Dear all:

I have not been reading posts lately because I have been working on another important 
task for our profession.  So, I cannot make any comments about previous postings and 
their positivity or negativity.

I will state that I feel our profession is in crisis and we have the responsibility to ensure 
that we continue as an empowered profession, not one that is weakened to the point that 
we have less freedom to discuss experience and evidence-based information than the 
Director of Marketing at the pre and postnatal childbirth education center where I run 
breastfeeding support groups.  I thought about the IBCLE version of the SOP when the 
Marketing Director was selling an herbal supplement and freely offering her opinion about 
it.  I realized that there were no restrictions on her saying whatever she pleased, but if I 
opened my mouth I might jeopardize my IBCLC.

The crisis is that IBCLE has written a scope of practice that puts us in legal jeopardy due 
to the contradictory wording.  We cannot assume that a lawyer will put a positive spin on 
this document.  Cynthia Good Mojab wrote the most eloquent critique of the obvious 
contradictions in this document.  Anyone who has not read her critique should go through 
the archives and read it.  No lawyer will care if we choose to interpret these obvious 
contradictions in a benign way.  The legal questions that have never been answered by 
the IBCLE to my knowledge are as follows:

1) Does the original SOP written by ILCA supercede the new SOP written by IBCLE?
2) Does an IBCLC who certified when the only SOP in existence was the one written by 
ILCA have to follow the new SOP that was written by the IBCLE long after they certified?
3) Does the fact that the IBCLE removed the SOP from some of their websites mean that 
they have temporarily rescinded that SOP?
4) If we choose to recertify (or certify) does this mean that by default we are agreeing to 
accept the new SOP written by IBCLE?

Apart from the IBCLCs who are lawyers, the rest of us do not have a leg to stand on when 
we "interpret" the potential legality of these questions.

Furthermore, a member of the IBCLE has specifically made a statement to me that other 
lawyers I have talked to disagree with.  I was told that it would be "restraint of trade" to 
remove the certification of an IBCLC who directly took money from the formula industry.  
In fact, as I understand this is not the case.  Corporations themselves have rules and 
regulations about "conflict of interest".  Someone who works for a corporation who may 
have access to clients, patents or other "intellectual property" of the corporation often 
must sign contracts whereby they cannot take clients, patents, or other "intellectual 
property" with them if they leave the corporation.  Many corporations have tight rules and 
regulations about "conflicts of interest".  As I understand, trade is not restrained because 
any IBCLC may go work for the formula industry if she or he so chooses.  But that does 
not necessarily mean that a certifying body cannot choose to remove the certification.

The fact that there is an entirely opaque process within the IBCLE and that there has been 
little communication, and that someone who has direct ties to the nutritional 
supplementation industry is extremely troubling because this represents a HUGE potential 
for conflict of interests.  How was this person chosen?  Who chose this person?  What 
does a background in policy have to do with business management?  Policy makers 
review documents and develop policy statements.  WHO is an example.  The WHO really 
does not run international development programs and in contrast to UNICEF does very 
few interventions in countries.  They are not the action arm.  UNICEF is the action arm 
that runs large scale programs.  A business manager would be far more appropriate than 
a policy maker, particularly a policy maker who has been working on policies for an 
industry that is in direct competition with breastfeeding. We have every right to question 
the ethical standards of our certifying body.   This is not NEGATIVE, it is a positive, 
proactive stance to ensure the survival of our profession.  Burying our heads in the sand 
and pretending that all is well and twisting ourselves into linguistic knots to come up with 
some viable way to tell the truth about evidence based information is not the answer. 
If we want our profession to survive as a serious profession, we need to find a way to 
ensure that we have an IBCLE board that is responsive, transparent and free of conflicts 
of interests.  Without us, the IBCLE really would not exist. 

Finally, there are many aspects of the IBCLE SOP that clearly restrain what IBCLCs can 
do.  I have not read a single SOP from any other profession that is so negative or 
restrictive in its nature.  Most SOPs are extremely postive in nature describing what the 
professional can do, rather than what they cannot do.  I believe that the IBCLE SOP is 
extremely negative and we need to find constructive positive solutions to fix both the SOP 
written by the IBCLE and to improve the ethical standards of the IBCLE board.

Best, Susan E. Burger

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