by Eileen Murphy, RN, BSN, IBCLC, RLC
For 33 years, formula corporations have violated the International Code of Marketing of Breast-Milk Substitutes adopted by the World Health Organization (WHO) on May 21, 1981. To mark the WHO Code Anniversary this year, HealthConnect One joined Public Citizen in a Campaign to Stop Infant Formula Marketing in Healthcare Facilities, and we invited our community partners and allies to speak about their experience here on the blog.
This is the first of four guest posts on the topic.
The following are responses to questions posed by Brenda Reyes and RoiAnn Phillips at HealthConnect One.
What is your name?
Eileen Murphy, RN, BSN, IBCLC, RLC
How many children do you have and what are their ages?
I am a parent of four breastfed daughters, ages 28, 26, 21, and 19.
In your work with families, what is your role?
Under the auspices of Little Company of Mary Hospital, I founded a weekly Breastfeeding Moms Support Group in 2007 to encourage women who choose to breastfeed. In addition to hosting this group, I teach a monthly Prenatal Breastfeeding Education class that offers preparation and education for women who plan to breastfeed. This is all part of my work as a Lactation Consultant providing prenatal breastfeeding education and inpatient lactation assistance.
I am also the co-coordinator for maintaining Baby Friendly Hospital certification. In this role, I provide ongoing staff education and ensure hospital wide compliance with the Ten Steps.
How did you first become involved in this work?
Since very early in my career, I was interested in maternal/child nursing. Luckily, I was able to find a position as a mother/baby nurse. It seemed like so much information being disseminated about breastfeeding was based on anecdotal “personal” experience. Many, many patients expressed their confusion, saying things like: “Everyone tells me something different!”
For me, it was a natural progression to help patients further by becoming a Lactation Consultant (IBCLC). Remaining current in lactation research enables me to provide the most current evidence-based information to our staff, patients and families. One of the best parts of the Baby Friendly certification process is the required education for all staff on breastfeeding management. This benefits our patients, who benefit from getting the most up to date correct information, consistently!, from all our staff on all shifts.
When you speak directly with new moms in the hospital, what do they say to you about breastfeeding? What do you say to them?
Most frequently heard comments from new moms (everyday) regarding breastfeeding include:
“I don’t have any milk.”
“I don’t have enough milk.”
“The baby won’t latch on.”
“The baby only wants to be latched on.”
“How do you know if the baby is getting anything?”
It seems, in many ways, that we have entered an era of hyper-connectivity. According to a 2012 report by the Pew Research Center, some negative effects of hyper-connectivity include “a need for instant gratification and a loss of patience.” As just one example, the report cites a study conducted by the University of Massachusetts at Amherst in 2012 that found that roughly a quarter of Internet users abandon an online video if it takes more than 5 seconds to load — half give up after 10 seconds!
This impatience seems to carry over to frustrations with breastfeeding. Breastmilk continues to increase over two to five DAYS postpartum. Compared to waiting 5-10 seconds for a video to load in your browser, that is an eternity! Helping new moms with the process, questions, and occasionally slow pace of latching and feeding is part of my job.
Breastfeeding is a learning process for all involved. It’s a work in progress that requires lots of patience, skin-to-skin contact for mom and baby, practice to find a comfortable position and latch, learning infant feeding cues, and hand expression. To assess where each new mom is in the process, I first ask what her breastfeeding goals are so we can establish how much information and educational materials she will require. I generally review normal newborn behavior and realistic expectations with the overall goal of building confidence for new (and returning) moms so they feel well equipped to care for and feeding their babies when they leave the hospital.
Can you talk about the impact of artificial baby milk on your community?
Formula and bottles are still seen as the “norm” by most parents, families and their friends in much of the USA. A new parent’s confidence to breastfeed successfully is constantly challenged by formula marketing.
Again, it seems that “instant gratification” is a factor. When a newborn receives formula, she or he drinks quickly and appears “satisfied” to parents and family members.
The absolute key here is prenatal education with a Breastfeeding Peer Counselor on breastfeeding management, normal newborn behavior, newborn tummy size, establishing breastmilk supply, and supplementation only for a medical reason.
In 2008, as part of the Baby Friendly Hospital Initiative, all formula marketing bags, formula coupons, any and all material with any formula company logo on it (such as pens, notepads, mouse pads, and “educational” pamphlets) were removed from the hospital to comply with the WHO Code of Marketing Breastmilk Substitutes. Formula representatives do not come on our units and do not interact with our staff in any way. Formula is on our unit and used by our babies. Staff can be influenced outside the hospital environment by formula marketing.
In your experience with new families, where does the marketing of artificial baby milk happen prenatally?
Most moms tell me that they receive direct formula marketing, such as formula coupons and samples delivered to their front door. They tell me that they believe formula companies obtain their information from store baby registries or maternity store loyalty clubs. Many moms never know how they got on a formula company mailing list.
Have you seen the marketing of artificial baby milk impact a new family’s infant feeding decisions?
Many parents have told me they have heard that formula is now closer than ever to being similar to breastmilk, which is a very common formula marketing tactic.
I have heard breastfeeding moms say, “I supplemented with the formula made for breastfeeding supplementation.” Labeling formula as “like breastmilk” or as a “supplement to breastfeeding” are common marketing tactics.
A formula gift pack is an oxymoron — there is no “gift,” it’s only a marketing pack. Once a breastfeeding family uses the “free” formula, a mom’s milk supply can decrease and formula supplementation can increase, eventually leading to formula feeding and breastmilk supplementation for the formula! A family can end up spending well over $1,000 on formula, which rather gives the lie to the original “free gift.”
What is one thing you often say to new parents?
The primary concern of breastfeeding moms is establishing milk supply, so a few things I often tell new parents include:
“Do skin to skin with your baby.”
“Watch for early feeding cues.”
“When your baby is hungry, feed your baby, feed your baby, feed your baby — anytime, anywhere!”
Do you have any advice for someone who wants to support new families in meeting their breastfeeding goals?
My advice to someone who wants to support new families in meeting their breastfeeding goals would be to praise any accomplishments and goals met to provide positive reinforcement.
Review the ways to tell if breastfeeding is going well, including frequent feedings, comfortable latch, and baby output.
Remember that weight gain means a happy baby!
Remind new families to enjoy their baby.
Eileen Murphy, RN, BSN, IBCLC, RLC, has over 25 years of clinical nursing experience. She is currently a lactation consultant at Little Company of Mary Hospital in Evergreen Park, Illinois. She co-coordinated the five-year Baby Friendly designation process. The Hospital received Baby Friendly designation in late 2012. Murphy is responsible for continuing staff education and annual Quality Improvement projects to maintain the Baby Friendly Hospital designation. In this role, she remains actively engaged with emergent research on breastfeeding as well as a vocal advocate of breastfeeding.
HealthConnect One is committed to sharing a variety of perspectives on pregnancy, birth, breastfeeding and early parenting. Each guest post reflects the writer’s experience, and is not necessarily the view of HealthConnect One.
Photo Credit: Little Company of Mary Hospital