Tuesday, December 31, 2013

Pandora's Box -part 2-

                                    "Recognizing further that inappropriate feeding
                           practices lead to infant malnutrition, morbidity 
                           and mortality in all countries, and that improper 
                           practices in the marketing of breast-milk
                           substitutes and related products can contribute
                           to these major public health problems." 
                           --International Code of Marketing of Breast-Milk Substitutes

Should we whisper this quote or yell it in the mountains, letting it echo and steep into our consciousness.  All countries not just developing nations are impacted by inappropriate  infant feeding practices.  What world is this that controls, regulates advertising of cigarettes, yet sees no reason to control a product that causes death and disease in our most vulnerable population, our future?  What world is this where medical establishments, researchers, and health care professionals turn a blind eye to corporate funding and influence?  What world is this where the media tells the story and we are suppose to believe it?

What is reality in a world where the truth lies in a heap in the closet door of our dreams?  And will we ever know the truth?  Whose reality do you accept?  The reality the PR players tell you?  What happens when you find that you cannot believe what anyone is saying?  Well, here I sit and wonder at my desk, scratch my head and mumble to myself.  The little bit of me that is the scientist says I need the truth to understand my world and how I should act in it. The truth in our society seems to have gone into that Louisiana  fracking sinkhole.  Yep now ya see a glimmer of the truth and oops there it goes, all oiled-up and draining into the depths of the earth, never to be seen again.

So I want to tell the "story" about the AAP (American Academy of Pediatrics), and the Mead Johnson gift bags for breastfeeding mothers which have the AAP logo on them because I think parts of the story are being left out.
This website shows the gift bag and its contents.  http://motherbabysummit.com/?page_id=263

The booklet on breastfeeding included in the gift bag is entitled "New Mother's Breastfeeding Essentials," was adapted from at least one AAP book and pamphlets.  The AAP book that the booklet was adapted from is "New Mother's Guide to Breastfeeding" (second edition) edited by Dr. Joan Y. Meek, (also an IBCLC).  One can obtain AAP books and pamphlets from the website healthychildren.org which features the AAP logo and is sponsored by various companies like Coca-cola, Kelloggs and even a company called Perrigo--maker of store brand infant formulas. 

It all sounded so familar to me, like something from the past calling to me.  Oh yes, I remember now.  Back in 2002, the first edition of the AAP's "New Mother's Guide to Breastfeeding" edited by Dr. Joan Y. Meek, IBCLC was bought by Ross (infant formula company, a division of Abbott).  Ross put their name and teddy bear logo on 300,000 copies of the book.

So one would suppose that since this has happened before, that steps would be taken by AAP members involved in breastfeeding support to see that it would not happen again.  Yet here we go again.  Funny how this little fact seems to be lost in the accusations of AAP hypocrisy.  What happened?  How could this happen again?  There should be explanations and so far as I can tell there seems to be a epidemic of amnesia among breastfeeding advocates.

One of the things that happened after the 2002 absconding of the book edited by Dr. Meek was that some IBCLCs (not me) noticed that Dr. Meek had been doing speaking engagements funded by Mead Johnson.  In June 2003, Dr. Meek shared a letter she wrote to Karen Lundgren, MS, RD of Mead Johnson to the Lactnet community that she would no longer be doing any future pediatric grand rounds, CME programs, or other speaking engagements which were sponsored  by or associated with Mead Johnson.

So we seem to have come full-circle and are back at square one.  And nothing seems to have been learned.  Will there ever be any explanations of what happened?  Will we be able to believe any of the explanations?  This is somewhat as baffling a situation as the IBLCE (International Board of Lactation Consultant Examiners) eliminating the IBCLC duty to protect, promote and support by "complying with the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions." (accessed 2008)  In 2012, the Scope of Practice no longer includes this provision.  Hm, who in the IBLCE decided this?  In the FAQ, there is some kind of answer regarding the WHO Code and a duty to adhere to the principles and aim of the Code.  But it's not part of the Scope of Practice nor in the body of the Code of Professional Conduct.  And the question is asked whether an IBCLC can work for an infant formula company.  And the answer is that the IBLCE cannot prohibit it.  I find that odd.  Particularly since I just learned that some companies in the USA have a morals clause.  So a company can make individuals comply with a morals or ethics clause;  but an institution that regulates the lactation consultant profession feels they cannot make it a duty for its certificate holders to adhere to the WHO Code nor can they stop that professional from working for the competition (the infant formula industry).  All mighty strange to me and I believe it requires some answers.  

As for Dr. Meek, she has done a lot for breastfeeding advocacy.  This is why it is such a painful situation.  She has served on the boards of many breastfeeding organizations:  US Breastfeeding Committee, Academy of Breastfeeding Medicine, the International Board of Lactation Consultant Examiners, Florida Mothers Milk Bank, to name a few. 

Who ultimately has control of what you edit or write...the AAP or Mead Johnson?  What about copyright?  Does the AAP own the copyright to the book she edited?  How could this happen a second time?   I don't know what happened and I don't understand how it has happened again.  But it has and I get the feeling that the wheel will keep on spinning in the same place until this Pandora's Box is nailed shut and buried.
Copyright 2013 Valerie W. McClain

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