Is Formula Marketing a Problem?

I am a nursing mom. Over four years and two kids I have experienced many benefits of breastfeeding first-hand. Nursing my babies has been a very positive thing for me, on the whole. Because of that experience I believe in the value of breastfeeding. And because I believe in the value of breastfeeding I’m generally opposed to formula marketing as it exists today. Logic dictates that if we want to support something, we shouldn’t promote the alternative.

But the other day as I was recycling yet another brochure from a formula company I thought about my own history. When Hannah was born and she wouldn’t nurse they sent us home from the hospital with a couple of cans of formula, and we bought some of our own. Within two days she was nursing and we didn’t use the remaining 80% of our formula supply. If you really want to breastfeed, will you just disregard the ads? I know that I did, for sure. Does formula marketing really convince people to stop breastfeeding?

So I decided to do some research, to see what information there was, if any. Is formula marketing effective? Are people who are inundated with promotional materials and free samples more likely to use formula?

Here are some results that I found:

  • Women who were given formula company produced infant feeding information during prenatal visits were more likely to cease breastfeeding before discharge from hospital as well as before 2 weeks postpartum.
  • Giving women research based discharge packs that support breastfeeding instead of formula company sponsored packs resulted in higher breastfeeding rates, as well as delayed the introduction of solids.
  • The US Government Accountability Office found that in 7 of 11 studies it reviewed, breastfeeding rates were lower amongst mothers who received formula discharge packs from the hospital.
  • In the US women who receive free formula through WIC are much less likely to breastfeed.
  • Health care authorities and governments believe that formula marketing has a negative impact on breastfeeding.
  • When women were given commercial hospital discharge packs from hospitals, at every stage exclusive breastfeeding was reduced compared to women who received non-commercial packs or no packs at all.
  • The evidence certainly suggests that formula marketing practices have a negative impact on breastfeeding, while research-based information has a positive impact. It just sort of makes sense because the purpose of marketing is to convince people to use your product. Formula companies are no different than anyone else on this front. They are trying to sell us something.

    Of course, it’s our choice whether or not we want to use formula. If you have used it yourself I am not judging you. I think the problem is when it’s not really your choice. In a perfect world every mother would be satisfied with her breastfeeding experience, whatever it looks like. We aren’t living in a perfect world, though. In real life we are bombarded with conflicting information and we encounter problems we didn’t expect. The result is that many moms are not satisfied with their breastfeeding experience at all.

    I think that the only possible solution is good breastfeeding support and information at all stages of maternity and infant care. We need to be there to help moms who want to breastfeed but can’t. We need to make sure that we’re not giving out conflicting information or leaving distraught mothers with no one to turn to. We also need to support moms and not make them feel guilty for their choices.

    Based on the research and plain common sense unsolicited formula marketing may interfere with breastfeeding. Handing out free formula or promotional materials to all mothers ‘just in case’ sends the message that many moms probably can’t breastfeed. Sponsorship of medical conferences by formula marketers, posters in doctors’ offices, and samples distributed in the hospital lend a medical stamp to that message. And it’s a message that is just not helpful if we want to mothers to receive good breastfeeding information and support.

    I know now that I was able to breastfeed Hannah. There was a while there where I didn’t think I could. I don’t believe I’m the only mom who’s felt alone and overwhelmed and didn’t think she could do it. Thankfully I had excellent support from my midwives, who came to my home to help me. If the only information on infant feeding I had was a brochure from a formula company I’m not sure I would have succeeded. And that’s why I think formula marketing is a problem, because it doesn’t contribute to empowering women to make the choices that are best for them. Whatever those choices may be.

    Kids Are People Too

    A week and a half ago our family went out to dinner. It was a little after 5:00pm on a Tuesday evening, it was hot, and we didn’t feel like cooking. I’m pretty sure this was the first time all four of us have gone to a sit down restaurant, ever. Suffice it to say that dining out is not something we do regularly.

    As our destination we chose a family restaurant. It has crayons and colouring sheets for the kids, and a children’s menu complete with pictures and novelty pasta shaped like insects. They are currently running a ‘Kids Eat Free’ promotion. We deliberately chose a restaurant where we knew our kids would be welcome and reasonably entertained. We are not fools.

    As we waited for our food to arrive a mother and son came into the restaurant. My guess is that the mother was in her 70s and the son in his 40s – these were both adults. They were seated beside our family. Our kids were behaving themselves, Hannah was colouring and Jacob was eating a cracker. Neither of them were even speaking. But the mother took one look at us and said, “We don’t want to sit beside them. We are tired and we want a quiet dinner.”

    Making a wish on a dandelion
    Dinner disruption number 1

    The restaurant was full of families with small kids. None of the kids were out of hand that I saw. They were all colouring or eating their chicken fingers. The person seating the mother and son said, “There are a lot of children here. I’m not sure where I can seat you”, although eventually they were moved to another section. And then moved again because the new section was too sunny. Clearly, this was a case of people who wouldn’t be satisfied.

    All the same the whole thing made me angry. I felt singled out in the worst way. But more than that I felt indignant on behalf of my kids. I know that children can be inconvenient, and there are places where it’s better not to bring them. I think it’s safe to say that a family restaurant at 5:30pm on a Tuesday is not one of those places. I also think it’s unfair to assume that my children are going to disturb your ‘quiet’ dinner before you’ve spent 3 minutes in their presence.

    Jacob and stick in the garden
    Dinner disruption number 2

    No one is more uncomfortable than I am if my kids are being loud or crying or engaging in dangerous behaviour in public. I don’t enjoy it at all and I do my best to avoid those situations. But sometimes I just need to go to the bank or buy groceries or enjoy a family dinner out. I really do not need you to add to my anxiety or make my day worse than it already is with your glares, negative comments or downright rudeness. Plus, your hostility is likely to trigger the exact outcome you don’t want because it makes me anxious and then the kids get anxious and pretty soon everyone’s upset.

    I am a person, too. My kids are people, too. If you go out into public you may just encounter us. Expect it, learn to deal with it, or stay out of the restaurant running the ‘Kids Eat Free’ promotion.

    Thank you for listening. I feel much better now. And please, share your stories of hostile restaurant patrons or grouchy people in the bank line-up, I’d love to know I’m not the only one who encounters this sort of thing.

    Guess what? I wrote a post that is featured on Vancouver blog Miss 604 today! If you’re in BC and you’re interested in local history stop on by and check out what I had to say about the streets of Port Moody.

    Canadian Health Care

    I have a guest post running over on Raising My Boychick today! It’s part of the Womanist/Feminist Parenting Primer, conceived by the fabulous Arwyn. After you read my completely non-authoritative primer on Canadian health care, hop on over and read my post, called Talking to Strangers.

    I’m not a doctor or a nurse or a phrenologist and I don’t even play one on TV. I’ve never worked in health care other than a brief stint as a candy striper in the early 90s. But I have lived in Canada my whole and entire life, and I drew my first breaths in a Canadian hospital. So I decided to share my own perspective on our health care system, which we call ‘Medicare’. I am at least as qualified as any other random Canadian, after all.

    This is not comprehensive, because I am not well versed in the complicated and bureaucratic intricacies. I’m limiting my discussion to what I would call the majority of cases and my personal experience. If you have anything to add based on your own experience please do share it in the comments. :)

    I was prompted to write about Canadian health care when I saw this ad on a website:

    As a Canadian this ad sort of shocks me. You see, we speak about the evils of ‘American-style health care’ all the time. During election campaigns politicians accuse each other of wanting to introduce a two-tier medical system that will kill us all. It doesn’t surprise me that they found a Canadian who’s unhappy, we are a country of 30 million people after all. But I think that most of us find this ad surprising given our general assumption that Canadian health care is better than American health care in the vast majority of cases.

    So how does Medicare work? The health care system is regulated by the Canada Health Act and administered through the federal and provincial governments. There are slight variations from province to province, but the system remains largely the same across the country because it is required to. Here are the key components:

    1. It’s universal – Everyone is required to participate in, and be covered by, Medicare. There is no such thing as being denied coverage because you’re out of network or have a pre-existing condition. There are no private insurers. There is a 3 month waiting period before Medicare coverage starts when you move from province to province, but you’re covered by your previous province during that time. Being uninsured is not something we understand, and it’s not even possible for most Canadians.

    2. Publicly administered – Medicare is administered by a public authority in each province and territory. The plans are operated on a not-for-profit basis and the health authorities are accountable to the government.

    3. Covers all medically necessary services – In Canada it is illegal to bill directly for a ‘medically necessary’ procedure, anything deemed necessary must be covered under Medicare. Pretty much any services offered by a doctor or hospital are considered medically necessary, such as regular office visits, emergency services, surgery and diagnostic tests. There are no co-pays, user fees, or deductibles. When I visit the doctor or hospital I present my health card and they bill the plan directly, I am completely uninvolved in the process.

    4. Low or no premiums – In some provinces individuals do not pay any premiums for health insurance. Here in BC we do pay set medical premiums. The rates are $54 / month for singles, $96 / month for couples and $108 / month for families of 3 or more. If your family income is low you are subsidized in whole or part. If you are employed, your employer generally pays half your premium, so my family of 4 currently pays $54 / month.

    Some services are deemed ‘uninsured’ and aren’t covered by Medicare, such as dental care, optometry, prescription medications, cosmetic surgery and naturopathy. Most employers offer an extended health plan to their employees, which covers some portion of selected services. For example, I am reimbursed for a portion of my dental and prescription costs, and I am covered for emergency care if I travel outside of Canada. The premiums for these plans are very low, or may be completely covered by your employer.

    Most Canadians are generally satisfied with our system. According to our government in 2005 85% of Canadians were satisfied with the health care they received. And we’re getting good value for our money. In 2005 per capita medical costs in Canada were $3003 USD compared to $5635 USD in the United States. The per capita costs in the US from public sources were $2570 USD, compared to $2108 USD in Canada. Americans are already spending more for public health care without universal coverage.

    There are downsides to Medicare. Some patients are dissatisfied with the care they receive, although I would venture to guess that’s true in every other country in the world as well. No matter how you fund medical care there will be doctors who make mistakes or nurses who are having a bad day. Because there is no option to go outside the system it leaves people who want to pay a premium for ‘better service’ without recourse. And it doesn’t allow doctors to set their own rates, since their rates are set by the public health authority.

    But the truth is that we are not dying in droves. Our life expectancy is higher and our infant mortality rates are lower than in the US. We generally trust the system to care for our urgent needs. And we are thankful to know that in any circumstances we can count on our health care needs being met. We won’t become uninsured if we lose our jobs. A serious illness or injury won’t bankrupt us. Any of us. I think that’s a good thing.

    Pity Party on the Beach

    Last weekend there was this big huge blogger party that all the cool kids went to. They flew to Chicago where they got swag and went to parties and heard fabulous speakers.

    Me? I stayed home.

    View towards downtown
    I doubt there was a view like this at BlogHer

    However, a few of us decided to have a party of our own even though we weren’t going. A big old pity party on the beach. The always cool Left Coast Mama organized it and so we loaded up our barbecues and our kids and headed to Spanish Banks in Vancouver. Which always makes me, the suburbanite, a little nervous. What if I have to parallel park? What if my clothes aren’t cool enough or I don’t know the hip catch phrases?

    Freighters and North Shore mountains
    More with the Vancouver prettiness

    I needn’t have worried. It was a lovely day, and Jacob, Hannah and I had a great time. I only got a little bit lost before I managed to find the right spot. Really, hardly worth a mention. And Hannah calmed down considerably when I reassured her that she didn’t need to speak Spanish just because the place is called Spanish Banks. It’s a big relief because she hasn’t seen much Dora since back in November so she’s a little rusty these days. ;)

    The kids making sandcastles
    The kids are hard at work digging

    We were joined by Gwen, Tracey, Susan and Kerry, as well as kids, spouses and one Nana. The guest of honour, for sure, was baby Tara at just over a week old on her first trip out, so sweet. There was sun, sand and sea. Sandcastles were built and holes were dug. Jacob became thoroughly covered in beach debris but had a grand time crawling around and putting sand in his mouth. And there were hot dogs, thanks to Anthony and his mad barbecuing skills.

    Crunchy Carpets Kerry
    Kerry on her first outing with wee baby Tara

    Really, it was a lot of fun. Hannah was terribly sad to leave and asked if we could move to Spanish Banks. I told her I would check the couch cushions to see if I could find a spare $1 million or so. So far all I’ve found is $0.36 and a lot of stale Cheerios, but I haven’t abandoned all hope yet. In the meantime. I’ll leave you with the rest of my photos of the day:

    Hannah playing in a tidal pool

    Hannah and Caity digging

    Jacob modeling Adam's shades

    Aidan Posing

    Hannah posing

    Amber and JacobLeft Coast Mama Gwen holding Tara

    Sand, sea, mountains, sky

    Westerly view

    Who needs Chicago and free Crocs when you have beach toys and a great view? (Although I’m totally hoping to make it to BlogHer 2010 in New York, so don’t be surprised if my tune changes rather suddenly around this time next year.)

    Returning from Maternity Leave

    It’s Mat Leave Monday! Today I’m going to talk about planning your return to work once your maternity leave is over. This would be the time I would be making my plans if I were going back. Plus I did go back after Hannah was born. So I feel like I can offer a few insights.

    The first thing you need to plan for when you return to work is child care. Ideally, you will have done this very early on in your maternity leave, or maybe even before it started. Good daycare generally comes with a long wait list, unless you happen to be a close friend or family member of your provider, and you really don’t want to be scrambling in your last few days off. I wrote about finding childcare back in February, and it’s a great place to start if you’re still considering your options.

    I did one thing when I returned to work after Hannah was born that saved my bacon. I started her in daycare a full month before my return. (Keep in mind that this is Canada so she was already 11 1/2 months old at the time.) I was hesitant to do this because I really wanted to maximize my time with my child, but it ended up being a great choice. Starting daycare can be rough on everyone, especially for the first week or two. By starting her well before my return to work date I was able to be there and give her the most gradual and gentle introduction possible.

    But starting Hannah earlier was also a big help to me. By the end of her second week she was well settled. Although I’d already screened it, it wasn’t until we were underway that I felt totally confident with our daycare arrangement. By the time I started back at work a couple of weeks later I was no longer worried when I dropped Hannah off in the morning. Of course I was always thinking of her and I was sad to leave her, but I wasn’t distracted at work wondering if she was all right or trying to arrange another daycare option.

    Once child care is squared away you will want to be in touch with the office, if you haven’t been already. If you’ve been gone for a year your employer might not remember your exact start date so giving them ample notice of your return helps make sure all the logistics are ready for your first day. I also found it helpful to go in for a face-to-face meeting. Speaking with your replacement and your co-workers and getting a feel for what you’ve missed over the last months helps you get back into a work frame of mind. There are some things you just can’t find out as easily through email or phone calls.

    When you do return you will likely feel a little bit out of the loop. If nothing else you’ve changed a lot now that you have a baby at home. And that’s OK. Nobody expects you to dive back in as if you’d never left. If it takes you a few weeks to get completely up to speed it’s understandable. Co-workers who have kids themselves will be particularly understanding.

    In fact, one of the most interesting parts of returning to work post-baby for me was becoming part of the office parents’ club. People who I shared little in common with before became friends. We traded stories about our kids and commiserated about lack of sleep and shared parenting advice. It was like a whole other side of the office dynamic that I’d been left out of. I remember being in a meeting one day when a childless co-worker suggested that if you were facing too many interruptions in the office you should work from home. All the parents in the room just burst out laughing. Our homes had long since ceased being some sort of oasis of tranquility with the kids and the toys and Dora blaring from the TV.

    During my early days at work I felt as if I were constantly pulled in two directions. I feared I wasn’t being a good mother or a good employee, since they were both such all-consuming parts of my life. That did get better, and the feeling abated as Hannah got older. You might need to re-frame your expectations about work and parenthood when you’re doing both. It is a lot for any one person to take on. The good news, though, is that it was mostly my own feelings at play. My co-workers and my family were OK, I just had to come to terms with it myself.

    I think that returning to work is like a lot of life events. You can’t really picture how it’s going to work out until you do it. Having a baby was like that for me, as was getting married. Having a second child was definitely like that. But in all those cases I figured it out. I got through the rough early days and found a new equilibrium. Combining work with parenthood is much the same. You may not know how you’ll do it, and then you just … do.

    Do you have any tips for easing the transition back to work? Any pitfalls you wished you’d avoided or help you could have used? Please share in the comments.

    matleavecarnivalboxPS – There’s still lots of time left to sign up for the Carnival of Maternity Leave. I have finished the baby blanket and I am assembling the rest of the maternity leave survival pack that will be awarded to one participant. So please, if you have any thoughts about maternity leave consider writing a post for the carnival, or submitting a guest post to me by August 10. You don’t have to be on maternity leave, or to have even ever had a baby. As long as you have something to say I’d love to have you!

    Toy Bag Giveaway

    Yesterday at 6pm the draw for one of my toy diaper bags closed. In total there were 44 entries – 35 commenters and 9 email subscribers. I went to random.org and generated 2 random numbers between 1 and 44. The results were 4 and 23, making the lucky winners Michelle Kent and Kelly@ Parenting Princesses.

    Thanks to everyone who entered. And remember, if you didn’t win one of the bags I sewed, I did make a handy sewing pattern you can use. It’s also located in the sidebar under (conveniently) ‘Sewing Pattern’. Just click on the button to access it anytime.

    As for me, I am now working on baby blankets. I am the appliqué queen these days, I love making pictures using fabric.

    Busted

    Four and a half year old Hannah creates a lot of artwork. A lot of artwork. I would say that some weeks we have a couple of dozen masterpieces that are presented to me with great ceremony. And I love them, I really do. I love seeing her artistic skills evolve with the drawings she produces. They’re snapshots in time that can’t be duplicated.

    Except there are so many drawings that it’s become something of a problem. We have piles and piles and piles of drawings. I just don’t have room in my house for all the drawings. So when my child is asleep I recycle most of them. I save a few that really, but most end up on the curb with the cereal boxes and junk mail. It’s underhanded, but if Hannah cottons on to what I’m doing she becomes Highly Offended. How could I possibly throw away that beautiful butterfly that she coloured just for me? Or that butterfly? Or that one or that one or that one?

    I mostly get away with my subterfuge. Except for the times I don’t. Let me lay the scene for you.

    I am writing an email. Hannah approaches.

    Hannah: Mom, where is the princess I drew for you? You know, the special princess I drew for you? It was on pink paper.

    Oops – she had drawn the special princess weeks before. The special princess had gone to meet her maker along with all the other special princesses. I decide to distract and deflect.

    Me: I don’t know, have you tried looking for her?

    Hannah: YES! I looked and looked and looked. She’s LOST!

    Oh no, the jig is up. I am totally busted.

    Me: I’m sorry, sweetie. Your special princess is gone. She was recycled.

    Hannah starts to cry.

    Hannah: How could you recycle my special princess that I made just for you?

    And then Hannah decided to create another special princess for me. And thirteen more. This time I kept one. You never know when I will need to produce her as evidence of my maternal affections, after all.

    I know I’m not the only mom who recycles the kid art. Do you do it? Are you up front about it? I would love to know if you’ve been busted by your 4-year-old, too. ;)

    PS – You have until 6pm Pacific time today (July 25, 2009) to enter my draw for one of two toy diaper bags I sewed my very own self. Click on the button to the left to find out more and leave a comment. Or else you can just download the pattern and sew one yourself. Either way, check it out! :)

    Attack of the Plastic Packaging

    For two weeks recently I decided to save all the plastic waste that my family generated, whether it was bound for the trash or the recycling bin. It was an experiment for me, really, to see how much plastic actually passes through my hands. I do really try to avoid plastic where I can, because I know that it can persist in the environment more or less forever. And even recycling isn’t a perfect solution, since plastic degrades with re-use and overseas recycling plants are unsafe.

    During my two weeks of plastic saving I didn’t deliberately avoid plastic, but I also didn’t deliberately go out and buy more. I wanted to give a fair representation of a typical two week period in our home. However, when I see how much plastic I actually used, and how little of it is recyclable, I start coming up with excuses. I really want to say this isn’t a typical two week period, and explain why. I want to believe that this must be an anomaly.

    Honestly, though, I’m sure that something ‘out of the ordinary’ happens almost every couple of weeks, so I will more or less always have an excuse if I want it. Which means that this isn’t an anomaly, it’s reality. So, here it is, no excuses or justifications. Two weeks of plastic at my house.

    img_7974
    All of the plastic.

    img_7975
    The recyclable plastic.

    img_7976
    Mail-order non-recyclable plastic.

    img_7977
    Fast food non-recyclable plastic.

    img_7978
    Kid non-recyclable plastic (that bag was used to hold dirty diapers, it’s so not getting re-used).

    img_7979
    Food non-recyclable plastic.

    I could definitely reduce my food-related plastic. After seeing this I dug out the re-usable produce bags I haven’t been using . I also won some more re-usable produce bags in a giveaway recently so I am set on that front. By buying more things in bulk I can also cut down on plastic waste. However, I’m not sure there are good ways to eliminate everything here, like pill packs or the plastic wrap from cheese. Also, the tops of glass milk bottles are already a compromise.

    No matter what, this experiment was a wake-up call for me, and I certainly hope to reduce the plastic I produce substantially. I might repeat this in 6 months or so, so we can all see how well I’m doing in my efforts to reduce plastic waste.

    1000th Post

    This is the 1000th post here on Strocel.com. Can you believe it? I can’t.

    I considered what sort of celebration I should undertake on this momentous occasion, and I came up empty-handed. So I’ve decided that some pictures are worth 1000 posts. Here are some scenes as we keep it real in the suburbs. I’m glad you’re joining me in keeping it real, too. ;)

    Going Part-Time

    I returned to work reluctantly after my first maternity leave. My whole world had changed since I’d last set foot in the office a full year before. I had become a mom and I wasn’t even really the same person anymore.

    I was lucky that my former employer offered family-friendly policies such as flex time and the option to work from home. I decided to go into the office three days a week, and work from home for two. I got a laptop and I was all raring to go. However, I soon discovered that trying to get in an 8 hour day while caring for a one-year-old is very difficult. Maybe even impossible. So I found myself working around the clock whenever I could get a moment to myself. After a month it was clear to me that something had to give.

    As I considered my options I was worried. I’m an engineer. On my team of 14 or so people there was only one other woman. Many of my colleagues had wives who stayed home while they were the primary bread winners. They were working full-time and then some to support their families. If I didn’t want to work full-time would I be setting myself apart in a whole new way? What would the consequences be?

    There were some factors that balanced in my favour when I decided to go part-time. Thankfully at that time the economy was very different and my company was doing well. I had worked there for seven years and had a proven track record. Plus my salary as an engineer was sufficient that giving up a portion of it was something we could swing. I felt that, in my case, the risk was worth the potential reward. I know that not everyone has the same advantages, or would be able to make the same choices I did.

    I spent a few days gathering courage. I worked out a little speech in my head that involved loving my job, and wanting to be mentally healthy enough to give it my all. I walked back and forth to my team leader’s office a couple of times before I managed to poke my head in the door.

    In the end I needn’t have worried. I learned that if your employer values your contribution they may be more accommodating than you expect. My team leader was very understanding, and wanted to help me find an arrangement that worked for everyone. He was also a dad with small kids at home. He got it, totally. It was a huge relief to me.

    I chose to work 32 hours a week. I went into the office three days a week and worked 2 half-days from home. It was much more manageable, and I was much happier. I was surprised to discover that there were other employees who were working reduced schedules, too. I had no idea because I’d never asked, and it wasn’t necessarily something they were advertising. When news got out that I had gone part-time, though, I heard all about it.

    There are some downsides to going part-time. You aren’t going to be promoted or advance in your career in the same way. I have mixed feelings about this, but I understand why it works that way. There is still some stigma with going on the ‘mommy track’. And I did find that I wasn’t as tuned in to the office goings on as people who were there full time or more. There were upsides to being out of the political loop, but there were also downsides.

    It’s really hard to find balance as a mom. There may be no such thing. We’re all making compromises, some good and some not so good. Working part-time was one compromise that worked for me, at least most of the time.

    What about you? Do you work an alternate schedule? Or would you consider it if it were an option? I’d love to what other moms think about going part-time.

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