Tag Archives | Ban the Bags

Applauding Maryland’s Ban the Bags Initiative

The Maryland Breastfeeding Coalition has recently initiated a movement to “Ban the Bags” in Maryland. They sent the following letter and video outlining their efforts to to the CEOs of all birthing hospitals across the state, requesting the removal of all commercial infant formula discharge bags. We applaud their efforts and look forward to hearing how their actions support mothers and babies in Maryland. We hope that their letter and the influence it has can serve as a model for other states and countries to make the same changes in their communities.

banthebagsThe Maryland Breastfeeding Coalition lauds and strongly supports the recent release of the Maryland Hospital Breastfeeding Policy Recommendations by the Maryland Department of Health and Mental Hygiene (DHMH). As part of these recommendations, in an effort to protect and improve maternal and infant health in our state, we write today to urge your hospital to join with all hospitals in Maryland in discontinuing the distribution of commercial infant formula discharge bags. The initiative to ban the practice of marketing formula by health care institutions and professionals in all birthing hospitals is supported by DHMH’s recommendations, as well as other public health authorities, including the American Academy of Pediatrics, the Centers for Disease Control, and the 2011 Surgeon General’sReport.

Banning the bag is feasible!  Your hospital can join those hospitals that have committed to protecting breastfeeding and refuse to act as marketing agents of formula companies.  Several Maryland hospitals have already banned the formula company discharge bags without significant hardship or obstacles. In the process, they have been able to simultaneously increase their marketability.

  • Through working with their purchasing and marketing departments, some like Upper Chesapeake Medical Center and Shady Grove Adventist Hospital have designed and distributed their own discharge “gifts” which advertise their respective hospitals.
  • Johns Hopkins Hospital stopped giving out formula samples over three years ago as part of a hospital-wide effort to stymie the marketing of pharmaceuticals within its facilities.  The hospital administration has chosen not to give out a replacement bag.
  • Other hospitals such as Memorial Hospital at Easton discontinued distribution at the behest of Risk Management upon investigating their liability in the event of a formula recall or a baby getting sick from expired or contaminated formula.

While these hospitals and others no longer hand out formula bags upon discharge, banning the bag never prevents a mother from obtaining free formula samples if she so requests.   She can simply be directed to call the toll-free number on the back of every formula container to receive free bags, coupons, or samples. Your hospital aims to promote the health of infants and mothers, but when providing the bag and/or formula samples, the ongoing promotion of infant formula sends the inaccurate message that these products are medically approved, endorsed, and necessary.

The Maryland Breastfeeding Coalition has prepared a brief power point presentation to highlight the research regarding the effects of formula discharge bags and discuss further how hospitals can approach banning the bags. We encourage you to view and share it with your staff.

For more information, you can browse www.banthebags.org, and Public Citizen .  You can also visit the website of the Massachusetts Breastfeeding Coalition which has successfully led all 49 of Massachusetts’s birthing hospitals to ban the bag.  Our own Maryland Breastfeeding Coalition website will soon contain links to the You Tube video for staff and other resources. Help us make Maryland the next state to successfully put the health of our youngest citizens first by banning the formula discharge bags from all birthing hospitals. Please contact us if the Maryland Breastfeeding Coalition can be of further assistance to you, or if you have any questions.

Please share this information with other relevant departments within your hospital. We very much appreciate your time with this matter.

What is your community doing to eliminate the marketing of formula in your hospitals?

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World Breastfeeding Week: Massachusetts, USA Hospitals Go Bag Free

By Marsha Walker, RN, IBCLC

Massachusetts is now the second state in the US, behind Rhode Island, to have had all of its maternity hospitals eliminate the practice of distributing formula company discharge bags. Ban the Bags is a campaign that began in 2006 to rid hospitals of the practice of distributing formula company discharge bags or other discharge gifts to mothers when leaving the hospital. It was started after efforts in Massachusetts failed to insert regulations regarding such a ban into our hospital perinatal regulations. Ban the Bags, the Massachusetts Breastfeeding Coalition, and the MotherBaby Summit have all encouraged hospitals to eliminate this practice through letter writing, education of hospital management at summits designed just for them, and downright shamed them into doing it in order to get off the list of hospitals we kept who continued engaging in this practice. The list of hospitals who continued to give out these bags was displayed on the MotherBaby Summit website and was placed on a large poster board and displayed annually at the Massachusetts Breastfeeding Coalition’s yearly conference. Ban the Bags answered many e-mails with suggestions, references, and approaches to help individuals get the bags removed from their hospital.

Ban the Bags found that many hospitals did not really care about the effect of formula bags on breastfeeding but responded when told that it was a breech of medical ethics, was in opposition to the hospital’s own mission and vision, and was no different than unethical arrangements with pharmaceutical companies. We encouraged people to contact their hospital Ethics Committee for an opinion on a practice that promoted the use of a potentially hazardous product and how this related to the ethical principles of “first do no harm” and the obligation of health care providers to act in the best interest of their patient. We counseled people to contact the hospital’s Corporate Compliance Department to report how these bags were a conflict of interest, especially since HIPAA defines them as a form of marketing. We recommended that people contact the hospital’s Risk Management Department to inform them that because the hospital had no stock control there was no method to contact patients who had received the bags if there was a recall of the formula. Such a recall occurred in 2006 when one company’s bags were recalled due to the defective packaging of formula inside which resulted in a vitamin C deficiency. Also, the powdered version of formula is not sterile and the hospital could be handing out and liable for a product contaminated with Chronobacter sakazakii. Mothers were never instructed by the hospital in how to safely prepare the powdered formula that they were essentially marketing for formula manufacturers. Eliminating the bags was a fairly easy way to increase the hospital’s score on the mPINC survey.

Ban the Bags advocates toss bag into the original location of the Boston Tea Party!

Hospitals were concerned that they would have to pay for formula, as the formula companies fought hard to prevent the disappearance of this lucrative and inexpensive marketing tactic. We have found that this was not actually true, as manufacturers did not remove their product from the hospital which represented essentially a captive audience. Companies know that well over 95% of mothers continue to use the brand of formula given to their infant in the hospital. Why would a formula company give up this potent marketing advantage? We heard how terrible it would be for poor mothers who could not receive this “gift.” Of course there is only enough formula in the bag for about a week or so worth of feedings, just enough to reduce a mother’s milk supply and accustom the infant to the bottle. Detractors complained that we were “forcing” mothers to breastfeed or removing their choice of infant feeding methods. Mothers decide how they wish to feed their infants well before entering the hospital. Bags have no effect on feeding decisions, they have only one purpose, which is to cause a breastfeeding mother to use formula and create a customer/market where none existed before. We have found that when hospitals remove the bags, they show up in community pediatric and obstetric offices, clinics, and even in ultrasound departments. Make sure to ask that all of these entities cease distributing formula company materials, as this works directly to counteract your efforts in the hospital.

Ban the Bags at www.Banthebags.org has many helpful recommendations on approaching the elimination of this practice. I am happy to help and you can email me at Marshalact@gmail.com.

Marsha Walker is a registered nurse and international board certified lactation consultant. She maintained a large clinical practice at a major HMO in Massachusetts, is a published author and an international speaker. Consulting with hospitals, providing in-service presentations, speaking at conferences and workshops and advocating for breastfeeding at the state and federal levels occupy her professional time. She is currently a member of the board of directors of the Massachusetts Breastfeeding Coalition, Baby Friendly USA, Best for Babes Foundation, and the US Lactation Consultant Association (USLCA). She is a past president of the International Lactation Consultant Association (ILCA).

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