is declining, and a 2013 survey by Public Citizen and Ban the Bags has found top-ranked hospitals in the US no longer distribute infant food product manufacturer gift bags.

Public Citizens says 75 percent of hospitals in the US still distribute formula gift packs. And many mothers are finding they are targeted before they even get into the hospital to give birth. Advertising that targets pregnant women by offering prenatal education in conjunction with formula giveaways at doctor’s offices and ultrasound clinics is on the rise. 

Jennie learned this first hand during her second and third pregnancies. I interviewed her as she prepares to join families who are responding to Public Citizen’s call for a Day of Action to end infant formula advertising in hospitals and health clinics. After the interview, learn more about the Day of Action and about efforts worldwide to support breastfeeding families by reducing predatory marketing.

Jodine Chase: As an IBCLC who has worked as an advocate to end predatory marketing, you are very aware of the tactics that infant food product companies employ to increase their market share. But you’re also a mother expecting your third child. During this pregnancy what marketing tactics were you personally exposed to?

At 10 weeks into this pregnancy, my husband and I went in for our first prenatal visit. A medical assistant handed us a “gift bag” when she ushered us into the exam room. While we were waiting to see the nurse practitioner, my husband opened the bag and started pulling things out. Along with information from the obstetrician on diet and scheduling our visits, there was a small makeup bag from Abbott containing samples of their Prenatal vitamins along with an invitation to join the Similac Strong Moms website, as well as a portable cooler bag from Mead-Johnson with the label “Powdered Formula for Nursing Moms,” with a can of powdered Enfamil newborn formula.

Breastmilk substitutes Jennie received during pregnancy

Breastmilk substitutes Jennie received during pregnancy

The Enfamil package also contained 2 Breastfeeding Guides: the “New Mother’s Breastfeeding Essentials” with a label from the American Academy of Pediatrics and “Breastfeeding: The Best Start for You and Your Baby” produced by Enfamil. My husband was perusing these guides with the bottles of formula on his lap when the medical assistant re-entered the room. When he asked her how giving formula to new moms was supposed to support breastfeeding, she gave a wry smile and said, “Yeah, that is a little strange, isn’t it?” When he further queried how these things ended up in the bags, she said, “Well, the reps bring us lunch along with boxes of these samples, and we put whatever they give us in the gift bags for moms.”

We had our next visit at another office of the same practice. On the front counter was an

Breastmilk substitutes at Jennie's OB's office

Breastmilk substitutes at Jennie’s OB’s office

11×14 gift basket filled with every type of formula Enfamil makes, wrapped up in cellophane with a bow on top. Looking at this, my 7 year old son asked me “Mom, what is that doing there? Aren’t they supposed to help moms breastfeed?”

2) Was it easy for you to see how the ad campaigns are designed to undermine breastfeeding?

This one is tougher, as the formula companies have gotten very slick at marketing themselves as supporters of new moms. They’re so slick that they’ve obviously got many healthcare providers convinced that they are only providing free samples to help, not to hurt breastfeeding.

By providing booklets about breastfeeding, breastfeeding support phone numbers and saying “breastfeeding is best” at every turn, they make it look like they’re really out to help moms, and only step in when needed. But how can you support breastfeeding by giving moms cans of formula?

The formula companies are very aware that putting formula into a mom’s hands makes it more likely she will use it. Having a physician or hospital give the formula samples to moms makes it look like a health recommendation.

In my second pregnancy I received 8 cans of formula by mail and over 200 advertisements/coupons for formula. I definitely didn’t need my healthcare providers to hand me more of this in the guise of breastfeeding support.

3) Did you ever find the tactics influencing or swaying you personally?

No, but I was very lucky. I delivered my first baby with a midwifery practice that was affiliated with a Baby-Friendly Hospital, and was not given any formula marketing material by healthcare providers or the hospital. Perhaps that is why receiving such a huge amount of these materials so early in my 2nd and 3rd pregnancies really shocked me.

Like many new moms, I really struggled with breastfeeding my first, who was a little early and had lost some weight. If I had been handed samples of formula by my midwife or hospital, I might have considered using it.

4) What do you see that a woman expecting her first baby may not have noticed? What do you want pregnant women to know about these practices?

Despite what formula companies would have you believe, the research shows that mothers who are given samples of formula by their healthcare providers are more likely to give supplementary formula to their breastfed babies, more likely to buy the brand of formula given in the sample, and more likely to introduce solid foods (which are often also made by formula companies) earlier than recommended.

There is nothing altruistic about these samples the formula companies provide, they are a wise investment in future sales. Yes, some moms and babies may need or want to supplement, but the formula marketing is aimed at all moms, setting them up to expect to need formula and doubt their abilities to breastfeed before they even start.

The only way for us to stop this from happening is to speak up. With enough pressure from consumers (us!!), the hospitals and healthcare facilities will get the message.

5) What will you be doing on Public Citizen’s Day of Action?

I have already signed Public Citizen’s petition. Since I can’t be there to help deliver the petition in person, I will be posting pictures of myself and my sons on social media asking healthcare facilities to stop acting as marketing arms for the formula companies. My older son is already very aware of these tactics, and I’m proud that he is learning to be skeptical of marketing campaigns. My hope is that by the time he has children, formula marketing in healthcare facilities will be a thing of the past!

Day of Action

Public Citizen, a nonprofit organization dedicated to championing citizens interests in the face of corporate abuse, is calling on infant formula makers to stop using hospitals and healthcare providers as marketing tools.

A Day of Action takes place on May 21st, both on social media and at Mead Johnson’s Chicago headquarters. Mothers holding hand-made signs with messages like “no ads in hospitals,” “keep ads out of my doctor’s office” and “follow the WHO Code” will be posting their pictures and videos on social media. They’ll be sharing on the Facebook event page as well as on Twitter and Instagram with the hashtag #NoFormulaAds. And thousands of people have signed the petition for Public Citizen to delivery to Enfamil maker Mead Johnson. The petition currently sits at over 17,000 signatures, with more rolling in each day.

Marketing of Breastmilk Substitutes Worldwide

The Public Citizen campaign focuses on changing practices in the United States. The marketing of infant formula impacts families worldwide. To learn more about efforts around the world, check out the links here.

IBFAN Africa
IBFAN Afrique (French Speaking West Africa)
IBFAN Arab World
IBFAN América Latina y el Caribe
IBFAN Europe
Baby Milk Action/IBFAN UK
INFACT Canada/IBFAN North America

This is, no doubt, an incomplete list. Share your local efforts in the comments and we’ll be sure to add them to this post.

Jodine Chase owns a public relations firm that specializes in news analysis for a select clientele. She is the curator of Human Milk News and with her husband has parented eleven children and stepchildren. She has three grandchildren and two more on the way, and she wants infant food product companies to stop targeting her daughter Rose and her unborn granddaughter (photo) with unethical marketing campaigns. She joined the Best for Babes Foundation board in 2014 to support the BfB C.A.R.E.-WHO Alliance, and she helps run INFACT Canada ‘s Facebook page. She is a founding member of the Breastfeeding Action Committee of Edmonton (BACE).

photo credits:

image of Jodine’s daughter Rose holding sign, courtesy Jodine Chase
images of breastmilk substitutes received during pregnancy, courtesy Jennie Bever Babendure

Do you have a story to share about your efforts to enforce and/or enact the WHO International Code of Marketing of Breastmilk Substitutes in your country? Would you like to share it at Lactation Matters? Please e-mail us at media at ilca dot org.

18 Responses to Keep Infant Formula Marketing Out Of Healthcare Facilities: Action Day

  1. Jeanne Batacan 20 May 2014 at 20:54 #

    Tomorrow, May 21 is the TAKE ACTION DAY to keep infant formula marketing out of healthcare facilities – which I am all for and have been for many years (Ban the Bag campaign). BUT, I believe that our hospitals and doctors bear a huge responsibility in this travesty. They need to put their patients health before perks and money.
    No demand…… supply.

  2. Rachel 21 May 2014 at 09:47 #

    This is so offensive. You’re making formula using mothers seem like drug dealers. I’m a stay at home mom who had her heart set on breast feeding. Thank god, however, the hospital sent us home with a six pack of ready to drink formula. When it turned out my son was allergic to my milk, I didn’t have to run around Walmart hoping not to blow my stitches looking for formula. What you’re doing is mom shaming. I shouldn’t have to search for formula like I’m looking for illegal drugs. If you don’t want the formula, don’t take it. But don’t shame the other moms who need it or want to have it on hand just in case.

    • Jeanne Batacan 26 May 2014 at 13:48 #

      This is not a “mommy war”. It is about hospitals, doctors and formula companies complying to a 30 year old health code.
      The World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes in 1981 to protect and promote breastfeeding, through the provision of adequate information on appropriate infant feeding and the regulation of the marketing of breastmilk substitutes.
      You may have been a victim of inadequate information, as there has not been a documented case in the medical journals where a baby was found to be “allergic” to breastmilk. In fact, babies that are allergic to both cow and soy formulas (and too many are) are given donor breastmilk in order to survive.
      “Allergy” was a common diagnosis in the 40’s and 50’s however when formula was becoming more popular for – and marketed to doctors and “modern” mothers. I hope your doctor did not tell you that your baby was allergic to your milk, because s/he should have known better. Your baby may have been reacting to something in your diet that was upsetting his/her system.
      With correct information and good support, the vast majority of mothers that struggle with breastfeeding find success. I fear you did not experience either – and I am sorry for that.
      So, again Rachel, the international code is not meant to shame anyone but the health care professionals that should be “marketing” health and nothing else.
      I hope you are successful with breastfeeding (if that is your first choice) with any future babies. And if your choice is to formula feed, I am sure you will not have to “search” for formula. It is readily available just about everywhere.

  3. Lr 21 May 2014 at 13:55 #

    Overreact much… I work in a hospital and we pass on all samples to new moms so they have them. Some people need to supplement with formula for health reasons or by their choice. The hospital- or office probably has some clients who might need those samples. However, in the interest of equity and non-discrimination they give them to everyone. You don’t want it- give it back to your provider, I guarantee there is someone who does want it. We alo give samples of leak guards and nipple cream. Get over some people wanting to have options.

    • Lee-Ann 22 May 2014 at 00:00 #

      These “options” provided by samples and marketing drives up the price for the moms who truly need, or choose, to use formula. This is not about fairness. You paying more for artificial milk in the hopes that I might fail is not fair, ethical, or medically responsible.

    • Jeanne Batacan 26 May 2014 at 14:04 #

      Your hospital administrators and nursing staff should read Code of Marketing of Breast-milk Substitutes. It’s been around for 30 years.
      The World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes in 1981 to protect and promote breastfeeding, through the provision of adequate information on appropriate infant feeding and the regulation of the marketing of breastmilk substitutes. Hospitals should market health and nothing else.
      It is a FACT that breastfeeding mothers who are given “free” samples, by uninformed nurses, doctors and institutions, do not achieve their own original breastfeeding goals nor the recommendations of the WHO, AAP or any other health organization in the world.
      In a sense, you are discriminating against a breastfeeding mothers choice to breastfeed by the subtle insinuation that she will fail and need to supplement.
      Breastfeeding works! If it didn’t, we, as a species would not exist.
      I hope your institution adopts the code and also strives to be designated as Baby-Friendly sooner rather than later.

  4. itzybellababy 21 May 2014 at 18:29 #

    Reblogged this on Itzybellababy and commented:
    Free formula undermines women’s attempt to successfully breastfeed their babies. Do not fall victim to this MARKETING strategy. You are not being helped by this practice.

  5. Diana Cassar-Uhl, MPH, IBCLC 21 May 2014 at 21:00 #

    It’s so important that we not dismiss the effect this type of predatory marketing can have on breastfeeding rates, especially among the most vulnerable populations in the United States and around the world. The illusion of “choice” is just that — an illusion. I know I cheered when this study was published last year. I encourage the skeptics who think formula marketing in healthcare settings isn’t a big deal to take a read.

  6. ECBrooks 21 May 2014 at 21:02 #

    New families need evidenced-based information and support to meet their infant feeding goals — whatever those goals may be. Marketing of commercial products to vulnerable populations undermines informed decision-making about healthcare. Happy Birthday to the International Code … a marvelous model public health policy that recognizes families deserve facts, not smoke-and-mirrors, when deciding how to care for their children.

  7. dkersula 21 May 2014 at 21:18 #

    I’m from one of those “waste not want not” families and found it very hard to throw away the formula samples I got in the hospital with my first baby. I never did use them but felt guilty! Rachel, what if the money put into formula went instead to milk banks so you could give your baby safe breastmilk in those bottles! Formula is not made by farmers, it’s made by Big Pharma. These are truly predatory marketing practices.

  8. Delores Doyle 23 May 2014 at 02:52 #

    Getting a package of formula like that, from a doctor you trusted, is severe psychological pressure. It is much worse than peer pressure because a Moma knows how many years of specialized education her doctor’s office represents…and, in most instances, she cannot match. Unless she has a good balance of info and supporters, it would be normal for her to at least try it or incorporate it…when she is busy, sick, or, leaves her baby with a babysitter. She might even believe her doctor would not rate her as a good Moma, if she didn’t use the formula.

    • Jeanne Batacan 26 May 2014 at 14:15 #

      And, Delores, we all know what that too often leads to. A mother who did not reach her own breastfeeding goals – because her breastmilk supply was compromised by the supplemental formula.

  9. Katherine 16 March 2020 at 13:14 #

    I believe giving the formula for free to someone who really could use some is not such a bad thing? There are a whole lots of cases in which moms have trouble with the supply so they have no choice but to put the baby on formula? Pediatricians don’t really suggest formula just because someone advertised it. I think they suggest only if they believe that the mother & baby could really use some help from the supplement.


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