Marketing to Moms : Pediatricians Say Carnation Crosses a Fine Ethical Line in Direct Sales of Baby Formula
A new mother who checks out of the maternity ward at Long Beach Memorial Hospital often goes home with a little gift: a pastel box containing a teddy bear, pacifier and a free sample of baby formula.
The gift comes compliments of one of the major formula makers, which see to it that there are always enough samples for every new mother--often as many as 10--who leaves the hospital daily.
“We have a bulk order that we get every single month,” said Ladonna Butler, a nursing manager in the hospital’s maternity ward. “We never run out.”
Giving away samples is a subtle marketing tool that formula makers use to boost their share of the $1.6 billion in annual formula sales nationwide.
Subtlety is essential.
For the task of persuading mothers to use formula instead of or in addition to breast feeding is a sensitive subject, as Carnation Co. recently discovered.
Earlier this week, the Los Angeles-based foods company unveiled marketing plans for a new line of formulas--Good Start and Good Nature--that steer away from traditional methods and, as a result, have angered some pediatricians.
The controversy comes at a time a majority of American mothers--about 60%, according to some statistics--breast feed. The American Academy of Pediatrics recommends that mothers breast feed--or use formula if breast feeding is not possible--for at least a baby’s first six months.
But the increase in the number of working mothers, many of whom return to work relatively soon after birth, and other reasons have lead industrywide sales to grow by at least 10% a year, according to industry statistics. “A big factor today is working mothers,” said Cathy Babington, a spokeswoman for Abbott Laboratories of Abbott Park, Ill., the largest seller of formula and maker of the Similac brand. Although many mothers continue nursing long after resuming their jobs by pumping breast milk and storing it, some mothers breast feed the child early on and then switch to a formula when they return to work within a few months.
In trying to reach the working mother, or any other new mother, formula makers find themselves walking a fine line. They have to promote their product without appearing to advocate formula over breast feeding, and they must deliver their message to mothers without appearing to undercut the role of pediatricians or obstetricians. “You don’t want to glamorize bottle feeding,” said Ernie Strapazon, assistant general manager for nutritional products at Carnation. “You don’t want to make it look like it’s the more modern approach or scientifically superior (to breast feeding). Because clearly it’s not.”
As a result, the major formula companies have voluntarily refrained from advertising in parent magazines or other publications for new mothers.
Instead, they have provided free samples, coupons or brochures on breast feeding that are distributed at doctors’ offices. And product boxes and literature often carry a reminder that “Breast milk is best for infants.”
The voluntary restraint forces formula makers to advertise directly to pediatricians, who also receive free samples--as do hospitals--to give to new parents. It is up to the doctor to recommend a type or brand of formula to mothers.
“We just hope that the doctor will refer our product to them,” said Rolland Eckels, spokesman for Bristol-Myers, maker of such formulas Enfamil and ProSobee.
“They go after the pediatricians,” said James S. Apthorp, a pediatrician at Children’s Hospital in Los Angeles. “We get mail, circulars from the various companies introducing their products. We see them in pediatric journals quite a lot.”
But Carnation has other methods in mind.
Aimed at Awareness
Carnation, which is owned by the Swiss company Nestle, has unveiled plans to introduce a formula--called Good Start--for infants who are allergic to traditional milk and soybean-based formulas. Good Start and Good Nature, a formula for infants who have begun to eat solid foods, will be advertised in magazines that are read by new mothers--a break with the voluntary industry ban on such ads.
The campaign, Carnation executives say, is aimed at building awareness of the Good Start brand as the company battles to get a foothold in a market long dominated by Abbott Laboratories, Bristol-Myers and American Home Products. Those companies declined to comment on Carnation’s plans.
But a group of pediatricians has urged Carnation to reconsider its strategy. “We have no problems with the marketing to the doctors,” said Richard Narkewicz, president of the 34,000-member American Academy of Pediatrics. “The difference is that Nestle is proposing to market this directly to the parents.
“Marketing directly to the mother will decrease the amount of breast feeding,” Narkewicz argued. “Parents are forced into the position of making a medical decision without consulting a doctor.”
Protests by the American Academy of Pediatrics during the 1970s forced Bristol-Myers to drop an infant formula advertising campaign in baby care magazines, Eckels said.
For their part, Carnation executives said they consider their advertising informational in nature--not a hard sell. The print ads never mention Good Start, says Carnation’s Strapazon. Instead, the ads tell the reader that if a current formula is causing a baby problems, those problems may be linked to an allergic reaction. The ads recommend that the reader check with her doctor for alternatives.
The free samples given away to mothers at hospitals and doctors’ offices are much more likely to entice mothers to switch to formulas than the Good Start ads, says Strapazon, who added that Carnation will refrain from distributing free samples of its formula products. “I don’t think the (gift) packs are very subtle,” Strapazon says.
In fact, Butler at Long Beach Memorial Hospital says the free formula samples are popular. “I don’t think anybody turns it down,” she said. “Formula is very expensive on the outside. Anything that is free is a nicety--the parents do like it.”
Carnation developed the campaign, mindful of the controversy that surrounded Nestle. Health professionals had organized a worldwide boycott of Nestle products to protest what they saw as company efforts to discourage breast feeding in Third World countries. The boycott was called off in 1984 after Nestle yielded to the protesters’ demands to drop ads that depict formula as superior to breast feeding.
Emotional Decision
Although Carnation insists that its marketing campaign is much less likely to cause women to drop breast feeding than current methods, other formula makers say they will stick to their strategies. “We market all of the infantile formulas to professionals,” said Babington at Abbott Laboratories. “We feel it’s the appropriate way to market infant nutrition and will continue to market our products that way.”
For his part, Apthorp at Children’s Hospital says he recommends a type of formula, not a specific brand name--after the mother herself has decided whether to use one.
“It’s a highly emotional (decision) for her,” Apthorp said. But “usually by the time we get a chance to counsel, they have a pretty good idea what they want to do.”
