There has been a few post recently on the PNS. Some of these Post are asking
difficult legal questions which are difficult to respond (without a 30 page
legal treatise)  to involving restraint of trade, or price fixing. This prevents
me from responding. Other questions arise if a companies products are available
from Walmart or other locations. Heres a different perspective that addresses
why these questions are arising in the first place. (Limitations my personal
opinions and only applicable to the USA):

These questions basically come down to two points:

        1. Where should products be available

        2. Locations with Breastfeeding Support (LC, LLL) will enhance mothers
Breastfeeding outcomes.

Over and over in my travels nationally I hear these points. I talk with Rental
Stations and LC's they tell me that Breastfeeding outcomes would be better if
mothers had Breastfeeding support at the locations where they receive their
products. However, this has only been communicated on an individual basis with
referral sources. A referral source would be a location that influences the
mothers decision about where to obtain products (CBE, Dr. RN, Hospital Rental
List, etc.)

From the point of view of a referral source (on the average) there is no reason
not to refer a mother to a drug store or baby store unless they have some
personal knowledge that outcomes will be better.  A Rental Station can approach
an account. However, if an individual goes in with a statement that they should
be the person referred to this may not have sufficient clout to change policy. (
Or perceived as personally profit motivated)

If the referral source was truly educated of the benefits of education with
products  then of course they would make the appropriate decision and refer
properly.

The question arises how to educate these referral sources, Doctors, Nurses, CBE,
etc. One of the strongest ways of doing this is to have  some support from your
national organizations. Such as a statement of support would give a lot of
credence and might change the referral policy of Hospitals and Doctors. If a
good study backed this up this would be even better.

As some of you are aware, the current Breastfeeding Organizations are not
entirely  national in focus. They need to balance the needs of mothers all
across the world, For Example:  Mothers and Breastfeeding specialists in
Nigeria, Botswana, India, China, Sweden. The need for products and rental
electric Pumps in these areas is different than in North America. Thus, its
difficult to come up with a policy statement on some issues. In the absence of
any direction from national organizations, the current market forces will
dictate the course. Referral sources will continue to give the same weight to a
Lactation Professional as a local Pharmacy or Baby Store.
This is not to say that the current organizations are doing anything wrong, it
may just be that some issues inherently are difficult for them to deal with
because of differing needs.

So,  issues like should a baby stores or Walmart sell pumps arise.  Does this
encourage optimum outcomes for Breastfeeding or should locations have
Breastfeeding support. I would encourage you to direct this energy into a
proactive step and either look for a national organization that will represent
these interests  (American Academy of  Lactation Specialists?) or find a way
that your local affiliates can work together to support you in a way that many
of you know is correct for the USA. At the very minimum you may want to ask your
local affiliate to come up with a statement of support for your feelings.
Imagine meeting with your local hospital and stating that the "State Lactation
Association" has issued a statement and they reccomend for optimal Breastfeeding
outcomes that mothers be directed to locations that offer Breastfeeding support
in addition to selling products.

I know this may be a bit controversial but I think it may provoke some thought
and help move things in a positive direction.

Richard Weston
Medela Inc. USA