News article

Formula industry backs bill to protect hospital marketing

June 25, 2007

(Boston) Touting “maternity patients’ rights,” an International Formula Council-backed bill is under consideration by the Joint Committee on Public Health. The bill would legislate a mother’s “right” to formula samples and equipment in the hospital, protecting industry interests at the expense of public health.

Strong scientific data shows that formula marketing in health care facilities undermines mothers who wish to breastfeed. In testimony submitted to the Public Health Committee, Geoff Wilkinson, executive director of the Massachusetts Public Health Association, writes, “The bill, which lay readers might consider a benign measure to ensure access to information about infant feeding formula, actually constitutes a threat to maternal and child health and could exacerbate health disparities in the Commonwealth.”

H 2257 begins by paying lip-service to the benefits of breastfeeding. The bill then states that “formula is a safe and recommended alternative to breastmilk,” directly contradicting both scientific data and recommendations of all major medical organizations.

“This bill has nothing to do with maternity patients’ rights, and everything to do with formula company marketing strategies,” said Alison Stuebe, MD, an obstetrician at Brigham and Women’s Hospital in Boston.

“Formula companies use hospitals and health care professionals to sell their product. A sales training manual for Ross Pediatrics puts it plainly: ‘Never underestimate the importance of nurses. If they are sold and serviced properly, they can be strong allies. A nurse who supports Ross is like an extra salesperson.’”

To garner support for the marketing legislation, the International Formula Council has launched a web site titled “MomsFreedingFreedom.com.” The site describes H2257 as a bill to “ensure moms’ feeding choices are protected.” (see related article)

Testimony on the bill was heard on June 13 before the Joint Committee on Public Health, immediately following the close of testimony on bills to protect breastfeeding in public and in the workplace. Committee co-chair Sen. Susan Fargo had introduced two of the pro-breastfeeding bills, and her staff had assembled an esteemed group of experts to testify in favor of the legislation.

In addition to the testimony of Representative Harriet Stanley, who introduced H 2257, testimony was heard from five women who said that the formula samples and marketing materials were helpful.

Following the women’s testimony, breastfeeding advocates rose to the microphone to testify against H 2257: Stuebe, nurse Marsha Walker, and Dr. Melissa Bartick, an internist who chairs the Massachusetts Breastfeeding Coalition. They rebutted the women’s assertion that the marketing materials do not influence breastfeeding, citing scientific data to the contrary.

Walker expressed concern that bill appears to “handcuff” the ability of the Department of Public Health to write regulations banning hospital-based formula marketing. Bartick testified that when DPH submitted regulations to ban formula company discharge bags last year, the proposal had the support of leading state and national health authorities.

The proposed regulation banning the bags was rescinded in May 2006 after interference from Gov. Romney. Romney overturned the regulation despite letters from leading health organizations urging him to uphold the ban. Ten days later, he announced a $66 million deal with Bristol-Myers Squibb, the nation’s largest formula manufacturer, to build a pharmaceutical plant in Massachusetts. The deal was widely perceived as bolstering Romney’s presidential ambitions.

Romney’s efforts to defeat the ban included a carefully timed overhaul of the Public Health Council. As a result of his efforts, the 1989 regulatory language stayed in the new regulations. Like H 2257, the regulations state that a nursing mother can get the formula company materials only at her request or with a doctor’s order.

In practice, however, these regulations are difficult to enforce, and nursing mothers routinely receive the marketing materials. “I got the bags with both my children,” said Bartick, whose children are now 6 and 8. “I neither expected the bags, nor wanted them. By the time my second child was born, I knew enough to leave the bag behind. A nurse ran after me as I was being discharged and called out, ‘You forgot your bag!’ I told her, ‘I don’t want it.’”

Currently, fifteen of the fifty maternity units in Massachusetts have banned commercial discharge bags, as they are contrary to their mission of health. If H 2257 passes, breastfeeding advocates are concerned that the bags would then have to be made available, despite the best judgment of the medical staff.