# Join us in a letter-writing campaign



## Victorian (Jan 2, 2003)

Feel like writing letters? This is an email that I received yesterday. The National Breastfeeding Awareness Campain is under attack by the AAP and the formula companies! It is very long, but includes the letters written by the AAP. I am also going to copy this over to the breastfeeding thread.

Victorian

Hello Breastfeeding Advocates,

Below is an email sent to me from Anne Merewood and Bobbi Phillipp at
the Boston Medical Center, one of the few Baby-Friendly Hospitals in the
US. Like Nursing Mothers Counsel, BMC is a Community Demonstration
Project for the National Breastfeeding Awareness Campaign.

As you will read, the formula companies are hitting hard at institutions
which work with mothers and babies, in an effort to block or dilute the
campaign. We know they have specifically sought out the AAP, and WIC.
Who knows where else? Please write to the addresses below, expressing
your support for the campaign messages to be left as they are, and
forward this to your colleagues.

Thank you in advance,
Amelia Psmythe
Nursing Mothers Counsel of Oregon
__________________________________________________ _______________________________
Dear Colleagues

We are writing to you as a result of recent developments concerning the
National Breastfeeding Awareness Campaign, which we have learned about from
our colleagues in the AAP and other breastfeeding organizations. Some of you
may already have heard about this as it has appeared today on LactNet and
several other breastfeeding listservs. We are sending out the info we have,
because we feel that you all should know about these developments, as our fellow
CDPs. Please note that Bobbi and I are sending this to you, it is not coming from
any official government source, and we have not consulted with either Gina or
Suzanne about sending this email. However - we have sent this out to many other
of our colleagues and it seems only logical that we send it direct to you.

Please read these attachments and consider writing a letter to express your
support for the NBAC in its current form. We are attaching four documents to
supply you with information that is available, which we have been asked to
disseminate as widely as possible.

Attachments:

1. National Breastfeeding Awareness Campaign - background
2. An email from Dr. Gartner, Head of the Section on Breastfeeding at the AAP
3. A letter from the AAP President, to DHHS Secretary Tommy Thompson
4. A letter from AAP Section on Breastfeeding to Secretary Tommy Thompson

If you find these developments concerning please:

1. Write a letter to Tommy Thompson, and mail to:

Honorable Tommy G. Thompson
Secretary, Department of Health & Human Services
200 Independence Avenue. SW
Washington. DC 20201 or

2. Send an email expressing your support to me ([email protected]).
I will mail out three envelopes of these emails by overnight express,
on Fri 11/21, Monday 11/24 and Wed 11/26 or

3. Send your letter by fax to 617 414 2662, and we will include in the above
mailings.

We hope you will read the email attachments, and we look forward to your support.
Please feel free to forward this information to as many of your colleagues as
you choose.

Bobbi Philipp, MD Anne Merewood, IBCLC

attachment 1

Information: National Breastfeeding Awareness Campaign

The US Department of Health and Human Services Office on Women's Health (OWH) has been funded to put into practice recommendations of the HHS Blueprint for Action on Breastfeeding (2000) with a National Breastfeeding Awareness Campaign (NBAC). This 3-year campaign will promote breastfeeding and will especially target first-time parents (mothers and fathers) and African Americans, populations groups that would not normally breastfeed. The overall goal of the campaign is to increase the proportion of mothers who initiate breastfeeding to 75% and those who are breastfeeding at 6 months postpartum to 50% by the year 2010 (Health People 2010). The campaign aims to empower women to commit to breastfeeding and to illustrate clearly the consequences of not breastfeeding such as higher likelihood of diabetes, obesity, some childhood cancers, and other illnesses and conditions. Besides trying to raise initiation rates, the campaign will also stress the importance of exclusive breastfeeding for at least 6 months.

The campaign will be produced pro bono on behalf of The Advertising Council, a private, nonprofit organization, which has been the leading producer of US public service communications since 1942. The communications programs are national in scope and have generated strong, measurable results. Ad Council campaigns include, "Friends Don't Let Friends Drive Drunk," "Take a Bite Out of Crime," and "A Mind is a Terrible Thing to Waste." (www.adcouncil.org)

The NBAC public service announcements (PSAs) will incorporate television, radio, newspaper, magazine, billboard, and web banner advertising. 18 US cities have been selected to work as resource sites, Community Based Demonstration Projects (CDPs). Another available resource is the OWH-funded National Women's Health Information Center breastfeeding helpline. Breastfeeding Information Specialists are available to answer emails and assist callers with breastfeeding issues. The number and website, 1-800-994-WOMAN (9662), TDD 1-888-220-5446, www.4woman.gov, are available in English and Spanish and are open Monday through Friday from 9am-6pm, EST

ATTACHMENT 2

Email: Sent Wednesday 11/19/2003 4:42 PM

From: Lawrence M. Gartner, MD Subject: Breastfeeding Awareness Campaign

Dear Colleagues:

We recently learned of the existence of a letter sent over the signature of Dr. Carden Johnston, the President of the American Academy of Pediatrics, to Secretary Tommy G. Thompson of Health and Human Services, both applauding the Breastfeeding Awareness Campaign and also objecting to the use of "risks incurred by not breastfeeding" in the PSA's. I spoke with Dr. Joe Sanders, Executive Director of the AAP to find out if such a letter had been sent and the circumstances of its development. He confirmed that the letter had been mailed on November 6, 2003. A copy of the letter is attached.

Dr. Sanders indicated that this letter was written by the Executive Committee, which consists of Dr. Carden Johnston, Dr. Carol Berkowitz and Dr. Joe Sanders. We have not been able to confirm whether Dr. Berkowitz knew of the existence of the letter. Other sources have indicated that the AAP Board of Directors did NOT know about this letter, although the issue was discussed at the Board meeting in New Orleans in the context of their deliberations over the US Breastfeeding Committee's Strategic Plan. The advertising campaign is one of the items on the USBC agenda. It was Dr. Sanders himself who introduced and led the discussion of the USBC Strategic Plan at the AAP Board meeting, unusual for him to do so on such an issue.

During my lengthy conversation with Dr. Sanders, he admitted, after I asked, that formula company representatives had approached him at the New Orleans meeting to express their great objection to the Breastfeeding Awareness Campaign and particularly to the "negative approach." It is my understanding that the formula companies have been lobbying many leaders in AAP and also in other organizations, including AAFP. It is alleged that they also have contacted congressman and other legislators. There is ever reason to believe that they are pulling out all the stops to get this ad campaign buried, or at least, modified to be less effective.

In response to my question about whether Dr. Sanders and Johnston considered contacting someone within the Section on Breastfeeding to discuss their concerns, Dr. Sanders said, "No, they did not." I expressed very serious concern that they had excluded us from the loop and had gone off to take an action relating directly to breastfeeding and to the section without having any discussion with us. It is clear that Dr. Sanders and Johnston simply did not want to talk to us about this matter.

I told Dr. Sanders that the Section on Breastfeeding intended to write directly to Mr. Thompson to express a view contrary to that of Dr. Johnston's letter. He did not respond.

This entire affair is a very serious matter which raises many questions about the leadership of the AAP and the influence of the formula industry on AAP activities.

The letter to Secretary Thompson from the Section on Breastfeeding is attached. It was sent today by Fed Ex. It may have some effect, but what is needed is for everyone to write letters to Secretary Thompson indicating support for the Breastfeeding Awareness Campaign in its current form. Please get as many people to write as possible. Time is of the essence. Signed, Larry (Lawrence M. Gartner, MD, Professor Emeritus, Departments of Pediatrics and Obstetrics/Gynecology, The University of Chicago)

ATTACHMENT 3

November 6, 2003

Honorable Tommy G. Thompson

Secretary

Department of Health & Human Services

200 Independence Avenue. SW

Washington. DC 20201

Dear Secretary Thompson:

It has come to our attention that an advertising campaign to promote breastfeeding is about to be launched by your Office on Women's Health. We applaud this initiative.

The American Academy of Pediatrics has always been staunch supporters of promoting breastfeeding as the optimal source of nutrition for most infants in this country. The current data indicate that the numbers of mother's who initiate breastfeeding while in the hospital following delivery has steadily increased over the past decade, and now nearly 70% of these mothers are electing to nurse their new babies. Unfortunately, the number of mothers who continue to breastfeed their infants at six months of age drops to about one in three. We think the numbers in both of these categories can be improved upon, and a public awareness campaign is certainly a positive step in that direction.

In reviewing the web page of The Advertising Council, the group that will be developing the media messages for this campaign, we note that the focus will be on the risks incurred by not breastfeeding rather than to expound upon the benefits to be derived from breastfeeding. We have some concerns about this negative approach and how it will be received by the general public. Let's not repeat the errors we made in the past relative to substance abuse among our youth where we focused on the risks associated with using drugs and alcohol rather than promoting on the positive consequences of not getting involved in these behaviors. We must absolutely avoid making any claims that cannot be scientifically validated and thus undermine the credibility of the campaign.

As you know, pediatricians are at the very forefront when it comes to discussing infant feeding with parents. The American Academy of Pediatrics is the association representing nearly 60,000 of these healthcare professionals, and we offer our assistance in any way you might deem appropriate to ensure the effectiveness of this campaign.

Sincerely,

Carden Johnston, MD

President

American Academy of Pediatrics

CJ/pj

ATTACHMENT 4

American Academy of Pediatrics

Section on Breastfeeding

Executive Committee Chair, Executive Committee

Ruth A. Lawrence, MD Lawrence M. Gartner, MD

Donna O'Hare, MD 28398 Alamar Road

Jane Morton, MD Valley Center, CA 92082

Audrey J. Naylor, MD, DrPH Ph: 760-751-9479

Richard J. Schanler, MD [email protected]

November 18, 2003

Honorable Tommy G. Thompson

Secretary

Department of Health and Human Services

200 Independence Avenue, SW

Washington, DC 20201

Dear Secretary Thompson:

You recently received a letter from the Dr. Carden Johnston, President of the American Academy of Pediatrics, indicating the Academy's support of the National Breastfeeding Awareness Campaign to be launched shortly by the Department of Health and Human Services. We, the experts on breastfeeding and lactation within the American Academy of Pediatrics must object to one portion of Dr. Johnston's position, however.

Dr. Johnston expresses concern about the recommendation of The Advertising Council to focus the advertisements on the risks incurred by not breastfeeding. The Section on Breastfeeding, with 800 members, does not share that concern. Dr. Johnston notes that he obtained his information on the planned advertising campaign from the web page of The Advertising Council. Neither he nor any of us have seen the actual PSA's because they are still under development. However, the web site of The Advertising Council provides some important insight into their development of the advertising campaign:

"It's a conversion - not awareness - issue. CONFIDENCE AND CONSEQUENCE are keys to conversion. Those who opt out/switch lack a key trait of committed and continuing breastfeeding moms - CONFIDENCE. While aware of the 'breastfeeding benefits', they currently perceive no real CONSEQUENCE to opting out. To breastfeed is seen as analogous to "adding vitamins to the 'standard' (formula feed) diet."

The Advertising Council and the Office on Women's Health, with assistance from many other organizations and from members of our own Section on Breastfeeding of the American Academy of Pediatrics have very carefully researched the question of how the campaign should be oriented. Through the use of many focus groups which included participants from the target population and other data collection points, they have come to the conclusion that for the advertising campaign to be effective, it is essential that the message point out the risks of not breastfeeding. The focus group participants found this approach entirely acceptable. We agree that this is a very appropriate and necessary technique. We believe The Advertising Council's extensive experience in public service messages should honored and followed. Many of their campaigns have had a major impact on improvement of health and social conditions for our citizens. Their PSA on Seat Belt Usage uses an approach similar to their plan for the Breastfeeding Campaign; they provide examples of what can happen when not wearing a seat belt.

Dr. Johnston's warning about "making any claims that cannot be scientifically validated" is entirely valid. We agree. We know from those who have participated in the preparation of the Breastfeeding PSA materials that every word and claim made in these PSA's has been reviewed by multiple scientists and validated by published research from respected medical journals.

We enthusiastically urge that the plans for release of the Breastfeeding Awareness Campaign be kept on schedule and that the content and message not be weakened. The health and very life of our children is at stake here. If we can increase breastfeeding initiation and duration in this country, we can reduce infant mortality, prevent an enormous number of major and minor childhood illnesses and also save a great deal of money that would otherwise be spent in caring for these illnesses and disabilities.

I and my colleagues would be very pleased to provide any additional data on these issues and to assist your office in any way possible to assure a successful Breastfeeding Awareness Campaign.

Sincerely, On behalf of the leadership and membership of the Section on Breastfeeding of the American Academy of Pediatrics

Lawrence M. Gartner, M.D.

Professor Emeritus
Departments of Pediatrics and Obstetrics/Gynecology
The University of Chicago
Chair, Executive Committee
Section on Breastfeeding
American Academy of Pediatrics


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## TiredX2 (Jan 7, 2002)

Comforting to know the AAP (or at least some of its leaders) *are* total sell-outs.


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## cynthia mosher (Aug 20, 1999)

The formula companies are working to squelch the National Breastfeeding Awareness Campaign, or at the least dilute it into something more to thair liking. Peggy and friends have prepared an action alert on the issue. You can read it here. Please write, call, get the word out, do what you can to raise awareness and support the NBAC.


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## Artisan (Aug 24, 2002)




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## Quirky (Jun 18, 2002)

Can you fix the link?

Off to get on my







to write a letter!


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## Meiri (Aug 31, 2002)

Already sent info to Mother Jones Magazine....hoping they act on it. This needs to get beyond the breastfeeding community.


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