Jan and Maureen raise legitimate questions regarding ILCA decision-making on
two un-related matters.

Jan, I am reading between the lines here, but I suspect that your decision
not to renew your ILCA membership came after the April 2007 vote by the ILCA
membership-at-large to change the by-laws, so that voting privileges in the
organization rest only with those who are IBCLC-certified.  Everyone pays
the same membership fee, everyone gets the same association benefits -- but
now, if you want to vote for a Board member (wink, wink), vote for a by-laws
change, or vote on a measure raised from the floor at the Annual General
Meeting (which has never happened), then you must be an ILCA member
who is also IBCLC.  These by-laws changes, when first proposed, were
discussed in eGlobe articles,
listservs to members, on the website itself, and in the ballot materials
themselves -- so I simply take exception to the notion that the change came
out of nowhere.  With full disclosure I'll note here that I personally voted
for the by-laws change.

The by-laws change was overwhelmingly accepted, by voting ILCA members who
then included non-IBCLCs.
It was made by vote of the membership, not by Board fiat.

The change was triggered because ILCA is primarily comprised of
IBCLCs.  It has for years (perhaps even since its inception) limited certain
leadership positions (Committee Chairs; Board members) to those who are
IBCLC.  The notion was to keep ILCA inclusive (anyone can join ILCA), but to
limit leadership and governance decision-making to our primary market for
advocacy:  the IBCLC.

I recognize, of course, that one can elect *not* to join (or renew) an
organization with this sort of governance structure.

Maureen asks about Lansinoh, a company which produces products that do *not*
fall under the WHO Code, but whose majority stock holdings were purchased a
handful of years ago by Pigeon (spelled like the bird), whose major market
is in Japan and whose marketing practices of Code-covered products are
famously non-Code-compliant.

Remember, please, our Economics 101:  a free market capitalistic economy
means a company whose shares (stocks) are
publicly traded cannot in any way restrict who the buyer might be.
Stocks are put
up for sale, and the person/entity who is willing to pay the most for them
gets them.  So:  Pigeon bought up the majority of Lansinoh shares.   BUT --
the corporate structure and governance at Lansinoh remains "firewalled" --
the same guys that ran that shop when it was bought are still running the
shop.

Lansinoh currently conducts itself in Code-compliant fashion -- largely
because they are entirely exempt from
its provisions, as they do not manufacture nor market any of the four
product-types falling under the WHO Code.

But if Lansinoh is the Good Child, owned now by the Bad Parent, does that
mean that Lansinoh must now be considered non-Code-compliant, too?

The WHO Code is entirely *silent* on the issue of such layered corporate
ownership.  It looks at marketing practices aimed at mothers (and health
care providers), period.
Nonetheless, I can assure you that the ILCA Board discussed this matter at
length, at several Board
meetings, as part of its overall endeavor to create a conflict-free
mechanism for examining Code-compliance as part of our fiduciary
responsibility to our members.

Thus, the decision was made by ILCA to allow Lansinoh to exhibit at the ILCA
conference (and similarly
the JHL editors allowed them to purchase ad space) on the simple rationale
that Lansinoh does not produce or market products that fall under the WHO
Code.

Again, a hypothetical.  I am a Good IBCLC.  I worked (until they
closed the maternity unit Nov 2008) at a Bad Hopsital, which accepted
formula bags and free formula.  (This is a gross WHO Code violation, and
Standard Operating Procedure for
hospitals here in the USA, altho the number of BFHI institutions rises each
year, hallelujah).  Does that mean that I am to be considered
non-Code-compliant?  Do I have to quit my job where I ethically served
hundreds of
breastfeeding mothers a year?  My self-determination on that question was
NO.  I didn't touch the discharge bags ... indeed, I used their presence as
a "teaching moment" for my HCP colleagues.  I only discussed formula,
bottles and teats with mothers in a fashion consistent with my IBLCE Code of
Ethics, IBLCE Scope of Practice and ILCA Standards of Practice.   And I took
that check from the hospital each and every month, and plopped it into my
bank account, without losing a minute of sleep.

Or this.  I am a Good WIC peer counselor.  I work at a Bad WIC Office, which
allows posters from formula manufacturers to be hung on the wall.  (This is
not a rare occurrence in the USA.)  Does that mean I am to be considered
non-Code-compliant?  Do I have to quit my job at WIC, where I serve mothers
who come from population segments with the lowest BF rates -- and whom we
know, from the research, will most benefit from my information and support?
Even though my own interactions with mothers (including our discussions of
Code-covered products) is handled perfectly ethically?
Or this.  I am a Good Researcher, teaching at a Renowned University.  A
pharmaceutical company which manufactures formula decides to donate a
mega-lump of money to my university, to fund a building in another
department way over on another part of campus.
Am I now to be considered non-Code-compliant?  Is the "money pot" from which
my paycheck comes now
"tainted" because a fraction of the funds within it came from the Bad
Company?

To repeat:  ILCA made its decision vis-a-vis Lansinoh on an examination of
the current
company, its current governance make-up, and its current product-line.  It
does not produce nor market any of the products covered by the WHO Code.

I recognize, of course, that one can elect *not* to agree with these
conclusions by the ILCA Board.  And you will no doubt let me know it, any
second now ....

Liz Brooks JD IBCLC FILCA (ILCA Secy 2005-11)
Wyndmoor, PA, USA

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