Since there is at present no real content in the exam for certifying IBCLCs
that pertains to prescribing herbs, a central question to consider would be
whether the IBCLC in question is competent to dispense them.  I know I am not,
but there are IBCLCs who are.  Please note that this competency does not
spring from their IBCLC credential.  Not all herbalists have a double role as
retailer of the products they prescribe, though there can be cases when it is
the only logical choice.  They need to be mindful of how to avoid a conflict
of interest, or even the appearance of one, in their clients' eyes.

I do have gentian violet available for emergency use, because there are no
pharmacies where I live where you can buy it between early Saturday afternoon
and mid-morning on Monday.  So far I think I have given it once, and I've had
it on hand for over a year.  If I were competent in herbal therapy I might
consider having small supplies for emergency use in the same way.  I would
personally not feel comfortable being a sales agent for a particular brand,
nor in taking a larger payment than my own expenses if I were to supply a
mother with a product I had advised her to use.

At the moment I'm attending a course on research ethics.  Ethics can be
defined as 'how we are to live our lives in a world we share with others'.
Research ethics is about how we apply ethics when acting as researchers.
Practice ethics is about how we apply them in our work helping mothers.  I
strongly believe that the principles behind ethics are quite universal, though
what may be seen as acceptable practice ethics in one place, may not be at all
acceptable in another.  And just because something is acceptable in a setting
doesn't mean everyone will choose to let that determine where their own
benchmark is.  To my mind, 'acceptable' is the minimum allowable standard, and
it may be far from 'laudable'.

I think Barbara Wilson-Clay's post on practitioners selling products, bears
re-reading.  I don't want anyone to confuse me with a supplier of equipment,
nor to wonder what my motivation for recommending any equipment is.  But I am
not self-employed as an IBCLC - I am in the category Magda describes, of
someone who is employed in another capacity (midwife) in which my IBCLC
credential is an additional one formally documenting my competence in the
particular area of breastfeeding guidance.  I'm fortunate in that my employer
appreciates that I am an IBCLC as well, but I am not employable in the
Norwegian health services with an IBCLC alone.  As a midwife it's no problem,
because midwifery is clearly defined and regulated throughout the European
Union, with full reciprocity among all the EU and EEC countries.  I think it
will be years before the IBCLC achieves such acknowledgement, if ever, and
that is not because there is something wrong with the IBCLC.  It has more to
do with the roles of existing health professions in helping with
breastfeeding.

Rachel Myr
Kristiansand, Norway

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