I’m not going to go on about how mother’s milk is better than formula. We all know that food that comes in a box and has a shelf life is not as good as the other type of food — whole food, natural food, whatever you call it, you know: food food. But infant formula is food for babies who don’t have access to mother’s milk for whatever reason and like me, I’m sure you don’t have any desire to keep babies from food. And just like if someone were to send you a jar of peanut butter, a crate of oranges, a pumpkin spice latte, a bunch of kale, a can of mace, or a puppy by mail, when you receive a box of infant formula by Canada Post it is your moral problem to do something with it.
You can eat it. You can chuck it. You can put it on a shelf in case you need it later. You could try having it sent back to the return address. Or, you can try to get it in the hands of someone who needs it right now.
My friend mentioned that her church was collecting goods to donate to Win House, so I sent my unsolicited box of mail-order formula with her. Win House accepts donations by appointment. I did remove the coupons first, though, as the internets tell me that as soon as the coupons are used, evil robots send more formula directly to your home.
I asked the Edmonton Foodbank about how they distribute formula and was told that it is only given to people who ask for it. Families ask for infant formula by brand and by type. Formula is on the Edmonton Foodbank’s list of “most needed” items. You can drop off donations at any major grocery store, fire department, or take them directly to the Foodbank.
The Foodbank produces a “Hunger Count” report on who is using their services. 841,191 Canadians use the food bank each month and that number is climbing. Of those users, more than one in three (36.9%) are children. If 6% of those children are infants (0-1) that means that at least 18,717 babies are fed by the food bank every month. (6% is likely a very low estimate and is based on a quick gander at census data from 2011 — I expect the number of infants to be much higher because families with new babies are more likely to need the food bank.) Grossly assuming that 6% of the food bank’s population are infants: at least 18,717 Canadian infants are being fed by the foodbank monthly. If 1 in 4 of those babies are exclusively formula fed 6 bottles per day, the food bank needs 10 million bottles of formula a year to support them. If, however, 9 out of every 10 of those babies are exclusively breastfed, only 4 million bottles are needed per year. If bottles cost $2.50 each, a 90% breastfeeding rate among food bank users would save 15 million dollars per year. But still: 4 million bottles would be needed. 4 million bottles. So don’t chuck it. Donate it.
One of the many heartbreaking things about those big numbers is knowing that formula companies are actively trying to tip the balance and increase the number of formula fed babies, whether or not they come from the most vulnerable population sectors. They’d rather Canadian food banks need 10 million than 4 million bottles of formula per year for obvious reasons: it’s a good business model for them to prey on newborns from low-income families. Do I sound paranoid?
This week, Reuters reports that a heap of Italian doctors has been arrested for taking bribes from formula companies (including lavish holidays, luxury cruises, televisions, apple computers, etc.) to prescribe formula instead of breastmilk to their patients. Yuck.
Baby food represents a more than 1/2 a billion dollar industry in Canada.When it comes to preventing predatory marketing by formula companies, Canada is “Failing to Make Baby Steps“. Which means formula companies are free to play their hunger games with Canadian babies. What to do about it? I wish I knew.
It arrived while I was teaching night school, and because it was close to my birthday and thinking it a gift, my husband told our daughter that she couldn’t open it for me, she had to wait, and so, a 2 kilo brown box with my name and address on it, full of expedited mystery sat tormenting her until I finally walked through the door and she pounced, pleaded, jumped up and down a few times, and tore it open.
It was a variety pack of infant formula samples for newborns, a rubber nipple in a bubble pack that could screw right onto the formula bottles, and two rebate cheques for when I buy more newborn formula at the store and/or a formula product for gestating women called “Similac Mom.” There were letters congratulating me as a “mom-to-be!” and explaining that “Similac Mom” could solve the problem of “making sure you get the extra nutrition you need so that you have energy — for you and your baby.” There was also some “wholesome support” in the form of 19-page booklet with info about feeding choices and especially how-to tips on bottle-feeding. The gist of the info-advertorial is that while breastfeeding is “truly magical,” Similac formula is nutritionally complete, does contain “galactooligosaccharides,” and has hassle-free packaging “designed with moms, for moms” with a scoop in the lid so it doesn’t get lost. There were coupons for other Similac products, a flyer advertising a free Similac app, and a brochure explaining why Similac is trusted by moms like me, with a nice black & white glossy photo of some strong male arms tenderly supporting a relaxed newborn.
Some context: I have three children and the youngest is in kindergarten. I am NOT a mom-to-be. I have been a mom for 9 years. I am not a has-been as a mom, I am still momming it up, but I am NOT preparing to hold a newborn in my arms. I did NOT consent in any way to being part of the “Similac Club.” That is why, when my 9 year-old opened the package, she proclaimed it, “The dumbest thing ever.” I think it’s worse than “dumb,” though. Here’s why:
When I was a kid in the early 80s’, I watched a documentary in the basement of the Stanley Milner Library about struggles toward development in third world countries. The documentary explained that in some of the poorest countries in the world, formula companies were aggressively marketing to vulnerable populations. They would distribute formula samples and bottles in areas with terrifying infant morality rates, insisting that bottle-feeding was better for babies, and young mothers would stop breastfeeding because they wanted to do what was best for their newborns. When the samples were gone, if a mother wasn’t able to buy more formula, and discovered that her own milk supply had dried up as a result of not breastfeeding while using the formula, her baby would die in her arms. Sometimes the babies wouldn’t die of starvation, sometimes they’d just be malnourished because the mothers would stretch the formula a long ways by over-diluting it with water. Malnourished babies are, of course, more susceptible to death by disease, though. And, if the mom didn’t have access to clean water, even if she could afford the formula, her baby’s new immune system wouldn’t be able to fend off everything that was in the water babies were drinking mixed with formula instead of their mother’s milk. Many babies, infants and toddlers died as a result of these predatory marketing strategies. This film made an indelible impression on me, and I can still vividly remember, 30 years later, the faces of these grieving mothers and especially their thin, empty, outstretched, pleading arms. Formula companies — I have not forgiven you for this. I see, however, that you’ve been able to put this history behind you and to move on. Well.
In 1981, The World Health Organization drafted the “International Code of Marketing Breast-Milk Substitutes” to restrict unethical and predatory marketing by the baby food industry. Every country in the world has been asked, by the UN, to adhere to it. Under The Code, formula companies are prohibited from producing “educational” materials about infant feeding that feature brand name products, like the one Similac sent me. The Code prohibits the baby food industry from marketing infant formula in hospitals via free samples to new families. The code prohibits initiating direct or indirect contact with mothers for the purposes of marketing. And the code says nothing at all about marketing adult formula for gestating moms. That is, I believe, a new loophole that Similac’s Abott Laboratories has cooked up to get their product into unborn babies. The “International Code of Marketing Breast-Milk Substitutes” is revised every 2 years to close loopholes that the baby food industry finds and exploits.
Does prohibiting the baby food industry from marketing infant formula in hospitals or elsewhere via free samples seem extreme in a wealthy country like Canada? Surely no babies will die as a result of her adult caregiver’s legitimate decision to formula feed, right? Is marketing infant formula in Canada different from marketing anything else to new moms like booties, bumbos and bras? Newborns can’t make decisions, but aren’t their caregivers solely responsible for making smart and educated consumer choices?
It is known that marketing infant formula is a special case. Formula samples don’t just provide an alternative to human milk; using the formula instead of human milk actually causes the supply of human milk to dwindle and disappear, thus creating a problem, otherwise known as “a market”, where there wasn’t one before. Breastfeeding often requires a learning curve. If you are adverse to struggle, and especially to seeing a baby struggle (and who isn’t?), and you use formula or pressure a mom to use formula at the first sign of struggle, the mom/baby pair are much less likely to learn to breastfeed. Where formula samples are handy and available, breastfeeding rates shrivel and droop.
In a study published in The Lancet, new mothers were given formula samples at the hospital, or not, and then surveyed at 1 month to see if they were still breastfeeding, or not. The moms who were given formula samples at the hospital were significantly less likely to be breastfeeding (78% vs. 84%). Of those who received formula samples at the hospital, some were also sent direct-mail samples, or not, and of those, the moms who received samples by direct-mail were less likely still to be breastfeeding (18% vs 10%). The study found that the trends revealed were even more significant in vulnerable subgroups: mothers who were less educated, first time mothers, and mothers who were coping with a medical condition.
It’s not about taking away anyone’s choice — formula should be available in pharmacies and other normal channels for families that need it. But new moms and their newborn babies are vulnerable people and if marketing formula to them interferes with their babies’ access to free and healthy human milk, those barriers should simply be removed. As humans, shouldn’t we all have a right to human milk? Isn’t this right more important than big pharmas’ “right” to market to infants? We don’t need to regulate the marketing of medical supplies like catheters or band-aids because people don’t buy them if they don’t need them. Formula is different. If it’s there, it’s much more likely to become needed in a long-term way that is profitable for manufacturers and costly to families and taxpayers. That’s why Similac can afford to send me an expensive box of formula samples. It’s like free drinks at a casino — the odds are stacked against you, baby.
A recent study (2014) looked at the effect of what was in the hospital discharge bags new moms were sent home with. Moms received either no bag, bags with formula samples or bags with breastfeeding supplies. The moms who received breastfeeding bags or no bags were significantly more likely to be exclusively breastfeeding. Moms who received formula samples were significantly less likely to be breastfeeding. Another study (1992). double-blind and peer reviewed, in the Journal of Human Lactation showed a decrease in exclusive breastfeeding when formula sample “gift packs” were distributed randomly to breastfeeding women. It’s the kind of gift that keeps on taking. From babies. Another (2008) study in the American Journal of Public Health showed similar findings, and the research goes on and on. Formula samples, coupons, advertisements and other “gifts” by baby food industry marketers disrupt the learning process and the confidence required to breastfeed.
Breastfeeding is not “magical.” It is physical. It is also social and cultural. Feeding decisions are highly dependent on what is considered healthy, proper, and normal. The signals women get from the ads they see, from the family members they love and respect, and from their caregivers — whether those messages are verbal (like 98% of women can breastfeed) or non-verbal (but just in case you are someone who can’t, we’ll send you home with some coupons and samples). — matter.
What is the harm of lower breastfeeding rates in industrialized countries?
There is the cost of formula to the families.
There are costs in terms of health care. One lactation specialist calculated the costs of not breastfeeding to the U.S. at over $1 billion dollars in annual health care for the treatment of just four infant medical diagnoses associated with not breastfeeding, including infant diarrhea, a big killer of babies in the third world. A 2001 article in the Journal of American Academy of Pediatrics calculates that if “90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants.”
Given this information, it might make sense for us, as a nation, to simply pay formula companies not to advertise to new families. But that’s not how it works, is it? We don’t get paid not to prey on infants. This is something we’re just expected to not do. When formula companies don’t play by the rules, who absorbs the costs? Taxpayers, obviously, absorb the economic costs. What about the other ones?
There are economic and there are personal costs. There are, literally, the costs of persons.
Then there are the costs that are much more difficult to quantify. If you speak to a woman who gave birth in the 70s in Canada, when it was routine for moms to be told “you can’t breastfeed,” and for their babies to be summarily given bottles of formula by maternity nurses, you will hear personal stories in which women search for the right words to describe what it feels like to not be “able” at a moment when they are so new and vulnerable, while at the same time caring for someone who is so new and vulnerable.
I’m not new and vulnerable. I’m old hat. That’s how I was able to sit and research this on a Saturday morning.
So how did I get welcomed into the “Similac Club?” Here’s what I think happened:
“Unquestionably believe that which you stated. Your favorite reason appeared to be on the internet the simplest thing to be aware of.I say to you, I definitely get annoyed while people think about worries that they just don’t know about. You managed to hit the nail upon the top and defined out the whole thing without having side-effects, people can take a signal. Will likely be back to get more. Thanks”
Now I do know better but sometimes I am a curious monkey and I replied:
“Thank you, Spambot. I appreciate your unquestionable believe of that which I have stated. The simplest thing to be aware is my favorite reason appear on the internet too! Also, what happens when you reply to Spambots? I prolly shouldn’t…”
A box of formula samples from Pharmacommunications Group Inc. arrived at my home, addressed to me, containing “A special gift for you and baby.”
The blog post is categorized as a “parenting essay,” it contains the words “fussy baby” and even “Nestle coupons” and is tagged with “mothers and work.” It’s about the malaise I felt as a new mom when I couldn’t get lost in writing and research projects like this one.
Similac, a.k.a. Abbot Laboratories, a.k.a. PharmaDirect, a.k.a. Corina Thomas: Similac Club Manger and Proud Mom, do you have Google-bots that comb mommy blogs for
new moms lost in a haze of confusion and sleep deprivation with their fussy babies target markets?
Is what you’re doing ethical? I do not think that it is.
I’ve worked in marketing before, and so my educated guess is that the World Health Organization’s Code of Marketing of Breast-milk Substitutes seems like some arbitrary hurdle getting between you and your doing your job properly, and not like some rules put in place to protect vulnerable people from predatory marketing. Might you be interested in taking a wider view on this?
It’s that time of year in Edmonton when the jackrabbits’ fur is not quite brown to blend in with the grass and dirt, and not quite white to blend in with the patchy snow that’s just begun to arrive. It’s the true transition between fall and winter when it dawns on all the little kids that their mom was right, their Halloween costume is going to need to fit over their snow suit.
Parents are dropping their kids off at Elementary school late and spent from the sheer logistical weight of all those extra layers of clothing. Things like soccer balls and gardening tools not yet tucked away look like refuges from a far away land, all helpless and frozen as if in terror to the ground. The walk to school requires at least 10 extra minutes so that the kids can smash the ice on all the puddles and stomp down the grass that’s turned from soft to brittle.
I love the changing of the seasons. Every spring/summer/winter/fall the season it’s not seems so unlikely, nearly impossible. And then there it is. It never fails to surprise me.
CBC’s Anne Marie MacDonald is, unshockingly, an excellent writer. I picked up her new novel, Adult Onset from the EPL\s Hits To Go section. Hits To Go is a shelf of what’s new, hot, and expensive (hardcover) at Chapters right now. The catch is that you have to read the book in a week. The awesome part is that you have to read it in a week.
Adult Onset is all Bloor and Spadina, having small kids at middle-age, Googling medical symptoms, piecing together distant and splintered memories, anxiety, aging parents, having nervous breakdowns while trying to get a toddler to put her boots on, and a dull fear that plastics in the water is giving everyone cancer. Wait. That last one might be me. Or is it Mary Rose, the main character?
One thing I love about fiction is it helps me appreciate how neurotic other people (ahem) are.
I fell in love with the book on page 62, when the narrator says:
It is five o’clock: witching hour for children and puppies, who tend to go rangy around then, bitching hour for those returning home from work, worry-and-wander hour for old folks suffering from sundowning. It is the primal tilt between day and night that strikes low-grade dread into the heart of Homo sapiens, a holdover from the time when we were prey. It is why cocktail hour was invented.
I hate five o’clock. Do you know what helps with five o’clock? A crock pot.
Can you see I’ve signed up for an Amazon Affiliates account? I don’t expect to make a shiny die, but I’m curious about how it works. And it’s true about the crock pots and 5 o’clock. I know it to be true. Don’t underestimate the power of a crock pot.
How alienating is this add content?
But wait…this is a book review. Sort of. I fell a bit further in love with Adult Onset when the protagonist insists that:
[She] has her inner Martha Stewart in check. That is a slippery slope: you start making your own ricotta, next thing you know you’re in jail.
House of Flurfel
Dear 10-year-old Marlene. It’s the 80’s. You play for the Athabasca Tomboys. You look like this:
You’re the wrong size and shape and you’re always in left field kicking dandelions, watching clouds drift by, and wondering why you strike out when it’s your turn to bat. The other girls on your team are all effortless grace, beauty, and athleticism. Well. It seems that way from left field. Your big brother is about to come to one of your games, notice how terrible you are, and take it upon himself to teach you how not to throw like a girl. This will be an important lesson for you. It will be the most important thing you ever learn. This is the secret: the ball goes where you throw it. Your intention matters. He’ll also teach you how to bat and catch. Same dealio: intention and effort. Sounds simple enough, but you’ll get the biggest shiner of your life figuring that one out.
He’ll throw pop fly after pop fly into the air while yelling at you to “Get under the ball!” You’ll eventually do it — run to the spot where the ball’s trajectory plainly tells you it will land. You will watch it come towards you and it will land on your eye socket. It will hurt very much. But it will be a revelation: you need to watch where the ball is going, run to where the ball is about to land, and stick your glove between the dropping ball and your upturned face. “Thwack” is the sound it will make landing in your glove. It is a beautiful sound. Once you get it you’ll catch every pop fly. Then you’ll get to be a short-stop. That will be a lot more fun.
Dear 40-year-old Marlene:
That’s all you know, really. Life is balls. You’ve gotta get under them. It requires effort and risk. Effort and risk are the twin engines that make anything go. That’s how you make a baby laugh. That’s how you write a play. That’s how you bet out of bed in the morning and how you love someone. Effort and risk are the twin engines of love. Effort and risk are the twin engines of creativity. Same dealio.
Dear Newborn Marlene:
I hate to tell you this but you are a writer — not the famous kind. It’s going to suck and it’s going to be wonderful. I don’t think there’s much you can do about it. In the meantime, please try to nap as much as possible. You’re going to need your strength. Please, please, please, Marlene, at this very important point in your life do not resist sleep. Resisting sleep and refusing rest is a bad habit that will exhaust you and those around you for the rest of your life and you should stop — just stop it — right now. You look like this:
You think your mama is the most beautiful thing in the universe. You are right. Of course. She is.
Dear 20-year old Marlene: It’s the 90’s and you are a baby who wears plaid and army boots and patchouli. Holy smack you’d be mad at me for saying that. Because you’re a baby. I could also offend you greatly by telling you that you have small-town hair. Because you do. You think it’s hard to be 20 but that 40-year-olds effortlessly have their shit in a nice tidy pile. You’re right — it is hard to be 20 though I’ll be damned if I can remember why. Something about being at the bottom of some very steep hills? Something about trying way too hard to appear not to be trying? Something about being judged, graded, cut loose, and expected to fit into a world you didn’t make? But you’re wrong about the effortlessness at 40 part. That one will come back to bite you in the ass when you start teaching 20-year-olds at 40. Hahahaha. Dummy.
But whatever. Like you’d listen to 40-year old me. Don’t. Have fun. 20-year-olds are better at having fun than anyone else. Make some great friends. Oh, and the freedom! And the having time to kill! Go ahead and kill time, Baby. Waste it lavishly and feel sorry for yourself about all the responsibility on your shoulders. Hahahahaha. Responsibility. Don’t be ashamed about being young, 20-year-old Marlene. There is nothing shameful about young. If you are too busy trying to act like you know everything already you won’t learn anything at all. Protect your face with your glove, of course, but don’t be so protective of yourself that you don’t bother running for those pop flys. Effort and risk, Marlene. Your intention matters.
Dear 30-year old Marlene. You’re going to spend this decade producing a small pile of babies in the suburbs. It will be the most wonderful thing that every happened to you, pudgy cheeks pressed up to yours and milky dreams, and it will be exhausting and paradoxically lonely. You won’t have a photo of yourself in this decade without babies and toddlers cropped out of it. Your house will be a disaster and you’ll often wonder if you’re doing everything wrong. You’ll feel like your writer-self is lost down some rabbit hole. Don’t worry about any of those things. That’s the way it’s supposed to be. The intensity of making all those decisions will ebb. Having babies is not an easy thing. It is better than easy, it is worthwhile. Worthwhile costs and it rewards.
But you should probably worry about money more. Or perhaps less? I don’t honestly know. We should ask 50-year-old Marlene when she gets here.
House of Flurfel recommends these Kelowna road-trip musts:
1) Hold your daughter in your arms while wracked with worry that her appendix is about to explode and then count the cherry pits in the cup holder beside her. 26 = a rite of passage; not a medical problem. We’ve all done it. Amiright?
2) Terrify your children by listening to Ogopogo monster “documentaries” on YouTube as you drive along Lake Okanagan. If you stop at a fruit stand, ask the cashier if she knows anything about the monster. If she says she’s never seen the monster but definitely has friends who say they have, ask her if her friends seem like reliable types. If she answers “sort of,” nod solemnly in plain view of your children.
3) Stop at a winery with your kids and find out it has brothel theme. Get the stink-eye from a couple there for being someplace inappropriate with children. Enjoy your glass of Gewurtraminer anyway. If your children notice you are quite relaxed on the patio over-looking the vineyard and take the opportunity to ask you about the cosmos, consider the time well-spent.
4) Learn a new constellation while star-gazing with old friends.
5) Start a blogpost on your iPhone using the WordPress App. Make sure the title promises a list of 10 things but don’t finish the list because it’s 39 degrees out and you’d rather go swimming. Publish it anyway.
If you check out the line-up for this year’s North Country Fair you’ll see Paper Wings Puppet Co. That’s us. We’ve got a gig. Papa Flurfel is starring as the Moosicorn in “The Moosicorn’s Tale.” There will be giggles. There will be uke. There will be a giant moth. There will probably be a giant moth. Follow our Paper Wings Puppet Co. blog for snapshots of what we’re up to. You can get a peek at Mordecai the Moosicorn there. I think he’s handsome.