I wrote this in response to the responses to Audrey McClelland’s post, Understanding the WHO Code. I was actually one of the friends who filled her in on the WHO Code. I feel that after the unintentional act of including formula in gift bags at an event at BlogHer, she now has a good grasp of why the WHO Code is important and why it should be enforced in the US. She has pledged to eliminate formula samples and/or bottles from all gift bags she is involved with. So far, all of the comments on her post were from her readers who don’t see anything wrong with formula samples so my response addresses why formula samples are wrong and why the WHO Code helps ALL women, yes, even the ones who exclusively formula feed.
The WHO Code is not about limiting choices, it’s about expanding them. The aggressive marketing of formula actually undermines breastfeeding and is one of the key reasons breastfeeding rates in the US are so abysmal- only 32% of women are breastfeeding exclusively at 3 months postpartum (74% of women try to breastfeed after birth). By supporting breastfeeding by eliminating aggressive marketing of formula levels the playing field significantly because it gives women the opportunity to actually succeed.
Supporting breastfeeding is something the US government and culture gives a lot of lip service to but does little to actually help out with. Women who have just given birth need help breastfeeding because most women of our generation were not breastfed so our mothers, even if they’re supportive, just don’t have the know-how. Throwing free formula at us from the time we announce we’re pregnant hurts this because we know there’s always that formula can in the closet “just in case.” And studies show that just ONE bottle of formula can be detrimental to successful breastfeeding because it’s a slippery slope… you give one bottle instead of feeding at the breast and your supply diminishes a little bit. Then you have to give another bottle and your supply will drop even more. Before you know it, you’re giving more formula than milk so you may decide to give up breastfeeding altogether. There is ample evidence that when formula is readily available due to samples being sent unsolicited or hospitals sending new moms home with “gift” diaper bags from formula companies, breastfeeding is less likely to succeed.
So the WHO Code is about protecting your choice in what to feed; it’s not about eliminating formula. It’s all about customer acquisition. If you indicate that you’re pregnant, or breastfeeding or even planning to breastfeed, they go after you because they know that when you start using one brand, you are likely to be loyal to it for all of your kids. If you tell them you’re using formula, they’re going to leave you alone because they know you won’t switch to another brand and they know you won’t go back to breastfeeding.
The return on investment is very high for formula samples and the markup is very high to make up for this. Even with the huge budget they have for marketing, the formula companies are still rolling in money because they pass those costs onto the end consumer. All of those freebies are not free! They’re figured into the retail cost. You’re paying for the few “free” cans you received initially when you pay $20+ per can. Just think— if they stopped their HUGE campaigns and advertising, the cost of formula should go DOWN, making it affordable to anyone who truly wants and/or needs it. (Think of how much organic food you could buy with the money you’d save!)
The WHO Code is also about not marketing formula in an inaccurate way. Remember “the breastmilk formula” campaigns? Or “similar to breastmilk?” That’s against the WHO Code too because it’s just not true. We will never be able to synthesize breastmilk in a lab because we don’t even understand it completely! Just recently, research revealed why certain sugars in breastmilk that were unused by the body - turns out they feed the good bacteria that lays down a protective layer in the gut. And one more thing- we also know that by breastfeeding exclusively for the first six months - meaning no solid food, no formula - we are providing baby with the immunity it’s designed for. Giving one bottle interrupts that process. Anyway, it’s why the AAP advises waiting to start solids at 6 months.
I am wholly sympathetic and empathetic to any woman who wants to breastfeed but is unable to — it’s why I became a Certified Lactation Counselor, it’s why I am volunteering with a local family center, it’s why I would like to become a WIC breastfeeding counselor — but with better support and education, MORE women will be able to breastfeed. We have to start when women are at their most vulnerable informationally (if that’s even a word) - when you’re pregnant for the first time, when you’re an exhausted mom of a newborn.
By the way, the US has agreed to (and signed) the WHO Code but has yet to enforce it.
