A private member’s bill aimed at restricting the ability of baby formula companies to supply their products free of charge in hospital maternity wards aroused a heated argument among legislators, Health Ministry officials and doctors in the Knesset Economics Committee on Wednesday.

The bill, initiated by MK Danny Danon (Likud), would prohibit hospitals from providing bottles of formula from a single company, something critics say can lead to aggressive marketing and the discouragement of breast feeding at home.

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But opposition to the bill came from a surprising source – physicians.

Prof. Avinoam Reches, head of the ethics bureau of the Israel Medical Association, said that changing the behavior of mothers to encourage breast feeding should be done through information and education, and not by legislation.

“The state should not introduce a law into the narrow space between the nursing mother’s breast and the newborn baby’s mouth,” he said poetically.

Reches’s position was supported by the Israel Neonatology Society, the Israel Pediatrics Society and the Hospital Directors Association, whose members would lose millions of shekels in gifts and cash from the formula companies.

Reches said that in most cases, a mother decides whether or not to breast feed while she is still pregnant.

Thus, information must be directed to pregnant women and not to those who have already delivered.

Difficulty in breast feeding during the first two days is the most important factor in whether a woman gives her infant formula or not, he said, and a law will not solve this medical problem. There is an urgent need to increase the number of breast feeding counsellors in the hospitals, he insisted.

The IMA said that a number of changes could be made in the bill that would allow brand labels of formula to appear on bottles in maternity wards but require hospitals to offer at least two different brands, and not grant exclusivity to just one.

Reches said that formula companies should be required to donate a certain percentage of their income to pay the salaries of breast feeding counsellors in the hospitals.

After the Remedia scandal, in which the lack of a B vitamin in that company’s soybased formula led to the deaths of several babies and disabilities in others, it is unthinkable that a mother would receive an unmarked bottle and give it to her baby, Reches said.

Danon, however, said the country had signed an international treaty to discourage aggressive marketing and advertising of baby formula.

He revealed that formula companies give hospitals NIS 50 million annually for exclusivity rights.

MK Rachel Adatto (Kadima), an obstetrician/gynecologist, said the Knesset had no right to make women who choose not to breast feed feel as if they were inferior mothers.

“Who are we MKs to intervene in the mother’s right to breast feed [or not] and to dare to force women regarding what to choose?” Adatto declared.

She added that the timing of the bill was suspect because Teva Pharmaceuticals had recently put a new infant formula on the market.

“Was it a coincidence that a bill comes now that disrupts existing agreements between the other formula companies and the hospitals?” she asked.

“Bringing order to formula marketing in hospitals is the job of the Health Ministry and not the Knesset. The ministry could easily set down rules for rotation among the companies, and we should not intervene.”

Dr. Mati Berkovich, head of the pediatric society, said he favored representation by all formula companies in maternity departments, with the mothers making their own choice.

“We at Assaf Harofeh Medical Center receive from the companies money to do important things,” Berkovich said. “We could not have established a new room for nursing mothers, hired breast feeding counsellors or medical clowns without it.” Economics Committee chairman MK Carmel Shama-Hacohen (Likud) said the committee would not approve a bill without dealing with the “failure that creates monopolies in marketing formula in hospitals.”

A representative of the Health Ministry said it wanted hospitals to receive donations from the companies, although companies should not have monopolies there. The ministry said it and other ministries had “updated” Danon’s bill so as not to completely prevent company gifts, but to stress the ability of mothers to choose among competing formula companies.

MK Nachman Shai (Kadima) urged Danon to withdraw his bill, saying it was a “deep and superfluous intervention in the way parents raise their children, as companies are allowed to give gifts to mothers if they agree in writing. A formula company requiring a mother to sign a document before giving her its product is problematic.”

Dr. Gila Rosen of Rambam Medical Center’s clinical nutrition department said that those who oppose the bill are not opposed to nursing. Breast feeding would increase, she said, if the newborn were brought to the mother immediately after delivery.

In the past decade, Rosen said, there had not been any change in the rate of breast feeding because formula had not caused harm.

“What causes women to stop breast feeding [prematurely] is having to return too fast to work,” she said. “Those who want to lengthen breast feeding should extend maternity leaves.”

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