Free Ain’t Free

Dad was right. There’s no such thing as a free lunch.

First, some stats: In 2013, 11.1% of Illinois babies had been exclusively breastfed at 6 months old. This means no formula supplementation and no solids. The U.S. Department of Health and Human Service’s Healthy People 2020 initiative wants us to be up to 25.5% by year 2020. (Other countries’ data.)

Why? Because we know that exclusive breastfeeding is better for baby and better for mom. (More on that here and here.)

OK, got it. Exclusive breastfeeding is ideal. “Breast is best” and all that. We’ve heard that song before.

There are LOTS of reasons exclusive breastfeeding doesn’t happen for moms and babies. Some are legit, and some are not. In the “are not” category lies the topic of today’s post: formula marketing in healthcare facilities.

Remember that time you were in a hospital and the doctor said, “Listen, I really need you to eat a healthier diet, but I know that’s really hard to do, so I left a hamburger and french fries next to your bed – provided free of charge – just in case you need it.”

No? That’s never happened in the history of medicine? So why is it OK for our medical professionals, the people we trust to guide our health decisions, to sell out our babies’ health in the name of corporate profit? We KNOW breast is best. We KNOW breastfeeding can be really difficult for some moms. We KNOW that our partners, parents, friends and employers can be total douchebags about our decision to breastfeed.

The last thing on earth we need is corporate profit weaseling its way into our breastfeeding relationship… through the people and institutions we trust!

Formula marketing in healthcare facilities has to stop if we are serious about helping moms and babies.

This is about MONEY and MESSAGE.

MONEY: Formula companies know that moms who get started on formula in the hospital will stay loyal to that brand. The logic: if I got it in the hospital, then the folks who know a lot about health must think it’s OK. Moms who get started supplementing early will also have trouble building up a full breastmilk supply, so they’re going to need to supplement for the full first year of their baby’s life. That’s some serious cash and definitely not “free.”

MESSAGE: Just as providing divorce papers – just in case – at a wedding ceremony is not the best message for newlyweds, providing formula at a birth sends moms a seriously mixed-up message. Yes, of course there are some moms choose to formula feed, and there are some moms who truly cannot exclusively breastfeed. We’re not talking about those moms. We’re talking about moms who *want* to breastfeed, who *plan* to breastfeed, who are *able* to breastfeed – those are the moms who suffer the most from this insidious practice. New moms doubt themselves… a lot! They honestly don’t know if their bodies can supply everything their babies need to grow and thrive. When healthcare professionals hawk breastmilk replacements – passively or not – they are basically telling a mom, “You’re probably not going to succeed at this. You are not enough for your baby.” Breastfeeding success depends on mom’s confidence in herself, but we are systematically allowing that confidence to be chipped away…


You’d think someone would have done something about this by now. Oh wait, they did. Thirty-three years ago, the World Health Organization (WHO) developed the International Code of Marketing of Breastmilk Substitutes. Even back then, in the dark ages, they knew that moms need all the help they can get to be successful in breastfeeding. By the way, I was 5 in 1981. That’s crazy.

Today I had the pleasure of participating in a petition delivery to urge formula companies to adhere to the WHO Code.* Better late than never, right?

Folks from Breastfeed Chicago, HealthConnect One, Food & Water Watch, and Public Citizen

Will we convince formula companies to stop marketing in healthcare facilities? Maybe not. Can we do anything else? Yes.

  1. Make sure your doctor knows that formula samples and marketing through them are in violation of the WHO Code and really not great for moms and babies. Let your doctor know that you trust her to help you make healthy decisions, so you expect her to become educated about this.
  2. Refuse “free” formula samples and talk to nurse managers, hospital administrators and your doctor about why your business will go elsewhere if they don’t change their practices. Here’s what a Baby Friendly doctor’s office looks like. Here’s proof that banning free formula samples is correlated with a higher hospital rating.
  3. Support your friends. New moms rely on their friends to help them through the most difficult parts of motherhood. If your friend is giving birth soon, help her connect to great, evidence-based resources on breastfeeding. If she’s having problems, help her connect to a lactation professional.

Get formula out of our healthcare facilities, Chicago! Help make it easier for moms to breastfeed successfully.


 *Thank to Public Citizen who organized the petition and its delivery. You rock! 

6 thoughts on “Free Ain’t Free

  1. Formula companies aren’t the only ones using less than truthful marketing practices.
    The benefits as well as the ease and success of breastfeeding are routinely overstated in breastfeeding materials and by breastfeeding advocates

    Formula is often presented by breastfeeding advocates being harmful, or in the case of this article, junk food (like cheeseburgers and fries).

    As an example of exaggerating the benefits, the author of this post give three links to support her statement that breastmilk is healthier (which I do believe to be true—just not quite to the extent that most breastfeeding advocates believe).

    The second link is to a paper by Marsha Walker, ”Just one Bottle…” which I believe was written in 2007. In this paper she make the case that breastfeeding can help prevent type one diabetes. The research she uses to support this is from 1994 and earlier (as is most of the research cited in the paper—one study was from 1922!)

    Most recent studies (as well as the Juvenile diabetes website) I have seen do not find this to be true. 2012 Review of Studies 2010 Infant feeding patterns and cardiovascular risk factors……. 2010 …neonatal risk factors for childhood type … 2008 …..breastfeeding and type 1 diabetes …. 2009 Early infant feeding and type one Diabetes JDRF Website

    I just feel those who promote breastfeeding should adhere to the same standards that they would like to see from formula companies.

    Breastfeeding is great—it should be enough to say that it can reduce the risks of common childhood illnesses, SIDS, and is on the whole better tolerated than formula. Breastfeeding is also inexpensive, eco-friendly, and if it works well can be convenient and a great bonding experience.

    It should also be okay for women to know up front that breastfeeding doesn’t always work, sometimes can be very difficult, and for those who can’t, or don’t wish to breastfeed for some reason, formula is an acceptable alternative and not junk food.

    1. I don’t disagree with some of the things you say – certainly there is a “cost” to breastfeeding, just as there is a cost to formula. There is both good and bad research around breastfeeding, and breastfeeding research is severely underfunded, so I’m guessing there are things about breastmilk that we still don’t know. The fact that it saves the lives of sick and preemie babies (proven through research) and can save billions of dollars a year in health care costs (per the AAP) is enough for me. That’s not what this article is about. You say that breastfeeding advocates should be held to the same standards as formula companies. The last time I checked, there was not a single breastfeeding organization in the world that had even a quarter of the money that formula companies have for marketing and outreach. If we really want to level the playing field, let’s talk about that. This article is not about formula vs. breastfeeding. This is about the insidious practice of formula companies using our health professionals and healthcare facilities to actively destroy the breastfeeding relationships of moms who *want* to breastfeed. That’s unethical.

      1. I don’t disagree that big pharm may have quite a bit of money in which to market formula and provide samples. Do you know what their budgets are?

        But really, breastfeeding promotion and support are funded fairly well. WIC requested 83 million for this purpose 2011, and 93 million for 2014.

        The Kellogg foundation has provided many millions in grants for breastfeeding,
        There was recently a $3.3 million grant for breastfeeding though HealthConnect 1.

        The CDC awarded $5.8 million for Healthyplaces Chicago (one of the four areas of focus is breastfeeding)

        Baby Friendly USA, NICHQ (Best Fed Beginnings) and the Surgeon General are all working hard to get out the breast is best message.

        In addition to all of the funding mentioned above, there are several grassroots organizations , such as Breastfeed Chicago, WABA, la Leche Leauge, Best For Babes, are providing providing outreach, encouragement and support. Trade organizations AAP , ABM, and the AAFP also support breastfeeding as opposed to formula.

        The US Breastfeeding Committee lobbies governmental agencies for funding and rights.

        I agree that this is not a breast vs. formula debate (I do feel that breast is better). My biggest issue is accuracy of information in promotion. I have seen breastmilk promoted as preventing all kinds of chronic, serious conditions, as well as increasing IQ and saving billions in healthcare costs .

        If the time is taken to really look into these claims (not necessarily made by Breastfeed Chicago), the research is mixed at best with most research not concluding that breastmilk can protect against obesity, diabetes, asthma, allergies, eczema, or significantly increase IQ.

        I feel that the best way to ‘level the playing field’ is to give women accurate, up to date, evidence based information, and as it is now they get propaganda from both sides.

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