Ethical Issues in Lactation

Autonomy and informed consent are core principles in the ethics of health care. We expect physicians and other health care providers to share relevant information about the risks and benefits of different treatment options, so that the patient can make a decision that aligns with her values and preferences. In infant feeding, these discussions are complicated both by aggressive marketing of infant formula and by the dual role of many breastfeeding support workers as both health care providers and breastfeeding advocates. Moreover, to what extent does "informed consent" require disclosure of rare, serious adverse outcomes, such as contamination of infant formula or accidental starvation of breastfed infants? Does "informed consent" require providers recommending Domperidone as a galactogogue to disclose that the United States Food and Drug Administration has warned that this drug should not be used in breastfeeding women due to safety concerns? And what information should providers prescribing hormonal contraception share with women about potential impact on milk supply?

Participants will explore the issues of autonomy and informed consent in relation to specific, commonly discussed, topics in the post-partum period.

Participants will be able to explain how the concept of shared decision-making might be implemented in infant feeding counselling.

Many studies in the field of breastfeeding and lactation have been challenged when published, simply because their findings are, at best, incorrect. Proper definitions, project design and industry conflict of interest are important factors, and these can be critiqued and challenged at the ethical review stage. Research ethics institutions protect the rights, safety, dignity, and well-being of research participants, and also have a duty to ensure ‘good’ research. Conducting poor research is unethical. In this presentation, Zainab walks us through the process of ethical review of research protocols, and how to effectively, and ethically, analyse published studies in our field.

After this presentation participants will be able to:

• Understand the primary principles of research ethics and the application of these
• Learn how to review studies in the field of breastfeeding, lactation and infant feeding       
• Be able to use the ‘3 D’s of brief assessment’ to assess a research protocol or peer review published paper, and the importance of transparency of Conflict of Interest in research  
• Be aware of the worrying gap of participant enrolment in research as it pertains to pregnant and breastfeeding women, and the impact of this on our field literature.

This revealing talk shows the marketing tactics of formula companies and how the producers effectively use propaganda, generalizations and advertising to convince the general public that their product is equal to breastmilk. Many examples and pictures are shown, captivating the visual learners.

After this presentation, participants will be able to:

-        List ingredients in breastmilk compared to artifi­cial milk

-        Read formula literature and packaging and identify misleading information

-        Distinguish marketing tactics exclusively for new moms and breastfeeding moms

-        Determine the best marketing tactics for breastfeeding

For decades, the inappropriate marketing of commercial formula milk has shaped our societal and professional norms, values and beliefs around infant and young child feeding. Formula milk marketing, not the product itself, disrupts informed decision-making through the deliberate misuse and distortion of scientific information to exploit parental emotions and aspirations. This presentation will look at the latest evidence supporting the importance of The Code of Marketing Breastmilk Substitutes and discuss the challenges faced in the digital age. It will also explore individual conflicts of interest and the role of healthcare workers in navigating the increasingly pervasive formula milk marketing landscape.

IBLCE Content Outline (VII)

        VII. Clinical Skills

Health professionals, including lactation consultants, have a duty to practice in an evidence-based manner. The human brain is a marvel, but it conserves energy by automating tasks and simplifying analysis. This presentation explores the use and misuse of heuristics and evaluation of evidence in the formulation of clinical reasoning in health care professionals assisting breastfeeding families in the context of ethical practice. It includes strategies to improve the accurate interpretation of research and avoid cognitive errors in a ‘blame-free’ context. In addition, it reviews new information on genetic susceptibility to confirmation bias and basic information about the brain pathways involved.

1.25 E Cerp (VII)

VII. Clinical Skills