Oct. 25, 2001
As a member of Martin Memorial's Baby Friendly Committee, it was brought to my attention that the pediatricians
had brought up the concern about MM
having formula available as a courtesy for indigent mothers. It is not a
to me that they have taken this stance.
Last November when I came to you to tell you what "IBCLC" is and talk to you
about "Baby Friendly," we briefly talked about the steps and what an
advantage this would be for Martin Memorial (MM).
Specifically, the advantages for MM are:
1) The (Baby Friendly Hospital Initiative) BFHI is a voluntary quality
process. This initiative puts breastfeeding into quality
2) The BFHI supports orientation
to community benefits. The focus of the
BFHI extends outward from the hospital to integrate preconceptual,
intrapartum and postpartum education and care with community
3) The BFHI reflects other women's health
issues by providing proactive
integrated care for breastfeeding women. As more facilities recognize women
as the gateway
to health care decisions and choices for the whole family,
interest has increased in women's health oriented programs.
meeting women's needs during the vulnerable days surrounding childbirth can
form a lasting positive impression
of the health care system.
4) The BFHI enhances marketing programs. Receipt of this international
an achievement to crow about! It indicates that the hospital has
voluntarily sought to provide cutting edge services
(FYI-MM could be the second baby friendly hospital in Florida. There are
about 20+ in the USA) I know
that several lactation [conferences] and other meetings have been held at the first baby friendly hospital in Cape Canaveral
just because they got this award.)
Anyway, you agreed that this was prestigious and worthy, and encouraged me
present this to Kathy Rowell [Director of Maternal/ Child Services] because this was her training/department and not
your area of expertise. When I did this, I learned that Kathy and her staff were quite knowledgeable and has made quite a
bit of progress in this area.
Other physician-lactation consultant that I have met at [national] conferences say
it is very typical of pediatricians to fight getting formula off the formulary.
I have learned from my conversations
with them that once the formula detail
men learn of what the hospital is trying to do, they go to the physician
complaining and putting pressure on the doctors to complain to
I can say for a fact that antibiotic
reps have offered me promotional to
bring up specific antibiotic in a physician's meeting and try to persuade
be more accepting.
So I want to encourage you that if a pediatrician has a concern about what
baby friendly is,
why don't you encourage them to approach one of us on the
committee. Please don't let yourself get pulled into the middle
aggressive marketing campaign by formula reps. And please don't let it make
you loose focus on all the wonderful
steps Kathy Rowell and staff have
already done to try to achieve this.
I also heard about the pediatricians
concern that indigent mothers may have
to pay for the formula if we don't accept samples.
First, I do support a
mother who wants to bottle feed, if it is a
well-informed decision. Unfortunately I hear way to many mothers say they
breastfeed because the had XXX disease, were on XXX medicine or
numerous other reasons AND it is their own doctor told
them they could not
nurse.I have never understood why the doctors won't refer to an IBCLC if
they have questions.
There are 5 in the area. There is so much new (last 5
years or so) research and new understanding of breastfeeding in the
years encouraging these women to overcome what was once thought were
barriers to breastfeeding. The baby friendly
initiative strives to educate
mothers, hospital staff, and physicians about this new information. I don't
why the peds would oppose.
Second, Women's Infants and Children has a program so that all indigent and
class mothers can receive plenty of infant formula for a year
with out charge. Again, I am confused why the peds
don't know this??
Breastfeeding mother's can also receive milk, eggs, cheese and other staples
through this program.
you and I know that when there is free samples of anything around it
often does not go to the indigent first. One great
example is when my first
son was born, his MM pediatrician said, "When you decide you want to stop
have all the formula you will need." I was not told that
breastfeeding is best, I was not even encouraged to continue by
pediatrician. It felt undermined. If I was told this and found this to be
discouraging, I feel so much for the mothers
who don't have as much
confidence and information as I do to keep up with what is best for the
baby. Also, I don't understand
why the peds don't know how much
bottles/gadgets and formula cost($1200.00+ per year) and what the cost of
of health care (Kaiser estimated it to be $1400.00 per year per
baby) is, and missed time from work from illness is when
a baby is not
receiving its mothers milk. Why don't they explain this to their patients?
Do they forget all this when
they are being detailed.
If "no availability of formula" for indigent mothers continues to be a
concern to the pediatricians,
I would encourage them to come to our meetings
and express their concerns. We can all discuss the issues and move forward
this notable achievement. I anticipate that there will actually be more
opposition from the pediatricians as our baby friendly
committee moves ahead
(the physician-lactation consultants have warned me of this, but I don't
understand why.) As a
physician who can take care of both mother and
baby, and specializes in lactation I am committed to helping MM attain this
I am approachable and would be glad to share with you or the inquiring
physicians any research or publications that would
You may also share/forward my comments to any of the pediatricians or MM
staff that you feel would benefit
from having this information.
Thank you for considering my letter,