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When I was expecting my first baby I received, on two different occasions,

samples of baby formula from Mead in the mail. I had not knowingly

requested these samples, which came in an attractive box, complete with an

infant development booklet, stimulatory flash cards for my baby, and some

product (mis)information. The first time this happened I was surprised,

bemused and annoyed. I had already decided to breastfeed my baby and I was

somewhat familiar with the benefits of breastfeeding and the hazards of

formula feeding; I was not for a moment charmed by this sophisticated

attempt to lure me into a world of sterilizing bottles, buying and mixing

formula and having a baby with a myriad of health problems that could have

been prevented with my own milk.

A few months later I received a second package, again from Mead .

This time I became infuriated; after receiving the first package I had

written letters to Health Minister Allan Rock and to a dietician at Mead

(more about that later). I felt this time that I was being

attacked; obviously my angry letters were not enough to deter this company

from making another attempt at convincing me that my milk would be inferior

to their product.

The third time I received a free sample of formula was after my baby was

born. We had put a birth announcement in the Toronto Star and as a thank

you they sent me a coupon for a gift pack from Sears. I should have known.

When we went to Sears to pick up our gift I looked in the bag and found,

among other things, a pacifier, a bottle and a sample of formula. This

time I was outraged and insulted. I refused the package, explaining to the

poor sales clerk that this violated the WHO/UNICEF Code of Marketing of

Breastmilk Substitutes and that they should not be giving the samples out

to new mothers (of course, she had no idea what I was talking about but

said she would tell her manager).

When I received the first sample in the mail I remembered having been

encouraged by The Complete Mother magazine to send all samples of formula

to the Federal Health Minister. I found the address and sent it to Allan

Rock, including a letter indicating my concern about Canada’s lack of

compliance with the Code. In his reply Mr. Rock listed the many things the

Canadian government is doing to support breastfeeding, for example,

publishing booklets, but he did not mention once the accountability of the

government to enforce the Code.

I also sent a letter to Elaine Sylvestre, a Registered Dietician at Mead

. The following quotes from her response reveal an insulting

attempt at convincing me that Mead puts the nutritional health of

infants before their revenues: “…the health of infants is first and

foremost in Mead ’s business practices and…we do endorse and support

breastfeeding as the superior form of infant nutrition.” “All our marketing

activities promote the importance of breastfeeding…” “Our intent is not to

persuade mothers to bottle-feed…” In response to this I wrote another

letter, this time not so diplomatic or polite.

The second time I received a formula sample I once again sent it off to the

Minister, as well as another, very sarcastic, letter to Ms. Sylvestre. I

received no reply from either. By the time I was given the third sample I

was a mother of a three week old, incredibly sleep-deprived, and in no mood

to write yet another series of letters. I was also feeling somewhat

attacked by the formula industry, like there was a conspiracy to persuade

me not to breastfeed my baby. This experience made me wonder why it was so

important to the formula companies to trick me (and every other new mother

in the world) into formula-feeding my baby.

The World Health Assembly passed the WHO/UNICEF International Code of

Marketing of Breastmilk Substitutes in 19811. The Code stipulates that

formula companies are not to advertise breastmilk substitutes, give free

samples to mothers, and have no images idealizing formula feeding on their

products, including pictures of infants2. The Code has not been passed

into law in most countries, although formula companies are expected to

abide by it. However, companies such as Mead and Nestle

consistently break the Code by giving women free samples and advertising

their products, with very much idealized images, in parenting and health

magazines.

There are many examples of how formula is aggressively marketed to new

mothers around the world. In many less developed countries (LDCs), “health

nurses” go into the communities to promote the products; these women are

often not even real nurses, but women employed by the companies to convince

women to use artificial milk3. Advertising campaigns in LDCs portray

formula-feeding as the Western ideal, with breastfeeding being depicted as

“primitive” and unsophisticated. Women are often given “gifts” of free

formula as they leave the hospital with their babies. Heise (Vol. II, p.

174) reports that female children receive less food than male children.

One of the most horrifying pictures I have ever seen depicts an Indian

mother with twin babies, a boy and a girl. Because she was convinced that

she did not have enough breastmilk to nourish both babies, she chose to

breastfeed her son, giving formula to her daughter. The female baby is

less than half the size of her brother, and obviously malnourished; she

died the day after the picture was taken4.

In Industrialized nations, women are similarly targeted. Free formula

samples are easily acquired: They are given out at Baby Steps seminars

held by Mead , which are supposedly informative workshops about

infant development; when a woman makes a purchase at Thyme Maternity

stores, she can fill out a form to receive formula for free; Sears and

Zellers give out gift packs containing formula (as well as bottles and

pacifiers) to new mothers; filling out a card found in pregnancy and

parenting magazines such as Great Expectations will get women some formula;

and, of course, in the hospital formula is not only available for any

mother who is “too tired’ to feed her baby, but is also given away as the

new family leaves. One company in the States is offering a $10.00 off

coupon for formula with every breast pump rental5! Formula companies often

offer architectural services to hospital nurseries, designing them in such

a way that they are located far from the postpartum rooms. Company slogans

can be found on name plates in baby basinets, on wrist and ankle bands

placed on mothers and babies, and on a myriad of other products given to

the hospitals for free, such as posters, growth charts and stationary.

Many hospitals accept gifts of millions of dollars from formula companies;

for instance, Women’s College Hospital (WCH) recently signed a contract

with Mead whereby WCH received $1 million the first year and will

receive $350,000 per year for the following nine years6.

When a woman is given free formula she is very often tempted (or

encouraged) to use it.

By the time the formula runs out, her milk supply has become insufficient.

She must then continue to use the formula, which has dire health and

economic consequences for the baby, the woman and her family. Many babies

die or become very ill because of gastroenteritis, which causes severe

diarrhea and dehydration. This is more prevalent in LDCs, where there is

no access to clean water with which to mix formula or sterilize bottles,

and where women are often forced to dilute formula to unsafe levels because

they cannot afford more (a week’s supply of formula may cost as much as a

family makes in two months). However, babies suffer from diarrhea,

dehydration, and about twenty other health problems caused by

formula-feeding in developed countries as well. Breastfeeding rates are

lowest amongst women who live in poverty. These are the families that

could most benefit from breastfeeding, as children living in poverty tend

to be less healthy in general, and a woman can save about $1000 per year by

breastfeedng her baby.

It has been demonstrated repeatedly that governments and hospitals can save

millions of dollars every year if babies are breastfed until six months of

age. This makes one wonder why there is not more done on the part of

governments to promote breastfeeding and endorse the Code. To understand

the answer to this question, one has to understand that when there is money

to be made, the health needs of women and children are cast aside. When

babies are fed formula many people (mostly men) benefit financially,

including hospitals, doctors and formula companies. The formula industry

grosses about six billion dollars a year7. The CEO of Bristol-Myers

Squibb, which makes the formula Enfamil, earns $13 million a year8.

However, no one makes money when a woman chooses to breastfeed9.

Governments in Canada and the United States are making half-hearted

attempts to encourage women to breastfeed, but there will never be full

compliance with the Code as long as the formula industry is pulling the

puppet strings.

According to Human Rights Watch, “International human rights norms ensure

to women the right to receive information regarding sexuality and

reproduction…” (Vol. II, p. 372).

Breastfeeding is an integral part of the reproductive process, and women

are not receiving adequate information about breast vs. formula-feeding.

In traditional societies, when the breast is offered to the baby

continually throughout the day, children are naturally spaced about two to

three years apart. When a woman does not breastfed her children, she is at

greater risk of frequent pregnancies spaced close together. This is

neither healthy for her nor for her children. Frequent pregnancies don’t

necessarily lead to many children and overpopulation, but they do lead to

higher prenatal and neonatal mortality rates. They also drain the

resources of the family, as there are lost wages, increased medical

expenses, and the cost of the formula itself.

Because women are childbearers and nurturers, they have perpetually been

excluded from having any power in the public sphere. In LDCs, especially,

it is not just women’s biology that leads to this exclusion, it is also

factors of class and race. Consequently, women are powerless in the

institutions of government and industry, the two forces that are making the

decisions that affect women’s lives.

In the last 150 years male scientists and doctors have created medical

problems that simply did not exist before. Home birth was safe and normal

until men decided that women should be “confined” for the event (the term

“expected date of confinement” is still used today). In fact, maternal and

neonatal morbidity and mortality rates increased after birth was moved from

home to hospital. Until men began developing “scientifically accurate”

baby formulas, women were breastfeeding their children, usually for at

least one or two years, without any problems. When formula was introduced

onto the market, infant feeding became a science. Since women could not

possibly measure exactly how much breastmilk their babies were getting, and

they were unable to tell what the nutritional constituents of breastmilk

were, breastfeeding was deemed unscientific, old-fashioned, and simply

inferior to formula-feeding. Through advertising, formula companies make

mothers feel guilty about not providing the absolute best nutrition for

their babies, and for most of the twentieth century women truly believed

that formula was superior to their own milk.

While there are some grassroots groups (mostly women) fighting to promote

breastfeeding and stop global formula-pushing, it has been an uphill

battle. Capitalism and patriarchy drive the formula industry, and the

belief that formula is as good as, if not better, than breastmilk, has

become ingrained in social belief systems worldwide.

The obvious solution to this problem would be to eradicate capitalism and

the oppression of women (perhaps in my next life I will be a superhero).

Formula is one of many products marketed to the public in a way that makes

people believe that it is an essential product to have access to. Without

financial gain as a motive, the formula industry would not exist; human

babies survived quite nicely for at least a million years without an

artificial form of nutrition available. It has only been in this century,

since formula companies, beginning with Nestle, discovered that they could

make huge profits by coercing mothers not to breastfeed. It is also big

business for doctors, hospitals (especially in the US) and pharmaceutical

companies who profit indirectly from treating sick babies.

In the absence of patriarchy, there would be no basis for the oppression of

women, including the control over women’s reproductive health. Just as

with prostitution and pornography, men exploit women’s bodies for financial

gain, and I find it hard to believe that women would genuinely choose to

formula-feed their babies if they weren’t being compelled to do so.

Breastfeeding can be an empowering experience for a woman; it can give her

a greater sense of self-esteem and more control over her and her baby’s

health. I also see breatfeeding as freedom from patriarchal and capitalist

clutches. When a woman chooses to breatfed she actively chooses not to

give (primarily) white men in expensive suits her money; she also chooses

to have more control over her reproductive life and her family’s health

than she would have otherwise.

These two solutions (the elimination of capitalism and patriarchy) are

long-term and idealist goals. One short-term and much more practical

solution is to increase education around breastfeeding. Information about

the benefits of breastfeeding should not just be available to pregnant

women or new mothers who have already been exposed to the influences of

formula advertising. Children (male and female) and young people

approaching their childbearing years should be knowledgeable about

breastfeeding before they become parents. Books that describe the how-tos

of breastfeeding can be very valuable for women who have no support or who

are having difficulties, but such books did not exist before the advent of

the formula industry. Women simply nursed their babies, and if there was a

problem, a there would be another woman close at hand who could help out.

La Leche League International has done much work to increase breastfeeding

awareness and to offer support for women around the world.

Another short-term solution is to make formula available by prescription

only. There are a few instances where breastfeeding is truly impossible;

if a milk bank or wet nurse are either unavailable or undesirable options,

formula could be made available in this way. This could actually benefit

some women if they have an insurance plan that would cover the cost. This

would help keep the formula companies and their advertising schemes in

check somewhat.

I have been able to strategize in some small, perhaps not very effective,

but definitely personally rewarding ways. First of all, I chose not to

purchase formula and bottles for my baby. I also made all of her baby

food, so these companies really did not get any of my financial support at

all. The health, interpersonal and financial benefits my family has reaped

have been empowering to me as a mother. My partner and I have also chosen

to boycott Nestle, as we feel that 1.5 million infant deaths a year around

the world is simply unacceptable. I take every opportunity to share these

feelings with others, and I know I have made a small impact. Because I

have educated myself in the hazards of formula-feeding, the benefits of

breastfeeding, and how the formula industry works, I am now able to educate

others, which I can do on an informal level, or professionally once I

become a midwife. I believe that even if I am only able to convince one

other person in my whole life, I have automatically doubled that knowledge

base. By nursing in public (I still nurse my thirteen month old) and by

answering questions posed by curious family members and strangers, I can

have a further impact on society’s attitude toward breastfeeding.

I found it very offensive to be sent free samples of formula while

pregnant. The reasons why I was sent the samples, why they should not have

been sent to me, and why I was offended are very complex. However, women

have to work together to fight for their reproductive freedom. It takes

absolutely no resources to nourish a baby with breastmilk, and when a woman

makes this choice, it sends a very powerful message to the industry, the

government and the public.

--------------------------------------------------------

Sheri Nakken, R.N., MA

Vaccination Information & Choice Network, Nevada City CA

http://www.nccn.net/~wwithin/vaccine.htm

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