Breastfeeding Medicine

Physicians blogging about breastfeeding

Giving moms what they want?

with 20 comments

I am sitting in my office just outside our community hospital’s special care nursery. One of the nurses just walked in and asked “would you (neonatologists) please reconsider giving out the formula company diaper bags? All the moms are asking for them, even the breastfeeding ones, and it’s embarrassing to just hand them a plastic trash bag from the hospital with our own breastfeeding handouts. All of us (nurses) want to be able to give the moms what they want.”

This is life in the trenches. The hospital wants to make the patients happy, and it definitely does not want to spend money on better/alternative diaper bags, or for that matter anything else (even decent newborn-sized stethoscopes for the special care babies — my pet peeve at the moment).

Here is the best solution I can think of (building on the approach a friend of mine uses in her pediatric practice):

Give them the bags they are asking for, but with the disclaimer (printed, spoken, or ideally both) that “evidence shows that moms whose physicians/hospitals give them formula company marketing materials are less likely to breastfeed successfully”.

And, of course, take out the formula company materials & substitute our hospital lactation service’s breastfeeding support information and phone number.

It’s not perfect, but neither is this world.

Thoughts?

Kimberly Lee is a neonatologist and member of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by neobfmd

June 16, 2010 at 1:33 pm

Posted in policy

20 Responses

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  1. I have been working in a truly “Baby Friendly” hospital for 3 years now. I am a labor/delivery nurse as well as a lactation consultant. Never, in all the years I have been HERE have I ever had even one patient ask for a bag. Coming from a facility where we DID give out the bags, I can tell you what a pleasure it is NOT to have to deal with those bags or the formula reps.It is really so much easier this way.

    Betsy Riedel RNC, IBCLC

    June 16, 2010 at 1:43 pm

  2. Sounds like a tough situation… I wonder if, since the hospital is not willing to purchase bags, there are community resources that might be able to help out. Are there local organizations like Healthy Start that might already have promotional materials like tote bags they are trying to get to new mothers? Or might they be willing to write a grant with you to find funding for the diaper bags?

    It also sounds like this is a conditioned expectation in moms, that they will get a free diaper bag…probably because all their friends did fairly recently. Eventually, do you think that expectation might fade, and these questions might stop? It could just be a matter of everyone gritting their teeth and waiting it out😉

    Rebecca

    June 16, 2010 at 2:05 pm

  3. Betsy, I am envious! Sounds like a dream come true.

    Rebecca, this hospital hasn’t been giving out the bags for at least as long as I’ve been here (4 years), but the expectation has not faded — if anything, it seems worse lately. (The formula folks are apparently doing their job.)

    neobfmd

    June 16, 2010 at 2:19 pm

    • Ugh, I’m sorry to hear that things are getting worse instead of better! When you say the formula folks are doing their job, are these moms getting mailers or other info from the companies telling them to ask for their free bag? In that case I wonder if Elita’s suggestion to make it very clear in advance that there are no bags available could help a bit.

      Rebecca

      June 17, 2010 at 11:21 am

      • Yes the formula companies are telling them to ask for the bags. I signed up for American Baby magazine which is pretty much just a front for formula companies. I have received a mailer every 2-3 weeks from them. Always in there is a pamphlet describing the bag with beautiful pictures. It actually says “don’t forget to ask for your free pack at the hospital.”

        Emily

        June 17, 2010 at 4:12 pm

  4. There is something already done called “Healthy Baby Bounty Bags” — click here for more information (scroll down to the Nov. ’09 post for the more detailed description of the bags).

    And if you want moms’ perspectives, this blog has several things mentioned in the comments.

    Kathy

    June 16, 2010 at 2:23 pm

  5. I’m totally speechless that moms are asking for the bags. I probably spent the most time picking out my diaper bags than any other item on my registry. I don’t think the plain ugly black bag I got from the hospital ever saw the light of day again. That said, I don’t think you should take steps backwards and give out formula company swag bags, even if they’re empty. They’ll still have the company insignia on the outside and inside and will, in my opinion, appear to be an endorsement of that brand. Maybe when moms come to the hospital for the tour or to pre-pay their deductible they should be told not to expect a bag and to make sure and bring their own diaper bag to the hospital with baby items.

    Elita @ Blacktating

    June 16, 2010 at 2:24 pm

    • That’s what I’m thinking. Tell moms in advance during tours, classes, pre-registration, etc. that the hospital does not provide diaper bags. Those bags are cheap and ugly anyway.

      three-cubed

      June 16, 2010 at 2:41 pm

      • We used the giveaway bag (donated the formula in it to a women’s shelter) as our backup bag. That is, if I left the good diaper bag in the car and my husband went somewhere, LO and I could still walk up to the library. What got me is all it really was was a collection of ads for things we didn’t really need, from the hospital picture package, to coupons for high-end disposable diapers and wipes- and of course formula. I got a packet of papers as a breastfeeding mom, but no swag LOL

        Rebeccca

        July 30, 2010 at 10:58 am

  6. The hospital we used had supplies in the bassinet & we were told anything in the drawers was our for the taking. That way they didn’t push formula, but we got a bag if we wanted it.

    becky

    June 16, 2010 at 3:16 pm

  7. We stopped giving any advertising bags of formula or gifts of any kind in 1993. We were certified in 1998 as a Baby-Friendly Hospital. For a while the formula company approached our physicians and told them we were depriving new mothers of much needed information. Several of the doctors that use our hospital give out free formula bags in the prenatal office.
    We try to teach everyone that NOTHING is free. The price they pay can be the cost of breastfeeding failure.
    We stress to our patients that we will give you a valuable gift. Breastfeeding care and continued support after discharge. It is PRICELESS!!!!

  8. It seems that many people want to get all the free stuff they possibly can. Sad. After all, they’re going home with the greatest gift possible.
    Besides your own lactation support services info,
    I would put in all available information on community lactation supports, especially phone numbers, websites and groups. It’s vital to help clients transition to their own community support systems. This will increase their chances of continuing to breastfeed.

    Eurika

    June 16, 2010 at 7:36 pm

  9. They can have all three of mine that I *tried* to leave in the room and the nurse chased me down the hall yelling “You never know! Just in case! You can’t be discharged without taking them!” (ugh). The bags aren’t very nice or cool or even a useful size. Mine have been in my daughter’s closet since the day we came home from the hospital.

    Ceri

    June 16, 2010 at 11:40 pm

  10. When we were ready to leave the hospital, we were paraded with these diaper bags full of formula and such. I was very determined and motivated to successfully breastfeed my son, even with a very painful start to breastfeeding. The diaper bags didn’t sway me one bit, but I can see how a situation could arise to where a mother may feel she needs to supplement or give up breastfeeding. Which I believe would happen much sooner if she was given formula to try. I gave mine to good will, and have never given my son any formula. I think what it boils down to is the mother’s determination to breastfeed and the support of her family and friends is HUGE! Because if the mom is determined, she will seek out the education and guidance needed to be successful at breastfeeding. I did!

    Jen

    June 17, 2010 at 12:35 pm

  11. The hospital I delivered at gave out beach sized tote bags with a hospital shirt for mom and baby (all with hospital logos, not formula branding), and pads for moms, diapers for baby. Nothing more. I left the formula sponsored bag for “breastfeeding moms” on the table as I left in protest. It contained two canisters of formula and one four pack of premixed bottles.

    Candy

    June 17, 2010 at 3:56 pm

  12. I plan to use my free large bag from the hospital to carry baby’s things to daycare and the insulated tote to bring the pumped breastmilk. Neither has any logos. I gave the coupons to friends who were already formula feeding. The formula has yet to be given away, but my daycare requires a can of powder or formula for emergencies. I will give one BUT I will send 1-2 extra bottles of BM every day.

    Adina

    June 17, 2010 at 5:19 pm

  13. I never used any of them, I mostly used the insulated tote that came with my breastpump. Those freebie formula bags were junk.

    I won’t even go into how they forced me to feed my 1-day-old twins formula bc my milk hadn’t come in yet. Nope, I won’t even go there.

    Jennifer

    June 17, 2010 at 11:17 pm

  14. I don’t have much of a comment, rather a plea: Please do not give in to these requests. You have no idea how much breastfeeding advocates like me count on doctors like you and your nurses to help us help mothers from the onset. It is very frustrating for me as a breastfeeding educator (PC for WIC) to have to tell my moms in every class I teach every single day to “please be sure to advise the hospital staff that you will be breastfeeding and do not authorize bottles or pacifiers, to bring baby to you when baby is ready to feed and to make sure to leave the free formula in the hospital so that you won’t be tempted to use it”. It’s so important that we get to a place in our culture where that isn’t expected, and it’s decisions like yours and the staff at your hospital, and what stance we take in those decisions that will get us there, slowly but surely. It isn’t about making the moms happy or not– the hospital’s end of the bargain should be quality care from a knowledgeable and personable staff. If patients want the “free” formula, then they can take the extra step and when they go to the pediatrician’s appt or WIC appt, get it there. But they shouldn’t leave a health facility (hospital) with something that is going to do anything BUT make them and their babies healthy.

    This is a sincere question and not meant to come off snarky at all, but are the nurses asking because they want to make mothers happy or because they aren’t fully educated/choose not to believe in the importance of “informed consent” and the many risks to both mother and baby of formula feeding?

    A friend of mine works in a baby friendly hospital in IL and I believe the procedure there is that if the patient is formula feeding in the hospital and requests a bag, then she gets a bag, but if she is breastfeeding, she does not. Could that be a compromise?

    Have you thought of contacting banthebags.org and see if they have some sort of advice for you or information on a path to funding for cooler, more fun bags?

    Hang in there and know you have a very large community rooting for you. “Be the change you wish to see in the world…”
    🙂

    Andrea

    June 18, 2010 at 9:20 pm

  15. I heard a recent physician’s comments in a lecture given to pediatrc resident. She said, “When a patient comes in for surgery – do they expect a gift from us?? Then why do we think that we have to give mother’s a gift?? The biggest we can give them is to have the evidence based right information, education, and counselling to help them, allow them, and encourage them to breastfeed.

  16. Thanks to all of you for the supportive comments! We are standing firm on the no-bags policy.

    neobfmd

    June 21, 2010 at 1:21 pm


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