ABM Executive Committee urges AAP to discontinue formula marketing relationship
Thomas K. McInerny, President, American Academy of Pediatrics
Dr. McInerny:
We are writing on behalf of the Academy of Breastfeeding Medicine (ABM), a multispecialty worldwide organization of physicians dedicated to the support, promotion and protection of breastfeeding and the education of our fellow physicians, to urge the American Academy of Pediatrics to discontinue its participation in infant formula marketing in maternity hospitals and pediatric practices.
It has come to our attention that the AAP has contracted with Mead Johnson to provide AAP-branded materials as part of the formula manufacturer’s maternity discharge pack. Such discharge packs have been shown in randomized controlled trials to reduce breastfeeding duration and exclusivity. Based on this Level I evidence, UNICEF, the World Health Organization, the Baby-Friendly Hospital Initiative, the American Public Health Association, the Academy of Breastfeeding Medicine, the Centers for Disease Control and Prevention, and the United States Surgeon General oppose infant formula marketing in health care settings. Concern about these harmful effects of formula marketing has led two-thirds of America’s 45 top hospitals to discontinue formula advertising in their maternity wards. It is therefore deeply troubling that the AAP has contracted with Mead Johnson to support this practice.
The AAP’s decision to contract with Mead Johnson also violates multiple AAP policy statements. Distribution of discharge packs has been identified as detrimental to exclusivity and duration of breastfeeding in the AAPs Policy Statement on Breastfeeding and the Use of Human Milk. In its resolution on Divesting from Formula Marketing in Pediatric Care, the Academy advises pediatricians not to provide formula marketing materials to parents of newborns and infants. Both the AAP’s Sample Hospital Breastfeeding Policy for Newborns and ABM’s Model Breastfeeding Policy prohibit provision of formula marketing materials to mothers.
AAP participation in formula marketing undermines consensus medical recommendations for exclusive breastfeeding for the first six months of life and is harmful to the health of mothers and infants. We urge the AAP to discontinue this relationship with Mead Johnson. We further urge the AAP leadership to implement a formal policy prohibiting Academy participation in direct-to-consumer marketing of formula or formula company materials.
Thank you for your consideration.
Sincerely,
Dr. Wendy Brodribb, President (Family Physician)
Dr. Arthur Eidelman, Immediate Past President (Pediatrician)
Dr. Julie Taylor, President-Elect (Family Physician)
Dr. Tim Tobolic, Treasurer (Family Physician)
Dr. Kathie Marinelli, Secretary (Pediatrician)
cc. Dr. Kinga Szucs, ABM representative to SoB AAP
EBS, MD, MS
aeidelmanmd
amalactancia
annkellams
Ana Parrilla-Rodríguez, MD
astuebe
awittbfmedneo
bfmed
caseyrosencarole
drharrel
drjanrmortomgmailcom
drjen4kids
drmarnierowan
drmilkarizona
drnand
elienrouw
galactodoc
gcalnen
helenmjohnson
julieware2
jymeek
kmarinellimd
labbok
lsinai1
mayabunik
Melissa Bartick, MD, MSc, FABM
neobfmd
newtoned
NKSriraman
rhaiderbd
ruthlawrence
sntierney
vpdn
wbrodribb
winterlb
Breastfeeding Medicine 
Perfectly said. I mailed a letter as well.
Cynthia A. Vella NP IBCLC
Cynthia
December 26, 2013 at 4:14 pm
Excellent letter. Thank you for taking an appropriate stance towards the complicity of the American Academy of Pediatrics with misleading advertising as well as distribution of promotional samples to mothers who do not want or need it.
Susan
December 27, 2013 at 7:43 am
I am so sick & tired of the constant push of breastfeeding. Of course its best we all know it is. When you are constantly putting formula feeding down you make mothers like me feel horrible. I pumped tried latching tried power pumping round the clock & took medicine to try & increase my supply. I was only making 1 oz a day for twins. I had to formula fed so my babies could survive. I appreciate marketing of formula so i could make the best decision about what type to feed my children. It saddens me that your pushing for the marketing to stop. I hope that other mothers in my situation will not feel so horrible about having to formula feed because those pushing breast look down on those whose body fails them.
Ashley
December 27, 2013 at 9:59 am
Ashley –
I’m sorry you had such a difficult time making milk for your babies. It sounds like you really struggled.
I think it’s important to make clear that ABM is not opposing the existence of formula. There are families for whom breastfeeding doesn’t work, and formula meets a critical need for nutrition. The issue being discussed here is whether a medical organization, such as the AAP, should help to advertise a particular brand of formula to moms who have just given birth.
Notably, the brand-name formulas that provide samples and gift packs in hospitals cost much more than store-brand generic products. To convince families to pay for premium brands, these companies use the credibility of hospitals and medical societies such as the AAP to market their product, implying that it’s better than equivalent generics. It’s the same strategy that pharmaceutical companies use when they provide “free” samples to doctor’s offices. When I was training to be an Ob/Gyn, I used to think I was being incredibly generous when I “gave” my patients cute plastic compacts with a “free” one-month supply of brand-name birth control pills. I had no idea that, when they went to refill those pills, they faced a $45 co-pay, vs. a $5 co-pay for generic pills that were just as effective at preventing pregnancy. “Free” samples from formula companies are similarly a way to get families to try high-priced formula, and they end up costing hundreds of dollars more over the course of a baby’s first year of life.
The free samples can also undermine moms who want to breastfeed. Some moms, like you, have difficulty making even a small amount of milk, and need support from skilled health care providers to develop a different feeding plan and choose a safe, reasonably priced formula.
Others are able to sustain a supply only if they breastfeed frequently — and giving a baby a supplement can interrupt the supply-and-demand process, causing their milk production to decease. For these mothers, a “free sample” could derail breastfeeding. I’ve also cared for mothers who were given free samples from health care providers and assumed that they therefore needed to supplement their babies with formula. Even though they had plenty of milk, they started giving bottles of formula.
It’s because of these potential consequences that it’s problematic for hospitals to give out formula advertising and samples. It’s a practice that’s fabulous for the corporations selling brand-name formula, but it’s not good for families.
Removing marketing from hospitals is only one part of what ABM and other organizations support to help mothers achieve their feeding goals. We also need to make sure that each family has close follow-up with skilled providers who can help develop a feeding plan that works for their baby, or babies. And those providers need to focus on the best interest of that family — not the sales strategy of a pharmaceutical company.
Does that make sense?
astuebe
December 27, 2013 at 1:38 pm
Ashley, thank you for intelligent reply- I was one of those mothers who almost got derailed by the formula in my expectant mommy gift pack from my first ob/gyn visit @ 10 weeks pregnant. I saved it until baby was born and started feeding it to her 2 weeks after she was born because of latch issues coupled with inexperience and fatigue. If I had to do it all over again I would’ve turned down the “gift” bag.
Joan
December 28, 2013 at 2:58 am
The marketing by formula companies is not to help you make the best decision what to buy. It’s for you to buy their product…period. It should be stopped and the push for breastfeeding needs to continue until people understand.
As a dietitian and a lactation consultant I know the importance and promote artificial baby milk when needed. As I am specially trained in nutrition support for women pregnant with multiples, I know the challenges and so should others.
What the AAP is doing is confusing to the consumer and healthcare professionals.
When we promote breastfeeding it should be in good nature and not meant to make people such as yourself who have gone out of their way to make it possible but just didn’t work, to feel judged. I’m sure it was a great struggle and you deserve a BIG HUG for trying. Please know that I and I think I can speak for most, would not look down and should not on those that were not able to breastfeed successfully.
It’s just the wrong message to send.
Susanne Trout
January 2, 2014 at 2:10 pm
[…] Rochelle, NY, December 27, 2013—The Academy of Breastfeeding Medicine today asked the American Academy of Pediatrics to end its formula marketing relationship with Mead […]
Academy of Breastfeeding Medicine urges AAP to end formula marketing partnership | Breastfeeding Medicine
December 27, 2013 at 2:04 pm
I am very happy to see ABM take this stance. It is always unethical for physicians either individually or through our professional associations to market products to our patients. When that marketing has been definitively shown to have a harmful impact on our patients, it is unconscionable. Money has a pernicious effect on our healthcare system. We need to do everything we can to reduce that impact, not to reinforce it.
Mary Applegate, MD MPH
Public Health Physician (Maternal & Child Health)
Associate Dean for Public Health Practice, Univ at Albany School of Public Health
Mary Applegate, MD MPH
December 27, 2013 at 10:49 pm
Great letter! Thank you for doing it. I’ve always thought that it is unfair that the inexperienced new moms are getting derailed by the formula samples. Right after giving birth and especially when it comes from the hospital personnel women tend to believe whatever they are told or given. At that moment women are so confused, tired, and exhausted that the last thing they want to do is to question doctors’ judgement. We all know that there is a formula alternative, if breastfeeding doesn’t go well. No need to impose formula samples on us right there and then when we are the most vulnerable!
Viktoriya from http://www.breastfeedingquest.com
Viktoriya
December 28, 2013 at 6:17 pm
I am so delighted to read this! Good on you. The AAP needs to stop their unethical marketing as soon as possible. Everyone will benefit and they will regain the integrity they have been losing over this issue. I have been researching and writing about how doctors are inadvertently undermining women’s ability to breastfeed for many years now. So glad to see this issue getting the attention it deserves.
Jennifer Margulis, Ph.D., author of The Business of Baby
December 31, 2013 at 1:41 am
[…] million-dollar question, and one the Academy of Breastfeeding Medicine (ABM) recently posed in a letter to AAP President, Dr. Thomas K. McInerny. While it’s unclear how much money the infant formula […]
AAP Partners With Mead Johnson | baby gooroo
January 15, 2014 at 9:48 pm
[…] Laboratories, Nestle, Mead Johnson and others will do just about anything to fill their piggy banks including slyly undermining the […]
Breasts On Our Minds | Our Milky Way
March 23, 2014 at 8:14 am
[…] attracted criticism from many, including the Academy of Breastfeeding Medicine (ABM), which called on the AAP to terminate its relationship with Mead-Johnson (as of November 2015, the AAP has taken no […]
How Discharge Kits Negatively Impact Breastfeeding Rates | baby gooroo
November 24, 2015 at 9:44 am
Is there an authority or doctor’s group who would send information to doctors who promote formula and early solids over breastfeeding? If not, there should be. When a mom posts that her doctor tells her that formula is better, or that she must start solids at 4 months, it would be nice if we could refer her to an organization that would send a strongly worded letter along with an informational brochure on why this is incorrect.
Jennifer R
May 13, 2016 at 1:50 pm