I found Barbara Wilson-Clay's post on this thread thought-provoking.   I
too am troubled by how entwined the field of breastfeeding support has
become with equipment sales and rental here in the US.

Until insurance reimbursement for breastfeeding support services becomes
the norm, it will be difficult for most breastfeeding helpers in private
practice to be adequately reimbursed for their time.  However, reliance on
the profits brought in from sales and rentals *could* lead to the
recommendation of unnecessary equipment.  Also, the visibility of sale
items in LC's offices and tote bags may incline grateful clients to
purchase things they don't really need or want, as Barbara eloquently
describes. Finally, this potential for conflict of interest is all the fuel
some detractors need to question our integrity, as Lori so unjustly
experienced.

My own personal answer to this conflict was to cease equipment sales and
rentals in my practice while encouraging area durable medical equipment
companies to initiate or broaden breastfeeding product lines.  Now I refer
clients to several area companies for equipment.

This may not be a viable solution for all individuals, areas and/or
situations.  However, I do believe that it is the ethical responsibility of
LCs to continue to examine this issue.

Cindy Turner-Maffei, MA, IBCLC
Massachusetts, USA