having hesitated in order to not appear to be taking any remarks personally,
i would like to issue what i suppose might be called a personal statement of
ethics. anyone who has IBCLC after his or her name, and lives in a country
where there is a milk bank (or banks) should know all the details about
recommending donor milk to a patient and implementing a plan that includes
donor milk.
i can think of no adequate excuses in this day of computers, long distance
phones, mail of all sorts, etc., for not obtaining the information. we should
be able to inform a patient of the reasons for suggesting donor milk, the
process by which donor milk is obtained and treated, and the process by which
it is prescribed, obtained and used.
believe me, this is much easier than describing some of the other basic
processes that we are expected to understand. (biochemistry not being one of
my easiest subjects.) i can think of several places in our ILCA code of
ethics that might indicate a basis for my belief.
1.3.6 facilitate referral to other health professionals, community services,
and support groups as needed
2.1 provide education to parents and families to encourage informed decision
making about infant and child feeding
3.2 practice within the scope of the international code of marketing of
breast-milk (sic) substitutes and subsequent resolutions, maintaining an
awareness of conflict of interest when/if profiting from the rental or sale
of breastfeeding equipment
3.3 act as an advocate for breastfeeding women, infants, and children
4.3 obtain informed consent from all clients prior to:
- assessing or intervening
(etc.)
here's my interpretations, in case they aren't obvious:
1.3.6 referral should be to milk banks when supplementation is needed
2.1 education should include risks of artificial feeding and information
about alternatives
3.2 practice within the scope of the code - it's pretty clear about what to
use when supplementation is needed
3.3 acting as an advocate for an infant or child would appear to include
promoting breastmilk feeding before artificial feeding
4.3 informed consent would include information about risks of artificial
feeding and availability of donor milk
i think it is pretty clear, myself. i ran into an ugly situation last week
when an employee of a hospital forced formula, bottles and a pacifier on one
of my patients, for extremely misguided reasons. i have no obvious recourse
because this employee was not IBCLC. so, i like to think our code of ethics
is important. and relevant.
carol brussel IBCLC
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