Parent had a long delivery, but infant was finally born at a Baby-Friendly Hospital Initiative (BFHI)-designated facility!  Exhausted, sore patient rings up staff to say: “Please bring me some formula.  My baby is starving, and won’t stop nursing.  I must not have milk.”  Or, a lactation support provider listens as the parent of a 2-weeker explains “I have low supply,” so they are regularly offering commercial milk formula (CMF), but “at least it is the one that will help brain development.”

For families who earlier expressed a desire to exclusively breastfeed, their request to suddenly veer course to use CMF within hours or days of birth often springs from fatigue, misunderstanding of baby behaviors, and concern about inadequate milk supply.  Families see CMF as a “solution” to lactation stumbling blocks, not realizing it can derail their plan to breast/chestfeed. But often, this is the same solution offered by HCPs in birthing facilities … even those who have had BFHI training (Step 6) in how to reassure parents that they, and their babies, are doing well, and do not need supplements of any kind.

The launch of the Lancet’s Breastfeeding Series in early 2023 reveals how pervasive marketing of CMF, worldwide, has derailed individual and public health in ways we are just beginning to understand.  The impacts will be felt for decades.  Insidiously, parents and HCPs alike are simply unaware of how the CMF’s marketing, designed to provide massive annual profits to a handful of corporations, is at the expense of their cognizant decision-making and good health. This session will explore how we got here.

This E-CERP eligible talk covers IBLCE Detailed Content Outline Section VII. C. (Ethical and Legal) and E. (Public Health & Advocacy).  After this session the learner will be able to:

1. Provide three examples of commercial milk formula (CMF) marketing that influence decision-making by parents, and healthcare providers.
2. Explain how marketing techniques designed to influence buying and prescribing behaviors can undermine individual and public health.
3. Define three “conversation starters” for an informed-decision-making discussion about formula use by lactating parents (whether in the hospital, or after discharge)

If something is legal but unethical, is it OK to do it anyway? We all understand, generally, that lactation support providers – from licensed primary healthcare providers to volunteer peer counselors – owe a “duty of care” to the parents they work with, defined by laws and ethics codes. Some fear their license or certification will be at risk if they provide the care the parent seeks. This session will explain the basics of an ethical and legal duty as a lactation support provider, and offer examples from the International Board Certified Lactation Consultant (IBCLC) literature. We’ll delve deeper into a few “hot topics” (Does the introduction of long acting reversible contraception (LARCs) impact lactation? How does that coexist with the pre-existing duty to support, protect, and promote lactation/breastfeeding?  Is the ease of insurance reimbursement for care (or procedures) unconsciously driving the clinician’s advice? Is the HCP ever blamed for bad outcomes if the lactating parent engages in risky or illegal behaviors?)  This session meets requirements for ethics credit from any awarder, and covers Sections IV, V, and VII.C. of the IBLCE Detailed Content Outline.

A parent whose baby is struggling with weight gain is one of your lactation clients. They call you, and announce that this weekend is the first full month home from the NICU, and they are going to celebrate with some champagne on Baby’s original due date! You know the baby is directly feeding at breast/chest. Parent says they may pump-and-dump, as they read on a parent blog this is important to do. Parent also mentions that the other parent doesn’t like to drink, but smokes a little cannabis now-and-again. It’s legal in our state now! They will all finally have a good long night’s sleep in their big bed! Their only question: how long after drinking should they use those strips they bought, that test alcohol content in the milk?

What is your advice for this family?

There is growing science about the pharmacology and toxicology of transfer of alcohol and recreationally-used medicinals into human milk. However, mainstream/online articles inaccurately describe the biology, and conflate true risks to the infant. Parents who use illegal substances, or legal substances to excess, are often shamed-and-blamed for their behaviors.  They are reluctant to seek information from healthcare providers. They end up using tactics and techniques advised by profit-driven companies or celebrity bloggers, that unnecessarily deprive the ease and long-term health benefit of direct breast/chestfeeding.  Some families end up introducing formula, or even weaning, much sooner than planned.

This session will review the impact of partying on human milk, and the ethics of advising partying parents in your care. The ethical obligation to provide patient-centered, evidence-based information and support will be explored. The conflict-of-interest inherent in “commercial determinants of health” (where parents make decisions based on heavy marketing, not healthcare needs) will be explained. This session is eligible for E-CERPs and covers material from three sections of the IBLCE Detailed Content Outline: IV-Pharmacology and Toxicology, V-Psychology, Sociology and Anthropology, and VII-Clinical Skills/C-Ethical and Legal Issues.

By the end of the session, the learner will be able to:
1. Describe how alcohol consumed by a lactating parent enters the blood stream, and then gets into human milk.

2. Identify sections of IBCLC practice-guiding documents about the ethics of consulting with families drinking alcohol during lactation.

3. List three factors to share with parents, to evaluate the risks of lactating-and-partying.

Parent had a long delivery, but infant was finally born at a Baby-Friendly Hospital Initiative (BFHI)-designated facility!  Baby has had a tough time latching. Exhausted, sore patient rings up the bedside staff at the hospital or birthing center to say: “Please bring me some formula.  My baby is starving, and won’t stop nursing.  I must not have milk.  I am exhausted and need some rest.”

BFHI was always intended to provide ALL parents with information to make well-informed decisions about their own and their infant’s healthcare and feeding decisions. For families who earlier expressed a desire to exclusively breastfeed (as all public health and healthcare provider [HCP] professional association policies encourage), their request to suddenly veer course within hours of birth often springs from fatigue, misunderstanding of baby behaviors, and concern about inadequate milk supply.  HCPs in BFHI facilities can easily reassure parents that they, and their babies, are doing well, and do not need supplements of any kind.

After discharge, families often see formula as a “solution” to challenges in lactation management, especially with a return to work.  Hospital staff, peer counselors, and community-based lactation care providers will all find insight in how to discuss non-medically-indicated use of supplements, with 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 this session the learner will be able to:

1. Identify which elements of Baby-Friendly’s Ten Steps to Successful Breastfeeding address supplementation for the infant
2. Provide an example of “motivational interviewing” to assist a patient/client to meet their infant feeding goal
3. Define three “conversation starters” to initiate a chartable discussion of decision-making about formula requests by lactating parents (whether in the hospital, or after discharge)

We all understand, generally, that lactation support providers – from licensed primary healthcare providers (HCP) to volunteer peer counselors – owe a “duty of care” to the parents they work with, defined by laws and ethics codes.  But many are concerned that they do not know what is really expected of them, in the moment of clinical care, when decisions about how to do things “the right way” must be made.  This session will cover the basic of ethics and legal duty as a lactation support provider.  Examples from the International Board Certified Lactation Consultant (IBCLC) literature will be used. A few topics that are the most common “hot spots” for practitioners (the ones that make us sweat) will be explored with a few slides.  Then we will get to what top of mind by the attendees: small group break-out (or) free-flow Q&A will explore realistic tactics to protect ourselves as practitioners with cool heads and clinical excellence.

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. At the end of this session, the learner will be able to:

1. Name one document for each kind of clinical practice guidance: (1) a mandatory (required) ethics document, (2) a voluntary (model, or best practices) document, and (3) a public health directive that is voluntary unless made into law
2. Define the difference between an ethics obligation, and a legal obligation, in clinical practice
3. Explain how gifts and samples from commercial entities, to health care providers, can change professional clinical behavior
4. Describe why de-identification of a patient/client, before discussing their case with colleagues, does not meet ethical standards for privacy and confidentiality

There is a lot of confusion about what the International Code of Marketing of Breast-milk Substitutes (International Code, a.k.a. WHO Code) means, and how to support it, in a world full of marketing. Do you violate the International Code if you work for a hospital that uses formula for its patient babies? Can you teach how to use a bottle-and-teat to breastfeeding parents? Can you share glossy handouts from pump or bottle manufacturers? Does it matter if your facility is seeking Baby-Friendly status? The IBLCE Code of Professional Conduct encourages IBCLCs to adhere to the International Code as do nearly all the lactation support provider organizations and groups. This session will use real-life examples to discuss challenges faced by healthcare providers and lactation support counselors, asking: a) does the International Code apply; (b) are other options available to curtail marketing influences in the healthcare workplace; and (c) what are the consequences when there is a violation of the International Code?

At the end of this E-CERPs-eligible session, the participants will be able to:
1. Describe the legislative history of the International Code of Marketing of Breast-milk Substitutes, and why lactation support providers should support its principles. 2. Define how the International Code aligns with designation under the Baby-Friendly Hospital Initiative. 3. Identify three areas of commerce and marketing, not envisioned when the International Code was drafted in 1981, that affect today’s commercial messages about breastfeeding. 4. Implement five or more immediate changes in professional practice to show support for the International Code.

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.

Lots of people help breastfeeding families: IBCLCs, WIC Peer Counselors, doctors, nurses, dietitians, midwives, parent-to-parent counselors, childbirth educators. Different legal and ethical responsibilities apply to each of these helper groups. And there are responsibilities that everyone must meet, no matter what the job title or work setting. This is a lively session to teach you how to follow the law, and meet high ethical and professional standards, all while serving breast/chestfeeding parents and children. Participants will be able to: (1) Identify differences in the scopes of practice for various professions serving breastfeeding dyads (2) Describe the difference between a professional “scope of practice” and a work place “conflict of interest” (3) Identify different ethical expectations for various professions serving a breastfeeding dyad

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.

When commercial interests (pharmaceutical and medical device manufacturers) mix-and-mingle with healthcare providers (HCPs), it changes the clinical behaviors of the HCP.  This presents a fundamental conflict of interest for the HCP.  Their clinical judgment and recommendations favor the commercial entity that has provided free meals and trips, or “freebies” like mugs and lanyards and pens, or educational subsidies, or lucrative honoraria to speak to other HCPs. And the HCPs are often not even aware of how their behaviors have been influenced.  This grooming of “thought leaders” is increasingly apparent in the field of clinical lactation care and advocacy, creating legal and ethical tensions with professional practice-guiding documents that caution against such unethical relationships.

This session will define personal and professional conflicts-of-interests (COIs), identify elements in practice-guiding documents for Lactation Helpers that warn against COIs, and provide examples demonstrating how for-profit entities have mastered marketing persuasion techniques to groom “thought leaders” (revered experts) to serve as unwitting shills for their commercial logos, brands, and products.

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. At the conclusion of this session, the learner will be able to:

(1) Define the differences between a personal and a professional conflict of interest;

(2) Identify elements in ethics and practice-guiding documents, for healthcare providers, that prohibit relationships with commercial interests that create a professional conflict-of-interest

(3) Describe how to change at least three clinical practices to reduce even the appearance of a professional conflict-of-interest

Can you advise a family about peer-to-peer milk sharing? Can you meet privacy requirements if call or text clients on a cell phone?  Can you use a photo you found on the Internet for your PowerPoint presentation? Can you have a quick chat with your neighbor’s child, visiting with the newborn, who has a few questions about this breastfeeding problem she is having?

The major practice-guiding documents for IBCLCs tell us the rules for safe and ethical professional conduct.  All breastfeeding helpers have similar guidelines for counseling or care.  The challenge comes when ethical questions arise that aren’t clearly answered by these documents.  This session will offer a quick review (for IBCLCs and all breastfeeding helpers) of the major mandatory and voluntary practice-guiding documents.  Then we’ll count down the top ten ways to assure your work with breastfeeding families remains ethical and legal.

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. At the end of this session, the learner will be able to:  (1) Identify three mandatory, and one voluntary, practice-guiding document(s); (2) Describe three best practices to protect client/patient privacy, when using Internet-based forms of communication; (3) Describe how to obtain permission to re-use copyright-protected material.

Is it really a violation of the International Code of Marketing of Breast-milk Substitutes (“Code”) for a healthcare worker (HCP) to help a family learn how to use a pump sold by a company that doesn’t respect the Code?  What about teaching safe bottle-and-teat use? New parents in the USA have to go back to work within weeks of birth; how are caregivers supposed to feed the babies?  Families from Black, Brown, and Indigenous communities have low rates of lactation and high rates of prematurity, morbidity, and mortality.  Are formula ads and marketing really all that bad, given all the commercials we see on TV and social media? This session will describe — in common sense language, with everyday examples — what the Code is all about.  We’ll explore the intersection of  professional conflict-of-interest, lactation support in historically-marginalized communities, and meeting the public health objective of human milk use in a culture/society where structural and institutional racism exist.

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. At the end of this presentation, the learner will be able to: (1) Describe a professional conflict of interest for a health care provider involving a product falling under the scope of the International Code of Marketing of Breast-milk Substitutes; (2) Describe how structural and institutional forms of racism impact health (e.g. create disparities) for Black, Brown, and Indigenous families in the USA; (3) Describe how commercial marketing techniques, even of products falling outside the International Code, are intended to influence clinical behaviors for lactation specialists and helpers.

Lactation care providers like IBCLCs have broad, well-defined areas of authority and expertise, explained in their practicing-guiding documents.  Yet in day-to-day practice, IBCLCs and other lactation care providers frequently meet “push-back” as they consult with lactating parents. Examples:  Primary healthcare providers who are not familiar with lactation research and practice (and undercut the care plan); family members who negate supportive teaching; colleagues who practice with “loose ethics” or conflicts-of-interest; co-workers who overstep the Scope of Practice and Clinical Competencies; social media kerfuffles about everything from formula supplementation to safe sleep to predatory marketing tactics.  What can (or should?) an IBCLC or other provider say, without compounding the problem? Effective communication matters – so much so that IBLCE will soon require five hours of teaching on communication skills for new IBCLC aspirants. This session will cover the IBCLC’s legal and ethical requirements for effective communication, charting, and report-writing.  These principles will appy to anyone helping lactation families. It will describe principles of adult learning that improve communication, and provide sample scripts (freely adaptable or used as-is) to cover a wide range of issues that vex.

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. At the end of this session, the learner will be able to (1) Identify two mandatory, and one voluntary, practice-guiding document(s) for the International Board Certified Lactation Consultant (IBCLC); (2) Identify 3 elements in the IBCLC’s mandatory practice-guiding documents defining the responsibility to communicate with and educate patients/clients, and members of the healthcare team; (3) Formulate 3 sample scripts for effectively discussing sensitive or controversial clinical topics with patients/client, and healthcare providers.

New parents aren’t just a married couple who self-identify as “mother” and “father:” Modern families reflect our changing societal customs and mores. Babies are conceived using procedures to overcome (in)fertility issues. Gestational carriers and adoption allow families to raise babies with some, all, or none of the intended parents’ gene pool. Families today may have single parents, same-sex parents, blended parenting arrangements, grandparents as primary caregivers, and shared custody and visitation. Breastfeeding and human milk use are a public health imperative … and as such, all those caring for children should be supported in breast/chestfeeding, lactation, and use of human donor milk. A full range of clinical and counseling skills may be needed for the IBCLC/Healthcare provider (HCP) to offer evidence-based information and support to the primary parent.  Folks who suffer harassment and discrimination due to their personal attributes/appearance — yes, even from HCPs — delay obtaining healthcare. Consultations may be clinically complex, given the physiologic history at play. The IBCLC/HCP may be asked where to find families with extra pumped milk; can they help with that? What if the other parent wants to induce lactation, too? Culturally-sensitive counseling skills are needed. Such simple factors as intake form wording, posters and signage, and pronoun use will signal to families whether they can expect inclusive care from a HCP. This session will describe the legal and ethical obligations to support all manifestations of the modern family.

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. The learner at this session will be able to: (1) Identify the IBCLC’s three practice-guiding documents describing the legal and ethical obligations of inclusive care to a lactation patient/client; (2) Describe three non-traditional family arrangements where a breast/chestfeeding child is not receiving human milk directly from the birth parent; (3) Identify three websites designed for HCPs with resources for providing inclusive care.

Recent focus on health disparities and institutional and structural supports for new breast/chestfeeding families reveals an ugly truth, in countries around the world: Marginalization of oppressed groups (example: racism) makes people sicker today. The same people whose allostatic load of biologic stress, accrued over many generations of oppression and colonialism, made them sicker to begin with. In the USA, black women die at three times the rate of white women in the first year after childbirth. Breastfeeding and human milk use can shift the script on this public health crisis, and this Jeopardy-style game show sheds light on the clinical, ethical, and legal obligations to use cultural congruence/sensitivity in lactation care. If I am “color-blind” in my care for patients, isn’t that proof that I offer equitable care? Is it “too late” to learn how to provide inclusive care, if I have been doing this work for decades? Why are we dealing with this “downstream;” isn’t the answer to make sure folks just get a good education or better-paying jobs? If I can’t speak the first language of my patient, isn’t using the hospital translation service over the phone what I need to do? How can I help my colleague to see that their well-meaning comments to a patient were demeaning or patronizing? This session gets everyone involved in a game show where we apply the practice-guiding and policy-guiding documents that shape IBCLC practice, and figure out which ones help in ethics- and culturally-cloudy scenarios like those described above. Attendees will walk away (with prizes!, and) with a better understanding of public health policies in play, phrases to use in inclusive clinical care, and providing lactation care that is empowering to the parents.

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 3 mandatory or voluntary professional practice documents, that provide a legal and ethical basis for inclusive care, by the IBCLC, or other healthcare providers (HCPs)

(2) Identify 3 evidence-based websites addressing health disparities and structural racism, with resources for the HCP to use in clinical care of families

(3) Describe 3 phrases that promote inclusivity when discussing breastfeeding/chestfeeding and human milk use with families, and clinical situations with colleagues

MDs, IBCLCs, and other licensed healthcare providers practice with an ever-present fear they will be sued for their even-excellent care. Yet lawsuits are not filed anywhere near as frequently as clinicians imagine. It is far more likely a practitioner will have a complaint filed against them at their licensing or certification board. The customary rules of due process that we expect in a lawsuit do NOT apply in an administrative law-governed licensing/certification board hearing. Professional liability insurance may not cover legal representation. This session will describe the basics of the disciplinary process for healthcare providers, IBCLC certificants, and typical physician state licensing boards in the USA. We will explore professional behaviors that give rise to a disciplinary complaint, and how to respond if one finds themselves the subject of a complaint.

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. At end of this session, the learner will be able to:

1. Identify 3 differences in rights for clinicians who are (a) sued in court, or (b) the subject of a disciplinary or ethics complaint at a licensing or certification board
2. Describe procedures used by the Ethics & Discipline Committee of the International Board of Lactation Consultant Examiners to conduct disciplinary proceedings
3. Define the 2 most common reasons for a healthcare provider to be the subject of a lawsuit or licensing board complaint.

Can you text on your cell phone with your client about the progress of the lactation care plan, and still meet IBCLC ethical requirements for privacy and confidentiality?  Will you be able to meet the extra-added obligations required of USA-based practitioners, under the HIPAA/HITECH laws?  In the 21st century, all over the globe, we use Internet-based means of sharing and storing documents.  Our client-families insist on using text messaging or even social media networks to communicate.  And yet our practice-guiding documents and legal obligations were drafted in the 20th century, when such technology was not even envisioned.  This session will offer real-world, use-them-today suggestions, allowing the IBCLC practitioner to ethically and legally use texting, social media and cloud-based document sharing in clinical care.  HIPAA/HITECH will be explained for USA-based practitioners, but the privacy/confidentiality concepts — and the tips! — will be useful for anyone, from any country.

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. At the end of this presentation, the learner will be able to:

1. Identify mandatory (at least 2), and voluntary (at least 1), practice-guiding documents that IBCLCs and health care providers must follow;
2. Explain the difference between sharing electronic health records online, and using social media for clinical information;
3. Describe three ways that social media use for lactation support can compromise patient/client care for the clinician;
4. Define three ways to provide education and information on-line, while protecting patient/client privacy.

Imagine parents in a bitter custody dispute: Parent #1, who is not lactating, wants overnight visitation. Parent #2 is still breast/chestfeeding the Baby at night, and wants you to testify on their behalf. Can an IBCLC or other healthcare provider (HCP) testify in court in this dispute? What if the Parent #1 is the party asking the IBCLC/HCP to testify? Can they be paid for their time to prepare for court?  What happens if the case gets settled at the last minute? Does the IBCLC need a lawyer when serving as an expert?  What about the rights of migrating or refugee families, who are threatened by authorities with separation of parent and child?  As our profession grows, more IBCLCs are finding themselves being asked to share their professional and clinical expertise in court cases. This session will examine the IBCLC/HCP’s legal and ethical responsibilities if asked to participate in a lawsuit involving lactation or a breast/chestfeeding parent’s rights. This one is for everyone: While Liz’s expertise is in American law, the concepts are universal, and the IBCLC practice-guiding documents are international in scope.

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. At the conclusion of this session, attendees will be able to (1) Identify the IBCLC’s four practice-guiding documents describing legal and ethical obligations to a lactating patient/client; (2) Describe the difference between a fact witness and an expert witness in a legal case; (3) Understand factors preventing an IBCLC from serving as an expert witness in a lawsuit; and (4) Explain why it is not a conflict of interest for an expert witness to be compensated for working on a case

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.

Note:
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.

Marketers of bottles and teats are happy to “teach” about their use with ads targeted at new families. IBCLCs know that best professional practice is built on a parent-centered model: Craft a care plan individualized to the family’s needs. The plan may involve medically-indicated use of formula or expressed human milk; there may be supplementation that involves the use of a bottle-and-teat. Perhaps the family has simply chosen to use bottles. Can an IBCLC even offer this teaching, while respecting both the IBLCE Code of Professional Conduct and the International Code of Marketing of Breast-milk Substitutes? What if IBCLC colleagues make (loud) accusations that such teaching does not support the International Code? When does “teaching” cross the line, and become “marketing” of products that fall within the scope of the Int’l Code? Who said this teaching had to be done one-on-one … and what happens if it occurs on-line?

This session examines the ethical and legal tensions that can come into play when IBCLCs and other healthcare providers offer suggestions to breastfeeding or bottle-using families about the use of bottles, teats and infant formula.

Note:
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. This session will allow the learner to:

(1) Identify which sections of IBCLC practice-guiding documents (IBLCE Code of Professional Conduct, Scope of Practice, Clinical Competencies and ILCA Standards of Practice) cover discussion of bottles, teats and formula/supplements

(2) Describe sections of public health documents ([WHO] International Code of Marketing of Breast-milk Substitutes and UNICEF/WHO Baby-Friendly Hospital Initiative 20-hour training course for healthcare workers) that cover discussion of bottles, teats and formula/supplement use

(3) Compare and contrast examples of product descriptions, versus product marketing

(4) Learn language to teach to breastfeeding families best practices for the use of bottles and teats

It’s all about the Internet! Families today want to be connected to their network of families and friends. They use Internet-accessing devices and social media to share news, gather information and seek opinions. If this is where families are … can an IBCLC (or other healthcare provider) be there, too, without violating long-standing principles of privacy and professional ethics? Can healthcare providers engage in clinical discussion with someone on Facebook, Twitter, a chat room or a website? What about real-time webinars, or static websites, where parents type in their clinical questions? Is texting ever permissible? Can a clinician post a picture of a client, or ask colleagues on a private listserv about a tricky case? This session brings everyone into the 21st century! We’ll learn how the Internet is used by new families to seek and share information … and the professional risks and liabilities of “friendly” clinical care by the IBCLC or HCP who joins the conversation.

Note:
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. At the conclusion of the session the learner will be able to:

(1) Identify sections of the IBCLC’s practice-guiding documents governing client/patient privacy, and Internet-based means of sharing clinical information;

(2) Distinguish between clinical care of a patient/client, and education of interest to all, when communicating on the Internet

(3) Design a social media presence with boundaries that meet ethical requirements of the IBCLC profession

(4) Describe the necessary elements of consent for all uses of an image or video of a patient/client or the baby

Parents have been using each other’s milk since the dawn of time. The 21st century imbues this age-old practice with legal and ethical tensions for the healthcare provider not imagined by our ancestors. Can an IBCLC be the “link” between the parent with too much milk in the freezer, and the low-supply parent whose baby doesn’t qualify to receive milk from a milk bank? How does a healthcare provider (HCP) counsel a family shaken by the birth of an extremely premature baby, and who want to collect expressed milk from friends and neighbors? Can HCPs be sued if they counsel a family about milk donation, and the parent unwittingly passes on a pathogen in that milk that harms the other baby? The Internet offers a worldwide market for human milk sharing. Is that even legal? This session looks at all the risk and liability angles at play here: for the baby, the family, and the healthcare provider.

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. At the end of this session, the learner will be able to:

1. Explain the different rationales for regulating human milk as a tissue, fluid, or food;
2. Identify one health risk and one ethical concern for the healthcare provider associated with sales of human milk tissue/fluid;
3. Identify at least three practice-guiding documents for healthcare workers to use when consulting about the use of shared/donated human milk.

This session offers a broad overview of legal and ethical issues that IBCLCs should have on their radar. Imagine this: You are the IBCLC on the postpartum ward, and the parent who is happily breastfeeding just told you they smoked a little marijuana yesterday to ease labor.  The chart indicates an injection of hormonal contraceptive has been ordered before discharge. Your colleague handed the family a sample of free formula “just in case.” The baby’s non-birth parent is also lactating, and is demanding to cross-nurse the infant, but the birth parent is now balking about it.  The baby’s biological, non-custodial parent wants overnight visitation, starting next week. You just assessed short frenulum and diminished tongue function in the infant, but your facility has no practitioners who diagnose and divide tongue-tie. You know this family needs a pump, and you happen to rent them on the side. What could, should or must the IBCLC say or do? This talk is a first of its kind: an examination of legal and ethical tensions unique to the IBCLC. Regardless of one’s other professional licenses or credentials, there are four primary practice-guiding documents for the IBCLC (The IBLCE Code of Professional Conduct, the IBLCE Scope of Practice for IBCLCs, the ILCA Standards of Practice, and the [WHO] International Code of Marketing of Breastmilk Substitutes). After a review of those “rules of the road,” we’ll navigate a simple algorithm the IBCLC can use to determine what she could, should or must do, in any situation that sets off ethical red flags in the IBCLC’s mind. Then, we’ll hit highlights of legal and ethical issues for the IBCLC: certification vs. licensure vs. certificates-for-classes-and-courses; who is the patient/client?; the IBCLC on the Internet; conflicts of interest (and tensions from “wearing many hats”); intellectual property law; the WHO Code; the IBCLC in the courtroom (as expert or witness); the IBCLC on the Internet; the IBCLC as breastfeeding advocate, and its corollary: the IBCLC as advocate for a breastfeeding mother.

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.

Principle 2.5 of the IBLCE Code of Professional Conduct (IBLCE CPC) states: “Respect intellectual property rights.” What are they, and how does the IBCLC do it? “Intellectual property” (IP) includes copyrights (covering written material, photographs, slides, illustrations, etc.), patents (covering inventions) and trademarks/service marks (used by companies to protect their brands). ALL healthcare providers (HCPs), generally, have an obligation to follow the law  — which includes respect for intellectual property law.  Most HCPs simply want to know: where can I get my hands on some good, free photos and hand-outs? This session provides an overview of IP law. The legal concepts are amazingly similar around the world; this session is relevant to an international audience. Then we’ll get right to the good parts: the participant will leave with a long list of sources for fabulous materials, that can be immediately used and adapted, in clinical lactation practice.

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. At the ends of the session, the learner will:
Objectives: 1. Define the four areas of intellectual property (IP) law that might affect an IBCLC/HCP 2. Describe the rationale for IBLCE CPC Principle 2.5, requiring IBCLCs to respect IP laws 3. Describe procedures to obtain permission to use IP materials from others 4. Learn how to protect your own materials from unauthorized use 5. Identify several sources for permission-granted lactation materials, that are immediately available for use

Note:
90 minutes is ideal for this E-CERPS-appropriate program.

Hospitals and birthing centers are proud to offer specialized breastfeeding care to parents in the immediate postpartum period. But what happens after those those parents and their babies are discharged … and breastfeeding hasn’t quite sorted itself out yet? Even when the teaching immediately after birth is spot-on and evidence-based … it often doesn’t “translate well” into conditions when the dyad returns home. Hear funny, poignant and thought-provoking case studies from an IBCLC and other lactation helpers who do home visits, and see families shortly after the birth.  If you work with families in the first few days of life, this session will offer insight into hospital-based practices and teaching styles that “stick” with the family long after discharge. It will offer suggestions to improve post-discharge outcomes. If you work with parents who are back home with new babies, this session will offer suggestions for adapting the original care plan using collaborative (rather than contradictory) language.

After this session the attendee will be able to: 1. Describe at least three clinical breastfeeding situations, in the immediate postpartum period, that rarely persist after hospital discharge; 2. Provide a discharge plan for lactation that considers conditions when parent gets home, and incorporates contingencies for changing circumstances; 3. Learn three key phrases to use in discharge teaching at the hospital, and during community-based care, to assist the parents who are home with their baby; 4. Learn five reliable web-based resources for parents to use after discharge for assistance with breastfeeding issues.

Note:
This is an L-CERPs-eligible session as the content is focused on breastfeeding and human lactation, though ethics and conflicts-of-interest situations are discussed.

Parent blood tested positive for opiods when they arrived to deliver the baby, and they now want to breastfeed. New parent hands you a print-out from a social networking site, and asks if you agree with the customer ratings given for various breastfeeding supplies. Low-supply NICU parent wants to know if they can bring in expressed human milk from their best friend, who is still breastfeeding a toddler. OB orders a hormonal contraceptive injection on Day 2 for an exclusively breastfeeding mother, and you are concerned the progestin will affect milk supply. Yikes! Who knew the road to safe, natural, biologic-norm breast/chestfeeding had so many legal and ethical potholes? At the end of this session, participants will be able to: (1) Describe the difference between a legal and an ethical responsibility as a health care provider; (2) Define a professional conflict of interest for the medical professional serving clients/patients; (3) Identify three reliable on-line, evidence-based lactation resources for parents, and for health care providers; (4) Implement immediate changes in record-keeping to conform with ethical benchmarks for lactation consultation

Note:
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. 90 minutes is the customary session time, although material can be covered in 60 minutes. A 120 minute session allows for plenty of Q&A at the end, which participants find very helpful.

When and how can an IBCLC/other healthcare provider speak (HCP) up … without losing their job or professional credibility? Is it ever appropriate for an IBCLC to “chase down and correct” negative comments about their clinical practices, rumored to be coming from a former client? What is the best course of action if the primary HCP for the parent or baby flat out disagrees with the IBCLC’s assessment or care plan? If all HCPs should support and promote breast/chestfeeding, how can the IBCLC get them to read, understand and appreciate all the new research on tongue-tie, skin-to-skin, co-sleeping, brain development, and birth practices that impact lactation? This presentation arms the IBCLC/HCP with information about the practice-guiding authority underpinning clinical practice, provides tips on how to handle combative or abusive clients or colleagues, and offers “scripts” for keeping information-sharing diplomatic, and patient-centered.

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 this session the learner will be able to: (1) Identify two mandatory, and one voluntary, practice-guiding document(s) for the International Board Certified Lactation Consultant (IBCLC); (2) Identify 3 elements in the IBCLC’s mandatory practice-guiding documents defining the responsibility to communicate with and educate members of the healthcare team; (3) Describe how an IBCLC protects client/patient privacy when discussing controversial  issues with healthcare providers.

You rent pumps from your home-based business. Can you give a business card to the parents you see in your second job as a hospital-based lactation consultant? You’ve been asked to speak at a local conference about breastfeeding, but the event is being underwritten by a formula manufacturer. Can you do it? How about when the gathering is sponsored by a breast pump manufacturer? You started out as a peer counselor, and eventually became an IBCLC. You still lead parent meetings, and now one of those parents has approached you to discuss suspected low milk supply. Are you a volunteer, or a lactation consultant? You sell Brand X Nursing Bras at your clinic, and you’ve been asked by a customer your opinion on Brand Y. What can you say? Lactation consultants are often faced with conflicts of interest in their professional lives, and many are confused about “what to worry about.” This session is designed to describe conflicts of interest — in easy-to-understand language. And, we’ll review how the competent, ethical IBCLC/HCP handles them. At the end of this session, the participant will be able to: 1. define a conflict of interest for a health care professional 2. describe the difference between a true, and a perceived, conflict of interest. 3. identify three common, everyday situations where true conflicts of interest can arise in lactation clinical practice 4. describe how to disclose a conflict of interest 5. identify when a conflict of interest requires an IBCLC to step back, and refer the parent elsewhere.

Note:
This session covers legal and ethical definitions of conflicts of interest for the IBCLC. 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. The Q&A session can be quite lively. The presentation is ideal for 90 minutes, but Q&A can easily consume another 30 minutes.

Bias, confusion, tension, conflicts-of-interest (COI): is this the inevitable result when healthcare providers (HCPs) rub elbows with commercial interests like pharmaceutical and medical device manufacturers? Such COIs threaten the integrity of research, the objectivity of professional education, and ultimately the patient’s trust. This session explores how HCPs in research, clinical care and public health can avoid being pulled — knowingly or not — into situations where their judgment becomes (or is seen as) biased.

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. At the end of this session, participants will be able to:

1. Identify three voluntary practice-guiding ethics documents covering health care provider relationships with commercial interests. 2. Identify three mandatory practice-guiding documents covering health care provider relationships with commercial interests. 3. Describe the difference between a “professional” and a “personal” conflict of interest in a health care setting. 4. Define “reciprocity” in the context of healthcare providers accepting gifts from commercial interests. 5. Implement three practices, today, to reduce real or imagined commercial conflicts of interest (COI).