Similac targets unborn babies in their Canadian homes

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:

One of my most popular posts on House of Flurfel is Motherworkin’ Part II: Interruptibility. On October 4th, 2014 a visitor called “Google Authorship Program” visited the post and left the comment:

“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?