Monday, July 30, 2012

Pediatricians & Formula Paraphernalia - A Bad Combination

I am sort of bossy, but I try not to tell people how to do their jobs -- unless they are doing them wrong!  I have found myself twice in the last few weeks insisting that my pediatrician's office remove coupons for free formula from their check-out desk.

Let me back up.  When we first moved to the Ft. Worth area seven years ago, we got a reference for a pediatrician, but only stayed there for about a year.  The last straw was when I went to pick up my kids' medical records and -- you might think I'm a bit of a fanatic at this point! -- they asked me to write my kids' names on a pad of paper shaped like a bottle with "Similac" down the side.  I refused to use the paper and asked for a regular piece of paper.

Fast forward:  we've had the same pediatrician for about 5 years until she developed breast cancer.  I never saw any formula anything -- samples, coupons, or notepads!  When she got sick, they brought on a new doctor.  While I think she likes to hear herself talk, at least I didn't see any formula paraphernalia since she joined the practice.

Low and behold, the doctor we used when we first moved here recently joined this practice too and now there are coupons for free formula!  Ugh.

This is not an attack on people that formula feed.  I realize there are a million reasons why someone might want coupons for free formula, but again, that is not the issue at hand.  This post is about the pediatrician and whether or not they should display formula paraphernalia. 

So why is this a problem?  First of all, the biggest problem that I see is that it's NOT pushing breastfeeding.  By the very nature of having the coupons at the check-out, it sends a message to the parents that formula is endorsed by the doctor.  Who can resist a "FREE" coupon for anything?  Breastfeeding is also free, but I don't see a sign anywhere that reminds the parents of this simple fact.

"Please don't offer my mommy formula coupons unless she asks."

It is well documented that breastfed babies have fewer trips to the doctor's office -- something that benefits them for a lifetime, not just as a baby.  When the pediatricians make a comment about never seeing my kids, I always point out that they were exclusively breastfeed with no formula.  I hope they make the connection, but it's funny when you have a teenager sitting on the table.  Do the pediatricians even recognize the difference breastfeeding makes long-term? So the question must be asked -- Do they push formula so they see the kids in the office more often and therefore, make more money?  Just a thought...

When I said something to the receptionist the first time I saw the coupon, I definitely caught her off guard.  She didn't know what to say.  I wasn't letting it go, however, so she told me to hand her the coupons, obviously so she could end the conversation.  I asked if she was just going to put them back out the minute I walked out the door.  Pushy, I know.  While she said no, when I was back a couple weeks later, there they were!

When I said something the next time to a different receptionist, I went into the whole story about being there for 6 years and never seeing anything about formula in the office until the newest doctor came on staff.  Again, silence.  They don't see the problem and they don't know what to say.  How can they not see that this promotes formula-feeding and sabotages the breastfeeding relationship?!

Shortly after I posted about this on the BFBS Facebook page, a reader sent me a link to an Academy of Pediatrics statement on the distribution and display of formula materials in pediatrician offices.  Read it here.  It's all about the reasons why having formula materials in a pediatrician's office is a conflict.  I thoroughly enjoyed reading it and will be setting up an appointment with the head pediatrician to share it.

Several people suggested taking the coupons and throwing them away, but this doesn't solve the problem.  Then the doctors and receptionists think there is such a demand, they just get more.  Correct me if I'm wrong, but I believe there is a kickback from the formula company for distributing the coupons.

I told the last receptionist that since it's an area for "free" items, I'll bring her a stack of Resource Guides for the Tarrant County Birth Network promoting Mother-Friendly maternity care and plenty of great lactation consultants!  Again, silence.

I believe that it is so important that we speak up about the messages doctors send to new and vulnerable mothers.  We cannot expect change to happen and the normalization of breastfeeding to occur unless we advocate for breastfeeding.  If you are reading my blog, birth and breastfeeding have likely had a huge impact on your life.  Don't be afraid to share that, even if it means defending and promoting breastfeeding to your pediatrician. 


AnnElizabethLara said...

Awesome job! I always want to be that person, but wimp out. My favorite saying on breastfeeding isn't that "breast is best" it is the "breast is normal". Sure we all want the BEST couch, but we buy the ikea instead. Brest is normal resets the bar where people should be. Thank you again!

Bunnie said...

I'm sure the doctor do get kick backs from the formula company. Think of it this way, you know those samples of medication GP's hand out when you're in need of a medication? They get kick backs from those. Pharmaceutical Reps come in and offer them a lot of things. Not just note pads or clocks, but even all expense paid vacations, if they'll carry their drug, or in this case, formula. Have you ever seen, Love and Other Drugs? I realize it's a movie, but it sure opened my eyes. I no longer take the samples they give. I ask, is this what you would give your daughter if they had the same symptoms? Good for you for sticking up for breastfeeding! I think you should bring in some brochures on the topic, and I love the idea of a list of lactation consultants. Mothers need to know about that too!

Samantha said...

I feel the same way, especially when it comes to hospitals handing out those stupid formula sample bags, stuffed with free formula, coupons for formula, and worst of to wean your baby to formula from the breast!! It really makes me sad!! I totally understand that there are reasons why a mother would need to use formula (hopefully in conjunction with even a little breastmilk if possible), but I feel like if hospitals, pediatrician offices and stores keep making an 'easy' option available, people will keep taking it. And one can argue that breastfeeding IS the easier option, but when you do it full time, it's truly a commitment. I work as a nurse, and I always high five moms who breastfeed and praise them, because I know how hard it is!! If you're doing something that takes commitment and hard work and dedication, you deserve some kudos from a friendly face.

HoustonCourtney said...

Excellent writing & advocacy. I confronted my 1st pediatrician also on this issue +not participating in the federal vaccination reporting system & started going to public health clinics for immunizations. (those shot nurses know their stuff)
Also GOOD timing for your write-up; Send to Mayor Bloomberg!

Jim and Nicole said...

Things don't always work out the way we originally plan. For a mother who is experiencing severe breast feeding complications that free coupon may be a god send. I planned an all natural intervention free home birth for my first child. Instead I ended up with an emergency C-section. I planned on exclusively breast feeding for the first 6 months and instead only BF for two weeks before complications from my CS prevented BF any longer... With medical bills piling up those coupons etc were often the only thing that prevented my from having to choose whether to feed my husband and I or purchase formula for my child.

Kelly said...

I loathe formula advertising and freebies more then anyone! I am so glad the mayor of NY is standing up to this and saying NO MORE HANDOUTS!

Formula is a pharma product and should be handled as such...meaning available via prescription and subsidized for those who truly NEED IT. I am sick of the excuses. BF is not the 'easy choice' all the time and some times it is damn difficult, but it is worth it in the end every time.

beccalouise said...

when i was struggling with breastfeeding with my first one (for reasons that were preventable if i had known more), i was awfully tempted by the can of formula sample in the pantry. thankfully i made it though. but i can definitely see that having those things around does not help breastfeeding.

Emily said...

rock on, Donna! I hope to be able to have the courage to speak up like you have.

Perhaps if pediatricians insist that the coupons are there for people who truly cannot breastfeed and benefit from them, they should either have them when a woman presents saying she can't or does not want to BF, OR they could have them side by side with coupons for free breastfeeding-type assistance!

Hannah said...

Go you! I need to do this too.

Regina said...

Hmmm, I have honestly never noticed! We have an appointment in a couple weeks. I am going to check.

Jamie said...

You are a pain in the a$$ nut job.