Monday, June 18, 2012

"Breast is best, but choice is paramount" - a contradiction in terms?

The British Journal of Midwifery has been getting some flack recently because of it's association with an infant formula mild company, Cow and Gate. The concern is that Cow and Gate is breaking the International Code of Marketing of Breast-Milk Substitutes by influencing midwives' practice through providing free professional development. What is especially concerning is that a highly respected midwifery journal is supporting this practice.

Informed choice
The Facebook group  "British Journal of Midwifery- You can't be Serious!" has been highly critical of this, and is campaigning hard for the BJM to withdraw from this partnership. In response to the campaign, Professor Paul Lewis, a British midwife and midwifery academic, has replied in the BJM, with an article entitled "Breast is best but choice is paramount". In it, he says it is vital that midwives are informed about formula feed so they can provide information to women, so that women can make an informed choice about infant feeding.

Devil's advocate
Before I go any further, I have to say that I am not attacking individual women who make the choice to formula feed. What I am interested in, is the political, public health and financial agendas of this story. And I would like to be devil's advocate.

Informed choice is so often used to defend the use of formula feed, despite over-whelming evidence that breastfeeding is far better for babies, has far more health benefits, and ultimately will save the tax payer money (if a baby is healthier, he will not be needing healthcare). Smoking is a similar population health issue. It impacts on the health of the population, and burdens healthcare provision with illness such as cancer and heart disease. Yet, in the case of smoking, people are having their choice taken away from them. Increasingly, the freedom to smoke is being curtailed, with some countries even declaring an aim to be smoke-free in the not-so-distant future. Yet you never hear commentators talking about "informed choice" with regards to smoking.

Let's be honest
Please don't get me wrong...I am not saying women should be forced to breastfeed. But I do wonder if "informed choice" is used by health professionals to meet their own agendas.

All I am asking for is for the British Journal of Midwifery to be honest and say it as it's all about money, and little to do with informed choice.

What do you think?

Paul Lewis. (2012). Breast is best but choice is paramount.  British Journal of Midwifery. Vol 20:6 386-387.

Image: 'me_and_the_twins'


Anonymous said...

I absolutely agree with you Sarah, it is all about the advertising potential and I think it is a shame for one of the most respected journals to act in this way. Whilst informed choice is important, normalising artificial feeding should not be. It may now be a common way to feed babies but it isn't natural or normal. That isn't meant as an attack on women who do as I always respect their choices just a statement of truth. If we do not promote breastfeeding actively the downwards spiral of public health matters will only continue.

Sarah Stewart said...

We all know that advertising, even in its most subtle form, works. How tragic is it that we as midwives are responsible for introducing women to formula feed, especially without realising it.

Anonymous said...

There's nothing I love seeing more than a happy group of mums, confidently breast feeding their happy little babies. But there's nothing I hate more, than an isolated mum, sleepless and toxic from years of exposure to modern chemicals, beating herself down for failing to fullfill that long ago lost happiness to be human, and trying to milk those cincentrated toxins out of her childish nipples. Give the man a bottle of formula, and let him take the immasculating role of wet nurse in our pethetic attempts to retain some dignity in this lost world.

Anonymous said...

The Widower

Sarah Stewart said...

OMG, Leigh...that picture brought tears to my eyes :(

Sarah Stewart said...

Hi Leigh, this post wasn't about the rights and wrongs of bottle feeding, but rather the unethical attempts by formula companies to affect midwives' practice with "free" professional development, the way some midwives give this credibility.

Some midwives are saying that PD is so expensive we need sponsorship from companies such as formula companies. My argument would be that we need to review how we do PD, and look for more sustainable, affordable and effective modes of PD, other than flash, expensive conferences that take money off midwives, and are an ineffective method of learning.

Renee Hefti- Graham, RN. Lactation Consultant said...

Shame on the British Journal of Midwifery!! The formula companies want to advertise in our health journals because it then appears the J gives credibility to the product and because advertising works (while else would they do it?.

Have the decision makers at the British Journal of Midwifery and midwives not heard of the International Code of Marketing of Breastmilk Substitutes?

This Code has been endorsed by the British Government. Formula ads violate the Code.

How about protecting breastfeeding instead of promoting formula?

Maria Parlapiano RN IBCLC said...

Formula companies providing free professional education/sponsoring conferences are basically securing themselves a non-commissioned, renewed sales force. I recall being at a meeting in the US where maternity nurses were complaining about their pay rate and I interupted,"But you're working for the formula company for free!" Lol!
I wish BJM and others professional entities would "wake up and smell the formula."
These type of affiliations just destroy credibility, diffuse loyalty and play right into the calculated industry marketing scheme.