Section 4 - Building A Practice Philosophy Grounded in Ethics
The Guide for the Emerging Lactation Consultant
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The Emerging Lactation Consultant
A guide for preparing to be an IBCLC©, not just pass the exam.
Building A Practice Philosophy Grounded in Ethics
Ethical questions and dilemmas can sometimes derail you because they force you to make quick decisions in places where you really could have used more time. This section asks you to think ahead: to define, in writing and in advance, the practice philosophy that will govern how you care for people and how you carry yourself as a lactation care professional.
There is a quiet and common assumption that lactation care is neutral — that if you learn the science and the skills well enough, good care simply follows. It does not.
Skilled lactation care is shaped at every turn by choices about whose interests you serve, what influences you allow near your practice, and how you treat the people in front of you. Those choices are ethical, and you should make them deliberately before you ever take the exam. You don’t want to have to improvise and make snap decisions you could regret later.
A practice philosophy is the worked-out set of commitments that answers, in advance, how you will practice when a situation is complex or nuanced. Like any philosophy exercise, there are no universally right answers here; this is yours to define and you are responsible for it. But it has to be defined. Three categories matter most at this stage.
Conflicts of Interest
A conflict of interest is any relationship or incentive that could bias your care away from what is best for the client and toward something else — a product, a sponsor, a referral arrangement, your own convenience. These are not rare or unusual. They are routine, and the most consequential ones are the ones that feel normal because everyone around you accepts them.
Part of building your philosophy is learning to see conflicts of interest clearly, including the ones embedded in the field you are entering, and deciding in advance how you will handle them. The goal is not to pretend you are above influence. It is to know where the influences are and to structure your practice so they do not reach your clinical judgment.
Additionally, the IBCLC Code of Conduct holds you accountable to avoid even the appearance of a conflict of interest. This is important because it means that if something looks fishy even if it isn’t technically wrong, it could leave you out of compliance with the Code of Conduct.
Commercial Independence
The infant feeding field is heavily commercialized, and the marketing is sophisticated. The WHO Code — the International Code of Marketing of Breast-milk Substitutes — is the essential baseline here, and you should know it well.
But a practice philosophy grounded in ethics goes further than the Code’s specific wording. The Code addresses breast-milk substitutes, bottles, and artificial nipples; commercial influence reaches much wider than that. Any product marketed as improving breastfeeding or milk production — galactagogues, pumps, and pumping accessories among them — can carry the same conflicts of interest as a formula company relationship, even though it falls outside the Code’s original scope.
Sponsorship is the clearest example. A sponsorship by a pump company is not ethically different from a sponsorship by a formula company; both create an incentive that can quietly shape what you teach and what you recommend. Decide now where you stand. Which products, sponsorships, and relationships will you decline, and on what principle? Write the principle down because you will be offered things that test it, and a principle decided in advance is far easier to hold than one improvised under pressure.
This line of thinking connects directly to how you will continue learning because commercial influence does not only reach you through products — it can also reach you through education. A great deal of what is presented to lactation professionals as professional education is, on closer inspection, marketing. Building commercial independence into your philosophy means committing now to evaluate the education you consume with the same scrutiny you apply to a product. A later section of this guide takes up that skill in detail; for now, name it as part of your stance.
How You Serve Clients, aka How You Treat People
An ethical philosophy is not only about keeping bad influences out; it is also a positive commitment about the kind of care a person experiences with you. Skilled lactation care does not tell clients what to do. It respects the client as a person capable of making their own decisions. It educates, offers suggestions, teaches clinical skills, and builds plans with the client for navigating their own feeding journey. It works in relationship rather than from authority. That relational, non-authoritarian stance is itself an ethical position — a decision that the client remains the decision-maker about their own body and their own baby, and that your role is to inform and support that decision-making rather than to override it. Decide what standard of care you want every client to be able to count on and write it as something you can be held to.
These three categories — conflicts of interest, commercial independence, and how you serve clients — are not separate topics. They are one philosophy seen from three angles. Together, they describe a practice that is sustainable in a way you can maintain over decades because it does not depend on you happening to make the right call each time. The decisions are already made.
Build this philosophy now, while you are preparing for your IBCLC career. Doing it now means that when you encounter a sponsorship offer, a conflicted referral, or a client who wants you to simply tell them what to do, you are not deciding your ethics in the moment. You are applying a position you already hold.
The IBCLC Commission and IBLCE are the authoritative sources for the Code of Professional Conduct for IBCLCs and all certification requirements; this section is about the philosophy you build alongside those obligations, not a substitute for them.
Add to Your Plan
This section asked you to define your ethical stance before you practice; your plan should hold that stance in writing, where you can return to it and be accountable to it.
— Draft your position on commercial independence: which products, sponsorships, and relationships you will decline, and the principle that decides it. Note if and where your line goes beyond the WHO Code and why.
— Write one or two sentences naming a conflict of interest that is common and accepted in the lactation field, and how you intend to keep it away from your clinical judgment.
— Write one sentence describing the standard of care you want every client to be able to count on from you — phrased so that someone could hold you to it.
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A note from Christine - This guide reflects my own perspective as a practicing IBCLC. I am not affiliated with the IBLCE or the IBCLC Commission and do not speak on their behalf. Always refer directly to the IBCLC Commission and IBLCE for current certification requirements. You can find official information at www.ibclc-commission.org.