When health care workers accept education, gifts, or promotional materials from the infant feeding industry, the cost isn’t borne by the health care worker or the company: the cost is, very directly, passed along to the families for whom they care.
In last week’s blog, I used an illustrative example of the cost of ready-to-feed infant formula for a family encouraged to use this commercial product instead of breastfeeding. It makes for a neat short illustration, but if you wondered whether it really measures the likely reality, that is a fair thought. Where breastfeeding is not possible, regardless of the reason, and donated milk is not available, an infant will need human milk substitutes for at least six months.
Wouldn’t giving away infant formula that’s safe and free prevent more harm to the families who use the products, but can’t afford them? This seems logical, but remember that samples are sales inducements, not a secure supply. The straight cost of infant formula and related equipment, even without taking into account the costs of health care, absences due to illness, and other indirect costs, is substantial.
What’s not always obvious is how much the marketing of the products themselves adds to the cost to families - and how specifically marketing of premium brands through the health care system increases those costs. Generic and store brand products take advantage of existing consumer demand for a product, at a lower price. These brands use typically sales incentives such as samples, coupons, and giveaways much less than premium brands, who typically hold the contracts to supply health care systems. Premium products, which may still be marketed at different prices within a particular brand, are not superior in any objective way but are priced as though they are.
Do you want to see how? Let’s try another example - this time looking at the price difference between a premium brand and a store brand for the most common form of infant formula.
The cost difference above isn’t the difference between breastfeeding and formula feeding for 6 months: it is the price a family pays for successful marketing. The products involved are equivalent in every way and both are approved as breastmilk substitutes from birth to 12 months. The only practical difference is that a family who relies on the premium brand will spend more money to feed their baby.
Given how much influence health care providers have on brand selection and how heavily the premium brands market through the health care system, there is an urgent ethical responsibility on the part of health care professionals to avoid promoting brands, even to parents and caregivers who have a need for the product.
Health care providers who receive education, grants, or product donations from the infant feeding industry are in a conflict of interest, not with breastfeeding promotion, but the health and well-being of the families they care for, regardless of how those families feed their babies. It’s far past time that we stop allowing the narrative that the Code and the Baby-Friendly Initiative only protects breastfeeding families to the detriment of those who don’t breastfeed.
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Last Updated: September 2018