Showing posts with label Infant. Show all posts
Showing posts with label Infant. Show all posts

Thursday, December 15, 2011

Formula Companies Dare to Compare Imitations to the Real Thing

This post is about advertising, marketing and deception.  We as educators, public health professionals, moms, citizens, consumers, tax payers, etc.  have to demand honesty in advertising--especially from the formula companies.  These companies use inferior ingredients, cut corners in production, and then lie about its value, causing customers to flock to the registers with complete peace of mind.  As consumers, we question the quality of what we purchase and we want what we pay for...then there's formula...


I made some tongue-in-cheek posters last week.  I am a very visual learner, so I created a visual.  I was attempting to show the stark difference between formula and breastmilk in a vivid, humorous way, but the humor was lost on some.


My posters showed the stark contrast between artificial infant milk and breastmilk.  The superiority of breastmilk is not a new concept, but rather a well-documented, well-established, scientific fact. The two are NOT created equal.  In fact, by law, every can of formula must explain that breastmilk is superior to the product contained therein.  One is a man-made, synthetic recipe; the other a natural, organic species-specific food.  Just like vitamin C tablets are not as potent or healthy as natural vitamin C from real fruit consumed; formula (artificial breast milk) is not as healthy as natural, species-specific breastmilk.




Most of the people who viewed the photos I posted gave it a "thumbs up" and some re-posted. Facebook is pretty good at tracking where posts travel via shares and the subsequent comments.  It was the dialogue that surfaced on some of my friends' pages that truly concerned me.  I realized for the first time how successful the formula companies are at not only dominating the infant feeding market, but also controlling the critics that may voice any opposition.  They conjure up feelings of guilt, anger, fear, disappointment and frustration--not for their product or marketers--but at those who may want to point out that their product is inferior...how did they accomplish that?


One irate commentator "shouted" obscenities and cursed the person who made the poster...strong, emotional response--was this response to the false advertising and implied similarities of formula and breastmilk?  No, as far as I could tell, the reader took offense at what she perceived the message insinuated...that she was a "bad" mother. Nothing could be further from the truth.  I even prefaced the ad with the following remarks
"Just a visual reminder that no matter how the formula companies try to package it, formula and breastmilk are NOT created equal...another thought on the deceptive advertising of formula...(not-and never will be-an attack on those who use it...)"

If a mom gives her infant formula to ensure survival she is definitely a good mom!  There are many legitimate reasons to use or supplement with formula (adoptive moms, foster moms, dads with custody, moms on certain medications...all rely on the nutrition adequacy of artificial infant milk), but still the reader saw:  formula=bad mom; breastmilk=good mom; and I was absolutely, positively judging them!  When a company can cause formula-using moms to take things personally they have achieve a great accomplishment. These companies have undoubtedly succeeded in attaching feelings to facts and substitute perception for reality.


Then there was responses from colleagues in the lactation field.  A couple stated that although they know the risks of formula feeding, they anticipated that people might be offended and riddled with guilt if they were to share my photo on their wall.  Now, this is where the formula companies really hit the jackpot.  Not only do they promote their product, but they also have successfully silenced the opposition.  Really?!  Professionals can't share that there are risks to formula-feeding without retaliation?  Are we free to share risks of not using a car seat or feeding infants honey, egg whites and peanut butter?  What if parents want to give these foods to their children?  Does that mean I am prohibited to share the information for fear of causing guilt? Of course not, but these other safety and feeding recommendations do not elicit the same emotional response the formula warnings do.


It appears as though formula companies have even found a way to convince breastfeeding advocates to keep silent about opinions and concerns.  Even as I write this, I have a bit of fear and trepidation about how this blog will be received.  Will people understand that I want to educate, and that my heart is in helping moms regardless of what their feeding choice is?  Will readers understand I am campaigning for honesty in advertising, or will I fall victim to the scandal that all opposition is insensitive and cruel?  I really am at a loss for how to change perception.  I hope others will help me turn the tide of perception by sharing this post.


What other company can get the loyal consumers on board and silent the opposition? Formula is a taboo subject to discuss in any circle. It has a protective barrier around it and is off-limits when it comes to criticism.  How did they ever achieve this marketing phenomenon?


I am also a bit perplexed and maybe even in awe at how the big formula companies have succeeded in promoting their imitations as "close to the real thing." No one believes that artificial infant milk is as good as breastmilk, but the nation accepts that it is "close enough."  I have to congratulate the conglomerates for their marketing genius and their ability to control perception.


I often stand in front of a group I am teaching and take a side step to my left and boldly announce, "I am now one step closer to China." Of course, I am no where near China, but one step closer.  Recently, I created this poster to convey the same message:


Here's another way for me to put this in perspective.  If a young couple walked into a jewelry store, while window shopping for an engagement ring, and a savvy salesman produced the sugar-coated ring pop with the description that it is "closer to a diamond than ever before," the customers would be outraged, insulted and storm out of the shop (of course the guy may still nonchalantly ask, "how much for the beautiful topaz").  The point is, we are wise to manipulation--especially from salespeople. The candy sentiment may be beautiful, shiny, slide nicely onto the ring finger, but it is not the same as a diamond--and how dare a jeweler insinuate that it is!




Would honesty be appreciated?  Absolutely...the same salesman could have said, "I have this replica that could serve the purpose of a symbol during the nuptials.  It isn't a diamond.  It is made of hard sugar, but you can use it as a stand in."  Then the couple could make an informed decision.  Most would prefer the diamond, but no one but they know all the circumstances.  Maybe a diamond is not an option.  Perhaps the bride has adverse reactions to metal and the plastic alternative is perfect!  They can confidently select the confectionery token without any guilt.  Content with their choice, they are still happy for those who can buy diamonds and understand that diamonds are superior, they do not try to argue the incredible investment that ring pops are and become outraged when anyone suggests that diamonds are superior. It would be ludicrous.


Take the next scenario.  A customer steps onto a used car lot.  Just the location puts people on the defensive by anticipating lies or stretching of the truth.  I'm not saying it's right or even warranted, just a matter of  car lot facts. The car salesman approaches the on-looker with a beauty to sale.  It has four wheels, a new paint job, will get you where you need to go and is "just as good as" the Lamborghini parked adjacent.  Really, who are you kidding?!  Consumer Reports are out and the little, plastic toy does not beat the sports car in any category (well, except MPG--which could actually be a good selling point in this gas war).  The real kicker comes with the sticker price...the dwarfed vehicle is actually priced higher.  The salesman blames inflation and the premium parts that have been used in construction.  Once again, no sale.  We are not going to be duped by a smooth talker.  We are going to look under the hood, kick the tires, and we may in all actuality purchase the little car...not because it is better--or even as good as--the hot rod, but because we need transportation and it is a viable option, but not because we "bought the lie."




Now, let me attempt to share the how these same analogies are used in formula promotion. The impracticable, ridiculous sales tactics mentioned above are laughable, but when marketing experts use them to promote formula, they now miraculously work!  The company passes off an inferior product as the real thing.  Customers are promised that it is "closer than ever to breastmilk."


How can they make these unsubstantiated claims?  Professionals working in the advertising world will attest that these phrases can be legally used if even the color is closer to breastmilk than it was previously.  The American Academy of Pediatrics, World Health Organization, UNICEF and the Department of Public Health all try to expose the deceptive marketing to no avail. These companies seem to be untouchable--even with facts.


Not only are established organizations' warnings rejected, friends and family attempt to share the truth about formula and the "Ring Pop crowd" embraces a mob mentality.  All of the sudden well-meaning friends are labeled "Breastfeeding Nazis" or "Lactivists."  Why is the truth so threatening?  Why would sharing the truth be interpreted as "making formula-feeding moms feel guilty"?


Here's a confession, just because I feel like readers may think I cannot relate.  I formula-fed my first child.  Not exclusively, I breastfed when it was convenient. Do I feel guilty when I hear how certain risks are increased with formula-feeding.  No, absolutely not.  I was convinced that formula and breastmilk were equal.  My nurse gave my son formula...she was older, "wiser" and had more children than I, so I deferred feeding to the lady Nightingale.  Now, I am upset that no one shared the truth with me. No one said the manufacturers cut corners, use inferior ingredients and market their product in order to please the share holders because it is a commodity that people heavily invest in...that would have been helpful.  I also put my son on his belly to sleep--another sign of the times.  I would do things differently now.  A lot of us would.






I have friends, family and clients that have had to use formula to feed their infants.  They do not feel guilty either.  It is a matter of fact.  They almost all would have preferred breastmilk, but it wasn't an option.  They knew the facts, were informed and also admit that scientists and other experts are correct in stating that breastmilk is the best choice. They are not part of the crowd that takes remarks personally.


Remember, by law every formula company has to confirm that breastmilk is superior to formula.  They have to print it right on the packaging labels, but do we get angry at the formula companies for this atrocious declaration? No, we direct our anger at a friend, family member or random individual that posts something on Facebook.  Wow, how do they do it?




Why have my ads elicited such emotional responses from some people?  Once again, I think it is part of the marketing.  


Please indulge me as I share another personal analogy of artificial food.  TPN  (Total parenteral nutrition) keeps getting improved upon...it is "closer than ever to nutritious food."  My dad had to be on it to get nutrients that he couldn't get by eating food, we appreciated the medical advance, but wouldn't have chosen it as our first choice, we knew food was preferable...it was just a matter of fact that we would need to use it to replace food to sustain life...we didn't feel guilty for using the TPN, or offended when professionals explained there were risks to using TPN as a food alternative, I understood it was lifesaving, but I was also happy for the rest of my family that could eat whole food...no one ever tried to convince us that TPN was equal to whole food...doctors and nutritionists were very transparent. Why is formula any different?



These are some final remarks and observations that I believe help the formula companies perpetuate a feeling of guilt when someone mentions the formula vs. breastmilk topic.  Moms feel guilty. That is a fact. Formula companies know this and they take advantage of moms during a vulnerable time in their lives...they play on a temporary weakness.  Moms assume the "fight or flight mode" and fight off a perceived attack...guns are cocked and everyone is ready for a fight...we will defend ourselves at all costs...good meaning friends must also be aware of this delicate time in a mother's life and assume a protective role as we educate.  That may seem like an oxymoron, but it is possible and preferred. 



How else can we combat the advertising moguls?  We must figure out a way to remove feelings from formula.  Just like readers had to try to remove feelings from fact as this article was being read.  It's difficult because perception is reality.


So what can we say about formula?  The truth.   formula was created to sustain life by trying to replicate breastmilk, much like TPN is used, but that does not make it the same as breastmilk...education and truth can go along way, and everyone deserves to be informed...

Sometimes there is no choice, but given a choice, it only makes sense...

I hope this doesn't come across as segmented.  I have a lot of thoughts and this blog has taken way too much time to compose, but I have been cautious and rewritten it a few times.  I will just have to submit it to the public after I make a final note to my lactivist friends: we must be extremely cautions to never confirm what the formula companies try to insinuate: that guilt and fear, depression and anger should be directed at lactation consultants.  If we make clients defensive, we are promoting the formula companies agenda.  We must be honest, sincere, gentle, supportive and loving (in fact, maybe even a little more than we naturally are).



Hope this provided some food for thought...
Christy Jo Hendricks, IBCLC, RLC, CD(DONA), CAPPA CLE Faculty


Hope you can join me for a lactation training in the future...together we can make a difference
http://www.birthingandbreastfeeding.com/

Wednesday, September 21, 2011

Formula Marketing Exposed

The 2010 Pediatric Products Handbook by Mead Johnson boasted of a "new" formula.  What is this brand new miracle in a can?  It's a sleep aid for children.  Well, it doesn't read exactly like that, but the actual words under "Product Features" are even more frightening.  I photographed the page, because as skeptical as I am, I would want to see it for myself and I believe my readers deserve the same consideration.
The product, Enfamil Restful "contains a rice carbohydrate that is designed to gently THICKEN IN BABY'S TUMMY."  They say it like it's a good thing!   Enfamil is marketing this product "For Bedtime Feeding."


The product claims that this is a "natural way to help keep baby feeling satisfied"...it's all there, read it...as many times as it takes to believe it.  Since when is throwing starch into a bottle "natural"?  
As you are still shaking your head, read the section about "Long-Term Usage"...yep, they say it..."it can provide a sole source of nutrition for infants UP TO AGE 6 MONTHS! Moms are being encouraged to start their newborn out on this stuff in order to make "better sleep a better possibility."  This formula is also available at local WIC agencies.  I think more counseling needs to be done during appointments concerning this product.

What problems do I see with this marketing scheme?  Where do I start?  First, we are setting moms up to think babies are supposed to sleep through the night.  Most of us know, or have heard, about the importance of brain development during the waking hours.  We should not encourage newborns to go several hours without waking right after they are born.  This is detrimental to their growth and development.

Also, formula is supposed to mimic the gold standard, which of course is human milk.  What do we know about human milk and digestion?  The proteins in breastmilk are easily digested and human milk is processed quickly--requiring regular feedings (small, frequent meals--spaced out throughout the day--is even a recommendation for children and adults).  These small, regular feedings do not require the stomach to stretch to hold an abundance of food that must be processed over a long period of time.  Formula is far-from replicating breastmilk in this instance.

This type of formula and teaching is contributing to the obesity problem in our country.  A big meal before bed and letting an infant "sleep it off" is absolutely ridiculous.  

Why do I think Mead Johnson created this formula...because moms wanted it and it would be a huge money maker.  Parents are exhausted.  They want and need sleep.  Then they hear about a company that makes a product that will "help them get better sleep..." and the geniuses in the marketing division have a slogan to get these cans flying off the shelves.

The funny thing is, this formula has been around quite awhile.  Look back at the printed page.  Let me draw your attention to the bottom of the first paragraph.  "Enfamil Restfull is the same fourmulation as Enfamil A.R."  Really, this miracle has been around?  Yes, and it was successful at helping with spit up and doctors would often recommend it for reflux...okay, so why wasn't it a best seller?  The name.  Parents may not remember what AR does and what it stands for, but "Restfull" they understand.  Sleep...that's a word they would like to have back in their vocabulary, so... "A Star is Born" a gold star...confusing parents and causing them to rely on a sleep aid for their child.  The company did not invent anything new, they re-purposed something old...gave a face lift to a can, revived a recipe with a "sleep better" slogan.

What's in this can that helps a baby sleep so well?  According to the rules of ingredients, let's just check out the first four, to see what constitutes the greatest percentage of this product:
  1. Nonfat milk
  2. Vegetable oil
  3. Rice starch
  4. Lactose
Okay, it may make an infant sleep better at night, but I sure couldn't sleep knowing I had given this to my baby.  It is crucial that we educate well-meaning parents about the marketing tactics being used on them.  Parenting is a difficult job...we lose sleep when our children are infants, when they have the flu, when it's thundering outside, when they learn to drive...parents will have some sleepless nights and sacrifice a lot more than sleep for their children, but what they get in return is priceless.



It is not my goal to target formula in general, but the deceptive marketing strategies being used on new parents.  I believe we must be informed in order to make "informed decisions."  I hope you can use this information as a teaching tool for prenatal and new moms.  I have not had a mom, nutritionist or dietitian disagree with me about my concerns once I shared this information with them...share...inform...support...

If families need additional breastfeeding help, share a link with them or encourage them to contact a Lactation Consultant.

I have some more marketing and advertising tactics I am looking forward to sharing in the near future.  Stay tuned as I reveal what I have found in my research...

Christy Jo Hendricks, IBCLC, RLC CD(DONA), CLE
www.birthingandbreastfeeding.com


I will be providing a CAPPA CLE Training in October.  Would love to have more Lactation Educators sharing this information.  Find out about the Training on my Website.


Saturday, June 11, 2011

Normal Growth and Development for the Breastfed Infant

As I discuss the "normal" growth and development I have to remind everyone that every child and circumstance must be independently evaluated and guidelines are just that...guides, not concrete walls that determine absolutes...

Although there are facts and figures along with possible complications and interventions that are specifically related to a preemie, I am not going to address the preterm or near-term infant at this time.  This post will relate to full-term, healthy, breastfed infants.

I have to say one of my pet peeves is the CDC Growth Charts, their development and how they have become the final authority on growth for so many medical professionals.  In fact, many doctors use the charts to provide "scripted counsel" and inevitably recommend or require a baby be supplemented with formula. I am curious to know how many doctors or other professionals actually consider how the Growth Charts were developed and the margin of error that accompanies this type of data comparison.  The empirical data (data charted by experience or observation) and "convenient" smooth pattern created from the charted data vary extensively.

To paraphrase how the research was conducted, babies were measured at different increments and the empirical data was charted. Next, babies (not necessarily the same babies) were charted at different ages, points began forming a pattern, and that pattern clearly signified that over time, babies gain weight (not a difficult hypothesis to have to prove).  The problem I have with the charts is the smooth pattern that the researchers defined based on the empirical data...the points do NOT fall symmetrically on the curve, but vary greatly.  Knowing this, a doctor may inform a parent that their child is below weight, but when looking at the original data, the subject used to create the chart may not have fallen on the smooth curve either!

I really cannot do the report justice, but I implore everyone who works with infants and children to become familiar with the CDC Growth Charts Methods of Development.  It is astonishing to know how many people believe these weights and measurements are absolutes and not guides.

One step that I applaud is the transfer of confidence in the CDC Growth Chart to the WHO Growth Charts.  At least this data compares breastfed infants' growth patterns and establishes the child being breastfed as the baseline for a "normal" growth pattern.  WHO Growth Charts should be available for a base comparison, but more importantly, like previously mentioned, individual history and observation is more important.



Recently, I spoke to a mom that was experiencing regular "check-ups" for her breastfed infant because he was considered to be at "high risk."  The mom felt that her breastmilk was not adequate since the pediatrician questioned her son's weight gain and insisted on regular monitoring.  My frustration was compounded by the mom's emotional state.  She felt inadequate, scared, vulnerable, guilty--all emotions I try to alleviate in parents.

I asked her some basic questions.  Was your infant born early?  How much did he weigh at birth? How is breastfeeding going?  How many wet/soiled diapers in 24 hours?  How much did his dad weigh?  Describe his dad's stature.  How much weight has he gained?...etc.  The answers I received verified my hypothesis...the doctor had not taken a history...dad and mom were both small in stature...baby was gaining weight regularly, having plenty of output and was reaching milestones.  I also observed a feed and milk transfer.   

After counseling the parents and suggesting they speak to their pediatrician about their concerns and requesting "medical reasons why the baby needs supplementation" I was assured that the mom had been empowered and restored to her confident self.

Although no child has the same growth pattern, healthy babies do gain weight and grow.  I do not want to give the impression that failure to gain weight or thrive is in any way acceptable.  Monitoring the slow weight gain is also crucial.  Follow up is mandatory.

What patterns are common in most infants?  Here I will be brief, since these facts and figures can be memorized and retained for future use.  Newborns often loose weight after delivery.  I don't like the phrase "7-10% is acceptable"  it may or may not be...is the baby gaining weight now?  Is the baby alert and responsive?  We must be careful to not make blanket statements.  Babies do typically lose weight due to many circumstances following delivery...did the baby have a bowel movement?  Were meds and fluids administered during labor?  Has baby eaten?  Was the baby weighed on the same scale under the same circumstances...these scenarios allow for variation in weight.  We must remember that  babies are born "full".  they have a direct line to the all-you-can-eat buffet.  They are born with extra fat stores to help them during the transition from colostrum to mature milk, and allowing them time to stimulate the breast and cause Lactogenesis II to occur.  Babies are not born starving and in need of an immediate meal.  So, with that being said, panic should not set in when an infant displays some initial weight loss.

I created a reference chart for the common 10% weight loss and kilogram conversion from pounds.  Feel free to download a reference copy from my website under "Resources".

Other noted patterns of the breastfed infant include:

  • Babies regain their birth weight by 10-14 days
  • Birth to 1 month weight gain is .5 to 1 oz. per day
  • 2-6 month weight gain is 3-5 oz. per week
  • Birth weight typically doubles by 4-6 months and triples by a year
  • Head circumference increases by 3 inches in a year
  • Birth to 6 mo. infants gain about 1 in. each month
  • 6-12 months infants gain 1/2 inch each month
  • Infant's length increases by 50% at 1 year
Remember each baby is unique and should not be compared to other babies...the best comparison is made between the same baby the previous time you observed him.


Also, if you are sitting for the exam this year, dedicate some personal time studying age groups and milestones in regard to child development.  My students were surprised at how many of the IBLCE questions related to age group and photo recognition based on "typical" growth in the newborn.