by Susan F. Wood, PhD
Today’s Washington Post writes about one more instance where women’s health and children’s health were a lower priority than the interests of a powerful group. In this case, it was breastfeeding vs. the formula industry.
Marc Kaufman and Christopher Lee write:
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.
I was still working for FDA (and had previously been at the HHS Office on Women’s Health) when all of this occurred, and remember the concerns and disappointment when this new exciting campaign to promote breast feeding was watered down. What’s concerning right now, is that the new report by the Agency for Healthcare Research and Quality (AHRQ) that evaluates the data on increased risks of leukemia for children who were not breastfed is once again being minimized, so that women, physicians and other health professionals are not getting the information they need.
But other current and former HHS officials say the muting of the ads was not the only episode in which HHS missed a chance to try to raise the breast-feeding rate. In April, according to officials and documents, the department chose not to promote a comprehensive analysis by its own Agency for Healthcare Research and Quality (AHRQ) of multiple studies on breast-feeding, which generally found it was associated with fewer ear and gastrointestinal infections, as well as lower rates of diabetes, leukemia, obesity, asthma and sudden infant death syndrome.
The report did not assert a direct cause and effect, because doing so would require studies in which some women are told not to breast-feed their infants — a request considered unethical, given the obvious health benefits of the practice.
A top HHS official said that at the time, Suzanne Haynes, an epidemiologist and senior science adviser for the department’s Office on Women’s Health, argued strongly in favor of promoting the new conclusions in the media and among medical professionals. But her office, which commissioned the report, was specifically instructed by political appointees not to disseminate a news release.
Wanda K. Jones, director of the women’s health office, said agency media officials have “all been hammering me” about getting Haynes to stop trying to draw attention to the AHRQ report. HHS press officer Rebecca Ayer emphatically told Haynes and others in mid-July that there should be “no media outreach to anyone” on that topic, current and former officials said.
The results of all of this? Here are 2 separated paragraphs from the article:
After the 2003-05 period in which the HHS ads were aired, the proportion of mothers who breast-fed in the hospital after their babies were born dropped, from 70 percent in 2002 to 63.6 percent in 2006, according to statistics collected in Abbott Nutrition’s Ross Mothers Survey, an industry-backed effort that has been measuring breast-feeding rates for more than 30 years. In 2002, 33.2 percent of women were doing any breast-feeding at six months; by 2006, that rate had declined to 30 percent.
…… The industry substantially increased its own advertising as soon as the HHS campaign was launched. According to a 2006 report by the Government Accountability Office, formula companies spent about $30 million in 2000 to advertise their products. In 2003 and 2004, when the campaign was underway, infant formula advertising increased to nearly $50 million.
HHS’ priorities need to get back in order. The formula industry should play no role in the development of a breast feeding campaign or in how data and information is shared. But unfortunately they had/have a very big place at the table.
Susan F. Wood, PhD is Research Professor at George Washington University School of Public Health and Health Services, where she is part of the Project on Scientific Knowledge and Public Policy (SKAPP). She also served as Director of the FDA Office of Women’s Health from 2000-2005