The question is asked whether it violates the International Code for an
IBCLC to attend an educaitonal session sponsored by a formula company and
featuring a well-known speaker in the field of lactation.  A second
question ponders whether a hospital-sponsored BFg warmline must "legally"
provide for medical-charting of the call, over a simpler log book.

(1) [WHO] International Code Q first.  Code analysis is simply a subset of
coinflict of interest (COI) analysis. In Lactation Land, we must be
cautious when we interact with commercial vendors of the products falling
under the Code (formula, bottles, teat and weaning foods).  As healthcare
providers (HCPs) it is *well* known that a professional COI exists when
*any* educational offering is provided by a pharmaeutical or medical device
manufacturer.  http://www.ncbi.nlm.nih.gov/books/NBK22942/

Thus: it is a professional conflict of interest for an IBCLC or HCP to
attend any informercial-disguised-as-education, provided by a formula
manufacturer.  AND, such commercially-sponsored informercials will *not*
allow CERPs, CNEs or CMEs to be awarded.

It would be considered a Code violation if the HCP or IBCLC attended the
session for free, as a "gift" from the formula manufacturer.  However, if
someone pays to attend such a credit-less session, it removes the Code
conflict. BUT, one has to ask how much good evidence-based information
comes from a company with a decided interest in influencing clinical and
buying behaviors.

The well-known clinician offering the talk is not at risk of losing the
IBCLC credential ... IBLCE has made that position clear. (From the IBLCE
FAQs on the CPC:  "However, from a legal perspective IBLCE cannot prohibit,
or pursue ethical sanctions, against a certificant who chooses to work for
an infant formula company.")  However, the rest of us in the field can draw
our own conclusions as to the validity and motivations of teaching from a
hired spokesperson.

(2) As for the warmline ... what will "legally" pass muster at any given
hospital is a question to ask their Suits in the Legal Dept.  However, many
facilities do provide warmline service, to patients and the
public-at-large. Such facilities prepare a clear policy of how the warmline
will be monitored and answered, and how they will track minimal information
to verify that the policy was met (i.e. a log book). The real issue is that
once a person is discharged, the charting for the patient "ends."  So most
warmlines have some sort of regular way of letting callers know that if
they have true health concerns, they need to contact their own primary HCPs.

Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA

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