172643 Congratulations: It's a consumer! Successful strategies for eliminating formula company marketing to new mothers in the hospital

Wednesday, October 29, 2008: 12:30 PM

Anne Merewood, PhD, MPH, IBCLC , Division of General Pediatrics, Boston Medical Center, Boston, MA
Marsha Walker, RN, IBCLC , National Alliance for Breastfeeding Advocacy, Weston, MA
A-Reum Han, BS, MPH , Department of Pediatrics, Boston University School of Medicine, Boston, MA
Amelia Psmythe , Nursing Mothers Counsel of Oregon, Portland, OR
Deborah Kaplan, PA, MPH , Bureau of Maternal, Infant and Reproductive Health, NYC Deptartment of Health and Mental Hygiene, New York, NY
Melissa C. Bartick, MD, MS , Department of Medicine, Cambridge Health Alliance, Cambridge, MA
Dana Greeson, BA , School of Public Health, Boston University, Boston, MA
Background: Hospital-based distribution of formula sample packs is an established marketing technique which undermines exclusive breastfeeding. Currently, 92% of US hospitals distribute formula sample packs to new mothers at discharge, but this unethical practice is rapidly being discontinued in certain regions. In 5 states, fewer than 75% of hospitals distribute sample packs.

Goals: To determine strategies that lead to successful elimination of formula sample packs.

Methods: We identified sites where large numbers of hospitals had discontinued formula sample pack distribution in a short timeframe. We worked with city and state Departments of Health, health care providers, and regional Breastfeeding Coalitions to determine techniques that had successfully changed hospital practice.

Results: Activism by grass-roots community advocates, in combination with support from regional or local health departments, led to elimination of the practice. Despite endemic and long-standing resistance, successful strategies often had a regional, domino-like effect once employed. Effective approaches included setting goals to become the first "bag-free" US city or state; ethics-based campaigns, pursuing WHO Baby-Friendly(TM) status, and incentive-based strategies including distribution of awards to hospitals by the regional health department. In New York City, the Health and Hospitals Corporation removed sample packs from all the city's 11 public hospitals within a relatively short timeframe. In Portland, Oregon, 15 hospitals eliminated sample packs within 1 year, in anticipation of receiving DPH awards for improved public health practice.

Conclusion: Community-based advocacy, education, and pressure from health policy makers can successfully change an ingrained practice to enhance public health outcomes.

Learning Objectives:
Describe marketing practices used by formula manufacturers in the hospital setting Describe effects of such practices Detail strategies that work to eliminate such practices at the community and hospital level.

Keywords: Breastfeeding, Ethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.