Baby-Friendly USA, Inc. (BFUSA) has received numerous inquiries from Baby-Friendly designated facilities with NICU’s about the Infant-Driven Feeding® training program particularly designed for NICU staff.  Specifically, we have been asked to weigh in on potential conflicts of interest with this program and how/if it aligns with BFUSA’s Guidelines and Evaluation Criteria (GEC).

BFUSA is NOT commenting on either the quality of the Infant-Driven Feeding® Training Program OR any products developed and/or marketed by Dr. Brown’s Medical. Both are outside the purview and scope of our organization.  We are simply interpreting whether or not the use of this education program aligns with BFUSA’s 2016 GEC which require compliance with the International Code of Marketing of Breast-milk Substitutes (“the International Code”) and apply to the entire Baby-Friendly designated facility, not just the maternity unit.

DECISION

The ownership of the Infant Driven Feeding Program by Dr. Brown’s Medical is NOT in alignment with the GEC, which includes the International Code.

BACKGROUND

The Infant-Driven Feeding® education program was designed by two Occupational and Certified Neonatal Therapists (OTR/L, CNT) with the goal of improving “oral feeding outcomes for premature and/or sick infants within and beyond the doors of the neonatal intensive care unit (NICU) by educating neonatal professionals in the complexities of oral feeding practice and culture.”  The training program was formalized in 2013 and is now in use in many US NICUs.  On October 17, 2018, Dr. Brown’s Medical, maker of several oral infant feeding products, including highly specialized feeding systems geared to the NICU population as well as standard bottles and nipples, announced the acquisition of the Infant-Driven Feeding® education program.

RATIONALE

Although the GEC does not specifically address ownership of an educational program by a manufacturer of feeding supplies, this issue is addressed in the World Health Organization’s 2018 Implementation Guidance, “Protecting, promoting and supporting Breastfeeding in facilities providing maternity and newborn services: the revised Baby-Friendly Hospital Initiative.” In pertinent part, the 2018 Implementation Guidelines state that “[h]ealth professional meetings should never be sponsored by industry and industry should not participate in parenting education [p. 12].” Because the Infant-Driven feeding program is now owned by industry (Dr. Brown’s Medical) and as a consequence, industry is participating in parental education, the ownership of the program is inconsistent with requirements of the Code and thus inconsistent with the GEC.

GUIDANCE TO FACILITIES

BFUSA recognizes that many facilities started using this program prior to its acquisition by Dr. Brown’s Medical.  Therefore, it is understood that a transition period is necessary.  Facilities using this program must transition to a new option by September 1, 2020.