Remember Ginsu knives? They popularized infomercials and could “cut through a nail, tin can, radiator hose and still cut a tomato paper thin.” What really made Ginsu knives famous was their infomercial mantra, “But wait! There’s more!”
Baby-Friendly has its own “But wait! There’s more!” There are the Ten Steps to Successful Breastfeeding, but tacked onto the end is the International Code of Marketing Breastmilk Substitutes, sometimes simply referred to as “The Code.”
The Code was adopted in 1981 by the World Health Assembly to help countries where formula companies’ marketing tactics were harming babies.
There will always be a place for formula in hospitals. A few women will choose to formula feed, and a few babies will need formula supplements for medical reasons. However, using a product and participating in the marketing of a product are two very different agendas.
A Tale of Two Drugs
Let’s consider an analogy. What if there were two similar drugs used to treat a disease. We’ll call one Mediwrks and the other Medikindawrks. Now we know just from the names that one is superior to the other, and in fact research has demonstrated over and over again that Mediwrks is more effective and patients have fewer side effects. Most people choose Mediwrks and agree it is best. There are a few that prefer Medikindawrks and a small minority for whom Medikindawrks is more effective. That’s why it is still on the market.
Knowing its deficiencies and wanting to gain a larger market share, several decades ago Medikindawrks set out on a mass campaign to increase brand loyalty. They sponsored conferences for physicians and nurses where their sales reps had opportunities to share all the benefits of their drug. The sales reps also visited the doctors’ offices and hospitals where they would bring meals and give out what many thought were fun, harmless items.
The most genius Medikindawrks tactic was that they marketed to consumers in a way that made it appear doctors and nurses favored their product. The clicker pens and name badge holders used and worn by the nurses were strengthening their branding efforts, but that was just the beginning. They also sent materials to consumers saying things like, “Ask your doctor which Medikindawrks product is best for you.” And since Medikindawrks reps had spoken with doctors in their offices, hospitals and conferences, the doctors had the answers when consumers asked.
When patients were hospitalized, Medikindawrks was often used because the manufacturer gave it to the hospital for free. Every other product, drug and food was purchased by the hospital. Many thought this was a gesture of goodwill, but company leaders knew that if their product was given to a patient in the hospital, the patient would be more likely to use it once at home. Since Medikindawrks was only used by a minority of patients, the company began sending every patient home with a gift which included some useful items, product literature and some free samples.
The marketing campaign worked. Not only did Medikindawrks gain more market share, but the entire culture changed. People started to doubt Mediwrks despite the science behind it. Consumers came to expect their Medikindawrks gifts at the hospital and nurses couldn’t imagine sending patients home without it. Instead of wholeheartedly advocating what was best for the vast majority of patients, medical experts came to see the decision between the two products as the patient’s choice.
I’m grateful for Medikindawrks, for the babies who truly need it and for the families who have their own personal reasons to use it, but I don’t want any part in promoting it. I will have it available for those who need it and will continue to have a good working relationship with the sales reps who respectfully do a good job making their product available to us at a fair market price.
Our self assessment for the International Code of Marketing Breast Milk Substitutes:
11.1 Are all breast milk substitutes, including special infant formula, that are used in the facility purchased in the same way as any other foods or medicines? No
11.2 Do the facility and staff refuse free or low-cost supplies of breast milk substitutes? No
11.3 Are all promotional materials for breast milk substitutes, bottles and pacifiers absent from the facility with no materials displayed or distributed to pregnant women or mothers? No
11.4 Are employees of manufacturers or distributors of breast milk of substitutes, bottles and pacifiers prohibited from an contact with pregnant women or mothers? Yes
11.5 Does the facility refuse free gifts, non-scientific literature, materials or equipment, money or support for in-service education or events from manufacturers or distributors of products within the scope of the Code? No
11.6 Does the facility keep infant formula cans and pre-prepared bottles of formula out of view unless in use? No
11.7 Does the facility refrain from giving pregnant women , mothers and their families any marketing materials, samples or gift packs that include breast milk substitutes, bottles and pacifiers or other equipment or coupons covered by the Code? No
11.8 Do staff members understand why it is important not to give any free samples or promotional materials from manufacturers or distributors of breast milk substitutes, bottles and pacifiers? No