Thursday, September 23, 2010

Prescription Formula and Bugs in the Bottle

So, two big news stories have shaken the mothering communities across the world in the last week.  In Australia, a midwife by the name of Dr. Jennifer James has created waves of anger, shock, and vitriol when she told an Australian newspaper that formula should be given by prescription only, and all formula advertising should be banned in the country. (Story here: Women everywhere have been shouting their opinions about the matter on blogs, message boards, and news comment sections across the intrawebs worldwide.  "You don't know me and you don't know my situation!" one formula-feeding mother rages.  Another comment on is from a breastfeeding mom.  "I really feel that we shouldn't be demonizing formula, or making moms who feed formula made to feel more alienated or guilty than they already do.  Some moms just can't breastfeed."

While I understand the outcries of anger over James' statement, I can't help but feel it has some merit, particularly in the wake of this week's recall by Similac.  (Story here: Recall information here:  The fact of the matter is, the prescriptive drug industry is far more regulated than the food industry.  In the States, the FDA has thorough processes in place to test the safety and value of a drug before allowing it into the market.  Similar processes are in place in Canada.  While the formula industry has already recalled several of their products in various countries around the world this year, there has only been one recall of Children's Motrin and like products.  The drug recall was dealt with quickly and efficiently, and stores and pharmacies were stripped of the offending product as quickly as possible.  Within two days of the recall, there was not a single recalled product to be found in any of the stores here in my city.  The news reports included the recall numbers in the report, and parents were able to check quickly to ensure that they did not have any recalled product in their medicine cabinet.  This Similac recall, however, surely as important as the great Motrin Mishap of 2010, has been handled poorly and without the urgency.  The news reports did not include recalled batch numbers, causing Similac's recall website to crash, their phone lines to be permanently busy, and leaving many parents poring over their cans of formula, wondering if they possibly contained beetle body parts, and if they would make their children sick.  What to do?  Many moms I've talked to have simply pitched $40-$100 worth of formula.  Imagine all that money going down the drain with the beetle larvae.  Many parents can't afford to throw that much away, and many parents are left wondering if that illness their baby experienced in the last month was related to undigestible bug parts in the baby's intestinal tract.  What kind of regulation is that?  If formula were indeed a prescription drug, the formula companies might even have to step up and start regulating what is IN the cans, making the recipe consistent, rather than just using whatever ingredients are at hand and cheap at the time (Newman and Pittman, 2009, p. 34)(1).  A warning in Canada last week was issued when a baby became ill after consuming formula that had been tampered with, a man had replaced the formula powder with flour.  If formula was behind the counter and safely in the hands of pharmacists, parents would not have to worry about contamination or tampering.  Mothers would feel less guilty, as their decision to formula feed, or need to formula feed, would have been vindicated by a medical professional, and they would know that they had taken every possible step to try and breastfeed.  There would be less doubts about the mother's decision to bottlefeed.  In addition to this, with a ban on formula advertising, as purported by the WHO's International Code of Marketing Breastmilk Substitutes (, the millions of dollars that formula companies pour into advertising each year could be put to better use improving and regulating the actual formula.  Rather than targeting expectant, new, and already breastfeeding moms to use their product, formula companies could ensure the product is safe and consistent in content, creating a better alternative in cases where breastfeeding is not possible.  Pamphlets could be created to teach formula-feeding parents how to safely formula-feed, and the proper procedures for sterilizing bottles, water, and equipment.  More money could be put into ensuring that the formula itself is more sterile, and not as susceptible to outside contamination.  Formula-feeding pairs could only benefit from this kind of monetarial input, and industry regulation.

Finally, we all know that breastfeeding is the normal biological way for a baby to eat, and as such, more emphasis should be placed by the health systems on assisting mothers in breastfeeding when they encounter difficulty. As a mom who hit walls with breastfeeding every step of the way, I know what it is like to go and see a doctor for breastfeeding assistance, only to find out I know more about the issue than they do.  Dr. James' intentions are not to humiliate mothers, or to make formula-feeding parents feel guilty, but rather to push the healthcare systems in Australia (and worldwide) to develop more breastfeeding resources, and to look at formula as a medical solution, rather than an equal alternative to breastmilk.  If formula is made into a prescriptive medication, babies can only stand to benefit from better regulation on the industry, better help from the medical community in achieving breastfeeding goals, and a safer option for those mothers who legitimately cannot breastfeed.

(1) Jack Newman and Teresa Pittman, 2009 - Dr. Jack Newman's Guide to Breastfeeding - Toronto, Canada - HarperCollins Publishing Ltd.