Sylvia makes some very good points here, and as health care professionals, 
we are always thinking about the ethical issues in regards to the care we 
provide. I have been involved in many mother-to-mother peer support groups, 
and they are not always the best source of information and support for 
women; however, sometimes they are the ONLY form of support a woman is 
capable of seeking out. Oftentimes the information they receive from these 
supports can be biased and even judgmental.  So if we apply the ethical 
principle of beneficence to this scenario, providing telehealth services to 
these women is essentially providing the greatest amount of good to the 
greatest amount of people.  In addition, we also are concerned with doing no 
harm or nonmaleficence. This is where the IBCLC who is providing the 
telehealth services will refer out so the woman is receiving the appropriate 
level of care. So, ethically speaking, MilkOnTap is a progressive and 
promising service that can help promote, support, and protect breastfeeding, 
which is our ultimate goal.

Elisabeth Coble, BSN-RN, CPN, IBCLC

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