Formula Industry Tactics In The Spotlight August 31, 2007
The Washington Post TODAY REPORTS on how the pharma (infant formula) industry strongarmed the federal government to significantly change a pro-breastfeeding public service ad campaign.
I previously reported on this exact same story A WHILE BACK, but there are lots of important new details in the WP story, including the fact that the toned-down ad campaign seems to have had little to no impact on the nation’s relatively low breastfeeding rates.
From the WP story:
In an attempt to raise the nation’s historically low rate of breast-feeding, federal health officials commissioned an attention-grabbing advertising campaign a few years ago to convince mothers that their babies faced real health risks if they did not breast-feed. It featured striking photos of insulin syringes and asthma inhalers topped with rubber nipples.
Plans to run these blunt ads infuriated the politically powerful infant formula industry, which hired a former chairman of the Republican National Committee and a former top regulatory official to lobby the Health and Human Services Department. Not long afterward, department political appointees toned down the campaign.
The ads ran instead with more friendly images of dandelions and cherry-topped ice cream scoops, to dramatize how breast-feeding could help avert respiratory problems and obesity. In a February 2004 letter, the lobbyists told then-HHS Secretary Tommy G. Thompson they were “grateful” for his staff’s intervention to stop health officials from “scaring expectant mothers into breast-feeding,” and asked for help in scaling back more of the ads.
The formula industry’s intervention — which did not block the ads but helped change their content — is being scrutinized by Congress in the wake of last month’s testimony by former surgeon general Richard H. Carmona that the Bush administration repeatedly allowed political considerations to interfere with his efforts to promote public health.
Rep. Henry A. Waxman’s Committee on Oversight and Government Reform is investigating allegations from former officials that Carmona was blocked from participating in the breast-feeding advocacy effort and that those designing the ad campaign were overruled by superiors at the formula industry’s insistence.
“This is a credible allegation of political interference that might have had serious public health consequences,” said Waxman, a California Democrat.
The milder campaign HHS eventually used had no discernible impact on the nation’s breast-feeding rate, which lags behind the rate in many European countries.
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The breast-feeding ad campaign originated in a formal “Blueprint for Action on Breastfeeding” released in 2000 by David Satcher, who had been appointed surgeon general by President Bill Clinton. The Office on Women’s Health convinced the nonprofit Ad Council to donate $30 million in media time, and it hired an ad agency to work alongside scientists from the National Institutes of Health, the Centers for Disease Control and Prevention, and elsewhere.
Officials met with dozens of focus groups before concluding that the best way to influence mothers was to delineate in graphic terms the risks of not breast-feeding, an approach in keeping with edgy Ad Council campaigns on smoking, seat belts and drunken driving. For example, an ad portraying a nipple-tipped insulin bottle said, “Babies who aren’t breastfed are 40% more likely to suffer Type 1 diabetes.”
Gina Ciagne, the office’s public affairs specialist for the campaign, said, “We were ready to go with our risk-based campaign — making breast-feeding a real public health issue — when the formula companies learned about it and came in to complain. Before long, we were told we had to water things down, get rid of the hard-hitting ads and generally make sure we didn’t somehow offend.”
Ciagne and others involved in the campaign said the pushback coincided with a high-level lobbying campaign by formula makers, which are mostly divisions of large pharmaceutical companies that are among the most generous campaign donors in the nation.
hmmm…
the original ads were in keeping with the anti-smoking, seat belt ads, etc. And yet, the government does not cowtow to the cigarette companies lobbying against them. (If they do, but why wouldn’t they) It’s fine to show 30 people laying dead in the street. It accomplishes a goal. If you smoke, you can die. If I am a smoker, and I choose to ignore this warning, then I should have no guilt about it at all.
Same with breastfeeding. How does an ad make someone feel guilty? If that person feels guilty, then they probably know there are risks to ff and benefits to bf and they chose ff anyway. That woman already made her choice. Why should the new mothers not get the proper info because of someone else’s guilt. Scare tactics? Maybe. But it shows the seriousness of the matter. It’s not like choosing what pants to wear. It’s choosing the health of your child.
I don’t love scare tactics in general but I agree with Beth that they use them for everything else, and things related to kids like vaccinations, seatbelts, smoking in the home, etc. Obviously, they work. The information isn’t made up–it’s true, and it needs to be out in the public, not just in front of moms but their employers, caregivers and elected representatives. I really think the only way things will change overall is if EVERYBODY understands the real numbers/risks/benefits involved. It’s not about making individual mothers feel guilty.
Is there any evidence that the scare stories do work better than other types of campaign? This is the exact reverse of what I was taught both in my public health classes and in psychology; the evidence about human motivation is that we are more motivated by trying to achieve benefits than by avoiding risks, by short-term consequences rather than long-term, and by definite consequences rather than possibilities. By any of these criteria, scare stories don’t work very well. What I was taught was that it’s actually a lot better to focus on the benefits of acting a particular way.
And as far as breastfeeding is concerned, I’m not sure yet more information about the risks of formula feeding is the way to go. People already know that, health-wise, breast is best. It’s a cliché. They might choose to ignore that or not to believe it, but I’m not sure telling them again with scarier pictures is the way round that.
From everything I read, the reason mothers don’t breastfeed or stop breastfeeding isn’t because nobody’s ever told them that there are health risks to formula. It’s because breastfeeding is too difficult at first and they don’t know that it can get easier, or because they don’t have the support they need to see them through the difficult times, or because health care professionals are giving them lousy information and they don’t have sources of good information, or because they have to go back to work and either genuinely can’t manage to keep breastfeeding while at work or don’t have the information that would tell them that they could have done… You see what I mean? It’s the practicalities. Telling them yet again about how awful formula is doesn’t help solve those practicalities. It doesn’t tell a woman that she can pump milk at work or that the pain she’s feeling could maybe be solved if someone showed her how to get the latch right or that just because a doctor tells you you have to give formula doesn’t necessarily mean that that’s true.
But what it does do is make them feel guilty. And no matter how we try to brush that aside by saying that you shouldn’t feel guilty if it was your choice to formula-feed, that doesn’t change the facts. There’s also the risk of the guilt itself being counter-productive - I’ve read women on-line saying that they feel they won’t be able to try breastfeeding because they won’t be able to go for help if they need it, because they can’t face the kind of critical comments that pro-breastfeeding groups have made to them for using formula with a previous child or for even *thinking* about using it with this baby. I think there’s a very real risk that the scare stories are not only not working, but are backfiring.
So, if the current ad campaign isn’t working, maybe that isn’t because the stories weren’t scary enough. Maybe it’s because scare stories aren’t what we need. We need a positive campaign of information and help and support aimed at new mothers, so that they know that these problems can potentially be solved, they know where to go for help in solving them, and they know that they won’t be criticised or fed a guilt trip if they do seek that help.