Barbara asks about whether it is a conflict of interest for an IBCLC to
discuss brand-specific pump use with a mom when that IBCLC also sells/rents
that pump.

Short answer:  Yes.

But it is a conflict that can be "cured" with your full and prior disclosure
to the mom of your potential financial stake.  That puts her on notice to
assess and weigh your recommendations in light of your disclosure of
self-interest.

You see Mom in hospital.  Baby is in NICU.  Mom needs to know about pump
use, right?  So you'll discuss the generic need for her to use a pump -- any
pump -- that can do the job for her.  "Hello Mom.  We need to discuss your
use of a hospital-grade pump, to help establish your milk supply for your
baby.  Here is the one we have here at the hospital.  It works like this
yadda yadda yadda."

At this point, you are simply having a clinical discussion with the mother
about her appropriate use of medical equipment.  This talk would also, I
should hope, include your discussion of hand expression -- as a great way to
"oomph" the work of the pump, or to use when pumps and electricity are not
around!

Part of this talk will include your discussion of pump use once mom gets
home, while baby remains in NICU (not at all uncommon in the USA).  She will
then wisely and innocently ask you, "Where can I get a pump when I get
home?"

HERE is where your conflict of interest kicks in.  Your answer could reap
you benefit, because you could steer her business to your pump rental
station.  THAT is the definition of a "conflict of interest."

Now that you have moved from the *clinical* discussion to the *commercial*
discussion of pumps, you meet ethics requirements if you simply
say something like:  "Here is a list of local resources that rent and sell
pumps.  I am the fourth listed name."   (Note:  you don't have to draw
attention to your own name, but if you choose to do so, it should be
done simply and honestly.)

-- Liz Brooks JD IBCLC
Wyndmoor, PA, USA

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