I'm not a lactation consultant.  I'm a breastfeeding educator.  I started
selling pumps a few years ago because the only pumps available in the area
were the kind you get at discount stores that are of poor quality and are
made by formula companies.  At that time, I also instructed them on how to
use their pump and provided follow-up car as well.  Then, a couple of local
pharmacies began renting pumps and selling other BF accessories but the
clients were not receiving instructions on how to use the pump for their
situation.

I really like how Cindy's practice is set up in Virginia, where mom can get
a pump and receive proper instructions from a qualified professional, not a
sales person with no background in lactation as is the case at some
pharmacies and durable medical supply companies in my area too.   I don't
see this as unethical.  I call it quality care.  Being a new mom ( for the
3rd time) myself, I can tell you it would be a hassle for me to go one
place for an LC visit and another place for renting a pump with a baby and
two toddlers in tow.  I like the "one stop shopping" concept.

Many times, I've actually discussed the need for a pump with mother's when
all they really needed was proper treatment for engorgement or sore nipples
that didn't necessitate purchasing a pump, certainly within my scope of
practice as a BF educator.  I no longer rent pumps because it was costing
me more in $ and time than it was worth so I refer to the pharmacies
instead and discuss the mom's situation with her at length before
recommending any breastfeeding accessory.

Just my two cents.

Maurenne Griese, RNC, BSN, CCE, CBE