Information, advertising, spam: Medela crosses the line

There has been a lot of talk on twitter and on blogs in the past while about pump manufacturer Medela’s decision to stop complying with the WHO Code and its Medela Mom Mavens program where it solicits moms to help it spread the message about breastfeeding and about its products. A number of people have asked me why I am not supportive of Medela’s actions and a quick answer just didn’t suffice. So here goes…

Not complying with the WHO Code

The first issue that I have with Medela is that it no longer complies with the WHO’s International Code of Marketing of Breast-milk Substitutes. The company has always sold pumps and bottles, but until recently did so in a manner that complied with the WHO Code. I personally own two Medela pumps and had no trouble finding and buying additional bottles to go with them when Medela was still complying with the code.

What has changed?

Rather than simply making its bottles available for purchase, Medela has started advertising and promoting them. Although it generally advertises them as breastmilk bottles, the fact that it is promoting them at all is a violation of the WHO Code. The WHO Code does recognize that there is a legitimate market for bottles and even for formula and states clearly that “these products should accordingly be made accessible to those who need them through commercial or non-commercial distribution systems,” but it also states clearly that “they should not be marketed or distributed in ways that may interfere with the protection and promotion of breast-feeding.”

The provisions of the WHO Code that Medela most heavily violates are those in Article 5 relating to the general public and mothers. Specifically, those articles state (my comments on Medela’s non-compliance in bold following each article):

5.1 There should be no advertising or other form of promotion to the general public of products within the scope of this Code. Medela has run some advertisements that featured their bottle systems separately from the pumps.

5.2 Manufacturers and distributors should not provide, directly or indirectly, to pregnant women, mothers or members of their families, samples of products within the scope of this Code. Medela has done giveaways of bottles.

5.3 In conformity with paragraphs 1 and 2 of this Article, there should be no point-of- sale advertising, giving of  samples, or any other promotion device to induce sales directly to the consumer at the retail level, such as special displays, discount coupons, premiums, special sales, loss-leaders and tie-in sales, for products within the scope of this Code. This provision should not restrict the establishment of pricing policies and practices intended to provide products at lower prices on a long-term basis. Some retailers do offer Medela bottles at sale prices, but it is not clear if this is a Medela promotion or a store promotion (i.e. who is initiating the violation). Either way, I think Medela should make it clear that no in-store promotions or discounts on its products are allowed.

5.4 Manufacturers and distributors should not distribute to pregnant women or mothers or infants and young children any gifts of articles or utensils which may promote the use of breast-milk substitutes or bottle-feeding. As mentioned above, Medela has done giveaways (gifts) of bottles to mothers of infants and young children.

5.5 Marketing personnel, in their business capacity, should not seek direct or indirect contact of any kind with pregnant women or with mothers of infants and young children. Medela has encouraged mothers to register on their site and has founded a Medela Mom Mavens program where it provides information directly to mothers via a newsletter and website and also encourages them to share that information with others. To be fair, most of that information is about breastfeeding, but some of it is about how great their bottles are. They call their nipples “the preferred choice of breastfeeding moms and babies“, but I’ve never heard anyone other than Medela refer to them that way. It also includes information that is not consistent with the advice of lactation professionals (e.g. providing large bottles and medium-flow nipples, even though smaller portions and slow flow nipples are recommended for breastfed babies).

I don’t want to be overly critical of Medela. I think the company does a great job promoting and facilitating breastfeeding. Most of the information on its website is wonderful. Most of its products are of the highest quality. I have been nothing but happy with my Medela products. However, I do think that some of their current actions to promote their bottles are inappropriate. It would not be difficult for Medela to continue to promote breastfeeding and sell its bottles without promoting them. However, it has chosen to ignore the WHO Code and push more bottle imagery and bottle messaging on moms (more on why bottle imagery and messaging is hurtful here). The result is that Medela is directly pushing bottles on moms and also doing so indirectly via the Medela Mavens and others who might pick up on the message about how breastfeeding ties you down, so you really need a pump and bottles so you can get your hair done.

According to Medela, its actions that violate the WHO Code are in fact supporting breastfeeding and allow moms to nurse longer by increasing rather than limiting the information supplied directly to mothers. A lot of their information may be doing that, but their information on bottles is vague about when they should be introduced and some of their info may cause nipple confusion (a term not found on their Mom Mavens site anywhere) and effectively reduce the length of time a mom can successfully breastfeed. I am not exaggerating. I was a moderator on a message board with many moms who introduced a bottle too soon and couldn’t get their baby back to the breast, whose babies guzzled through 8oz bottles of breastmilk at work because they didn’t understand how to bottle feed a breastfed baby, or whose babies refused to take the breast anymore after having bottles at work because they liked the fast flow of the nipple on the bottle.

Encouraging moms to spam online communities for free stuff

I mentioned a bit above why I don’t like Medela promoting its bottles via the Medela Mom Mavens . However, it isn’t just the bottle marketing via this program that I object to. I think the entire premise is flawed. In response to Hoyden About Town’s post on the Medela Mom Mavens, Shannon (@zchamu) wrote:

Why is it a bad thing for a company that has people who swear by their product, to contact those people and say hey, if you use our product, talk to people about it? Every company does it (or should). Encouraging people to talk about their experiences with a product via word of mouth is a *good* thing.

Encouraging people to talk about their experiences with a product is a great thing, I think, when done subtly and not through any direct incentive. There are many products I have used that I like. I am in contact with some of those companies and I do promote their products to my networks, but I do it because I want to, not because I was asked to or induced by freebies to do so. It isn’t entirely clear to me what the Medela Mom Mavens get for their service talking up Medela’s products, but Medela does ask them to report back when they have said wonderful things about Medela. I wonder if good things come to those who chat up Medela most frequently?

I don’t think it is that bad for moms to talk up Medela’s pumps on their own blog, facebook or twitter stream. That is their space and they are free to do what they like there. Where it becomes problematic to me is when they are encouraging moms to go onto message boards and talk up Medela’s products. As Hoyden About Town’s post correctly points out, many of the communities that Medela is suggesting the Mavens promote their products in actually prohibit that type of promotion or solicitation. Not only does Medela suggest this type of message board spamming in general, but it also provides a list of boards to spam, will help you troubleshoot signing up and logging in, and even monthly suggestions on specific posts that moms can respond to.

As a former pumping message board moderator, I find those suggestions particularly problematic. We used to think that if a mom asked for pump recommendations that our community would provide a balanced list of suggestions of good pumps. Our moderators would generally say which pumps they used, but also list other reputable pumps and probe a bit about what the mom needs the pump for in order to make an appropriate recommendation. Medela pumps are great, but they may not always be the best choice for every mom in every situation. I worry about message boards being flooded with Medela recommendations via this program. Medela does suggest that moms disclose they are a Medela Mom Maven when posting, but that is likely to get them kicked off of most boards, so they probably won’t. I know that moderators on a number of boards are now going to look at all Medela recommendations with suspicion.

Final Thoughts

I know not everyone agrees with me. In fact, a number of moms who I admire and respect are either Medela Mom Mavens or have posted about or hosted bottle giveaways on their site. I don’t think it is right. I don’t like it. I think it would be easy for Medela to improve its practices. But that doesn’t mean I’ve lost all respect for many of the strong breastfeeding advocates who are involved in this type of marketing. To be clear, on a sliding scale this is not even close to Enfamil or Nestle or other formula companies. Not even close. But I would argue, and others do argue, that any violation of the WHO Code weakens its potential impact. We cannot say “it’s okay because you are Medela,” but then slap Nestle on the hand for everything it does wrong.

I think a clearer delineation between information and marketing is needed. According to a recent Angus Reid poll, 67% of Canadians say that advertising helps them find the products that they want. But 52% also believe that all advertising distorts the truth. So what if advertising is really helping people find products they don’t want and don’t need by distorting the truth? While you may take a commercial on TV with a grain of salt, a recommendation from a trusted friend or fellow community member is probably more likely to convince. Social media marketers are counting on it. Medela is counting on it.

Personally, when it comes to breastfeeding promotion, I will stick to working with companies that have made a commitment to upholding the WHO Code.