Your hospital has placed a “gag order” on IBCLCs, preventing them from discussing tongue-tie and injectable hormonal birth control with patients. The pediatrician told your client the IBCLC’s concern is “alarmist;” that a breastfeeding baby below birth weight at 2 weeks will “catch up” if the breast/chestfeeding parent just “keeps it up!” The grandmother at your in-home consult repeatedly interrupts to say to the new mother “You are NOT going to keep doing THAT [breastfeeding]!” You wonder if you need to report to child protective services the family that just brought a 6-monther to your clinic who is 1.5 pounds over birth weight. Dad walks into the room, reeking of cigarette smoke, and scoops up the baby to offer a wonderful hug and belly tickle with his nose. Same sex parents tell you they are getting human milk donations, off the Internet, for their baby, for its anti-infective properties, since neither is feeding at chest. The neonatologist at your facility goes to your boss and accuses you of slander when, in an evidence-based consultation with a methadone-regimen parent, you caution that the NICU personnel may disallow use of pumped human milk from that parent. Midwife reads your report, and tells your client there is no such thing as insufficient glandular tissue; all breasts make milk, but to limit timing of feeds so the fatty milk builds up. Your IBCLC colleague tells you it is a violation of the WHO Code to show a parent with low milk supply how to use a bottle to safely feed the baby … and then takes to Facebook to tell everyone else of your scandalous behavior. Ads show up in your neighborhood paper for “lactation consultations,” at more than you charge, from someone who took a one-week class for breastfeeding counselors. That same counselor now calls you and asks to shadow you for a few days, to pick up pointers about how to do a clinical consult. What would YOU do? Yes, these are all real-life scenarios, that happened to real-life IBCLCs. This session gets everyone involved in a Jeopardy-style game show … where we apply the practice-guiding and policy-guiding documents that shape IBCLC practice, and figure out which will help in ethics-cloudy scenarios like those described above. Attendees will walk away (with prizes!, and) empowered with a checklist of documents to cite, and phrases of diplomacy to use. They will know how better to protect themselves (as allied healthcare professionals), and how better to advocate for the families in their care.
This session meets requirements for E-CERP approval, for material covering Ethical and Legal Issues, and Public Health and Advocacy, coming under Section VII. Clinical Skills of the IBLCE Detailed Content Outline. After the session the learner will be able to:
(1) Identify mandatory and voluntary professional practice documents that guide legal and ethical care by the IBCLC, and other breastfeeding helpers.
(2) Articulate an evidence-based rationale for the role and impact of the IBCLC in clinical care.
(3) Describe clinical care practices that meet a health worker’s obligations of support for the International Code of Marketing of Breast-milk Substitutes.
(4) Incorporate key phrases that promote collaboration, and defuse confrontation, when in discussion with colleagues.