99 | Who cares about the WHO Code? We do!

Annie: Well, hey there Leah.

Leah: Hey Annie. How are you?

Annie: I am good. How are you?

Leah: Doing pretty good down here in the south. Super hot as usual. You know, I think I always talk about the weather. First, but you know, top of my mind today 'cause we're, we are definitely ramping up the heat.

Annie: It’s been cold here in New York, even though it's June, but then, oh gosh, it was cold last night. Now it's hot today. It's weird. I don't, I don't really know where I live today. I'm like, I am, I'm shivering and it's June. My God. I'm like, where's my sweater? It's very strange. I'm happy for summer. My kids are finally almost done with school. Yay. I think by the time this episode comes out, they will be done with classes and one of them will have just like two more exams and then one will be graduating. So exciting. So exciting. It's so, it's so wild to think about just all of that. And when we first started this podcast together, my kids were still homeschooled. They hadn't even been in real school yet. My God, I forgot about that. We've been through homeschooling to a pandemic to public school. School and now you know, the one's graduating and the other one's finishing our first year in high school. So I'm just, I'm very proud of my kids and like, it's just amazing to reflect on as we're recording this episode. So another thing, you know, in the spirit of reflecting is there was some news that came out recently, like a few days ago, that got me really thinking about the core of why I. I got into this work in the first place, what this work means to me and why I think being an IBCLC matters so much. And it was a good, like, reason to reflect on that. And also to kind of realize like that I, I care as much about this as I did when I first got into this work. And that is the news that Bobbie Formula has partnered with a group called Naps that is run by two IBCLCs to provide free feeding support. So I guess we could call it lactation support, but it is funded by a formula company as a free service for families. And two people that are IBCLCs are the head of this company that is offering these services. And it, I have to be honest. It was upsetting to read because it was like the number one thing that I learned becoming an IBCLC is about the WHO code and that formula Companies in the US violate the WHO code and we can't take money from them, can't work for them, can't take money for them, and that I thought it was something we all agreed on. It seems pretty, pretty blatant to me. Straightforward.

Leah: Right, seems pretty straightforward. I know. And it's just so discouraging because I feel like our profession is. People like the idea of being a lactation consultant. They're like, yeah, I'm a lactation consultant, but I'm like, at the core of that is the support for babies getting human milk and facilitating that in whatever way possible. Meeting parents where they are, certainly following their goals, but always at the core, making sure that our ethics are in such a way that. Our top priority is certainly what the parents want, but also like help more babies get human milk. And it's hard to wrap your brain around how you would do that and work in, in that kind of environment. You know, where you're swayed by the people who are paying you.

Annie: You know, when we look at the WHO code, just to give kind of a overview for people listening, the WHO code covers the marketing of Infant formula and that's what they call, which are basically bottles. And when we're looking at this, we're not looking at like the formula is the problem or the bottles? It's the problem. It's the marketing of human milk substitutes is the primary thing that the WHO code was established to protect and to fight against because the formula companies were engaging in predatory marketing practices all around the world, and UNICEF and other infant feeding organizations globally said. We are seeing babies die because of the way formula is marketed to them and we need to do something. And they got together and they did something and they did something. They took a stand and they said it is not ethical. Might even call it a human rights violation to market formula to families and to then also prevent babies from getting human milk. And so like kind of on a like just. Human rights level, like that was a really important thing that happened, and that was something like learning about that and reading about that was something that really spoke to me when I was working as a breastfeeding volunteer for LA Leche League and doing my coursework to become an IBCLC. Just really feeling, I guess proud to be a part of something that was so important and had such deep roots, and that still matters so much today because the formula companies don't care about the WHO code. Right? And the United States doesn't care about the WHO code. United States is like, yeah, we're fine with this, like line our pockets. It always felt good to me to say, you know, the money part is what it is and that doesn't matter to me because. It's about the babies getting human milk and, and the parents having the right to get support for their bodies to do something that they, their bodies can do and want to do. And that's a, is also a, a human right as well to have your body work the way it's supposed to work.

Leah: Yeah. And you know, it's crazy to think like when those people got together and were making these changes, it wasn't the marketing scene we have today. And it's like, if they only knew what was possible when it comes to marketing now, you know, it's just. Insane how like it, it used to be like, okay, you could get a billboard, you could get a TV commercial, you could get a mail out. But it was, you know, it was still pretty limited. Now I feel like you can be bombarded with marketing material like every second of every day. It's so insane. It's even more important that we try to protect babies because the marketing is so intense now for everything and, and then including this just makes it really hard for parents, I think, to get clear information and non-biased information.

Annie: Definitely. It's kind of like when you look, think back of like the fifties or whatever, and these pharmaceutical companies were, you know, getting their toes wet in marketing. It was like, we're gonna have an old man with white hair in a doctor's coat. He was also probably smoking a cigarette. But that's so different times giving you a very paternal, fatherly, authoritarian kind of. Discussion about this, you know, I know about this and this is science and you can trust me because I'm science and all of that, and we don't have that today. People, we don't, that's not the kind of thing that has speaks to this generation of parents. But what we have are, we have lifestyle influencers and Bobbie in particular has really come in hot in this area with their marketing is very much about Influencer marketing and about this kind of aspirational lifestyle that like, ugh, you could use that, you know, Similac or Enfamil with the Sy medical old fashioned names. Like that's, or you could have. Bobbie, which is super cute to say, and it's a membership and like we've got this really adorable social media and now look, oh, look how supportive we are. We have this like free feeding support and all of that, to be honest, like you do you, Bobbie, like, I don't care. Like you're out there doing whatever. It's just the, it's just a new version of the same thing. They also do have billboards. I've seen them, they had a billboard in Times Square. In Brooklyn. They have huge billboards. I saw some recently that were taller than me on like a 20 minute walk around one neighborhood in, in Brooklyn a few weeks ago I saw three different Bobbie billboards.

Leah: Oh my gosh. Yeah. So we definitely don't have that down here.
Annie: It. was crazy. It was like, wow. I was like, there's one and there's one and there's one. All of that is fine. Like go out there and, and whatever. And there are plenty of people, like there's plenty of ways to be to do feeding stuff. Without being an IBCLC. Yeah, but where I draw the line is as an IBCLC. Our code of professional conduct says we have to uphold the WHO code. That means not partnering with or accepting money or working for companies that are violating the WHO code and Bobbie is violating the WHO code. So therefore, as an IBCLC, I can't work for them. And so let's say Bobbie was like actually like, stop doing any marketing and like became who compliant, then we could all go work for them and like help them. Like, I don't know what we would do, but like some, there are some other people that really like the science and nutrition part of it could be like helping them. I mean that's like, it's the marketing part that's the problem. It's not the formula, it's the marketing. And their marketing is so, so big, so out there, so much money spent and it's just. You know, like the thought experiment being like, what if Bobbie came to me and was like, we will hire you. Tell us what you made last year. We will double it. If you'll work for us. Would I take that money? And the answer is no. And I got kids going to college. I know. You're like, I could send them to a really really nice college. I could use that money, but I don't want that money. That money. It's tainted. It's not, not a line that I wanna cross and it changes.
Leah: I feel like how you're gonna work, there's no other way. Even if it's like, you know, subconscious, like it's gonna change. You're gonna be biased. There's no other way. I think that's a really good thought experiment. And also just so telling, it's like holding up for us, you know, holding up this code of professional conduct. I think is really important, but it's sad to see that maybe not every IBCLC is taking it as seriously.

Annie: There are plenty of things in. Lactation that have changed since you and I both became IBCLCs? Like how, however long ago. 14 years ago, I guess. We're both coming up on our next recertification, I think soon, I don't know, two years, something like that. I don't know. However long it's been. I think it is this year. No, it's next year. Is it? Oh my gosh. Next year will be 16 years. Oh my goodness. Yep. Next year we'll be re-certifying with our required two hours of who Code education, by the way. I'll make sure to get those. Plenty has changed, like for the better in a lot of ways. Like the stigma around using bottles, the stigma even around like some of that has gotten better. Like I do think we've relaxed a little bit in ways that are healthy and helpful, but I don't see any reason to relax about predatory marketing by formula companies. Like I just don't, nothing has changed. Nothing has changed. And the same problems that the WHO Code was established to, to deal with are still happening today. People, babies are still not getting human milk, for plenty of reasons. And they need infant formula when they can't get donor milk, which, you know, that's a whole other story. But like, yes, we need food for babies to eat. Absolutely. But should IBCLCs be the one providing. Lactation support to families when that is being paid for by a formula company? Like how can you trust that person is really gonna have, want you to exclusively breastfeed, exclusively provide human milk for your baby when their paycheck is from a formula company. It's so discouraging. These are babies and this matters to families. Like how many families have you talked with and sat with that are just like, I just wanna make enough milk for my baby. That's what I want. I'm working so hard to do that and to really value that and value the work they're putting in and, and be able to support them using formula when they need to. And want to, I mean, that's their free choice. I can do all of that and still get angry at the formula companies for, for doing things like this.

Leah: A hundred percent. Yeah, I totally agree with you on that. I think this is hard because, you know, in the end there's like nothing we can do about this. We're, you know, two voices talking, these big corporations that have a lot of money. But it does also remind me of like reinvigorates me for the work that we do and that I really want to be out here making a difference and supporting families and honoring the certification that I got and following the, you know, professional code of conduct and the things that I agreed to do for myself. And in the end, you know, we can only control ourselves. And so in some ways I really feel like I. I'm even more inspired to really help as much as many people as I can and do the good work with as many families that I can serve. I'm trying to spin it to kind of take it as a source of energy into a positive direction because, you know, you can really get bogged down with how frustrating situations like this are.

Annie: Yeah, and as angry as I am reading this news and thinking about it, I have also been very inspired by just seeing the conversation that's being had in the lactation community and how, how many of us, IBCLCs. Don't agree with this, and just the reinvigoration of support for the WHO code and just that I'm not the only one that this matters to and that also I have appreciated seeing and I feel like for the most part. We are a profession that believes in, in this and that, you know, most people are wanting to follow the code of professional conduct and take that seriously because believe that it matters. And, and I have definitely seen that to be true in the way that people have been talking about this. So that's like always really great to see and that. We may not agree on a lot of things, but like we agree that, that we're in this. So to help babies get human milk and to help families feel supported in meeting their feeding goals, that as lactation consultants as IBCLCs, most people want those feeding goals to involve human milk, and that's, that's what we do. It's a very niche thing. Yes. It's a very specific thing and everybody else can have everything else. But I'm an IBCLC and the human milk is mine.

Leah: Well that's a good note to end on and it was good talking to you today, Annie. I'm glad we had this conversation.

Annie: I am too, and I'm looking forward to seeing how things play out. And I hope you'll join us for our deeper dive coming up in June with Sheherezad Dubash, who is a physical therapist. A physical therapist I have seen, I see every day almost because her office is across the hall from mine, but I've also been to see her. As a physical therapist, and she's gonna be talking with us about movement and how we can talk with our families about moving their bodies in the postpartum period and the different kinds of muscle strains that can come in, how we can just, you know, give them, give them those tips that can help them feeling more comfortable. And you know, when you're, when you're comfortable, the milk can flow and it's always good to feel better. And then in July, we'll be joined by Elizabeth Montez to talk about colostrum, which is like, I'm excited about that. I'm so excited about that one. I'm like thinking about it all the time, like. What are we gonna talk about? How's that gonna go? And I know she's got like done a lot of research into, into the practice of prenatal colostrum expression and how it all works. And I'm so excited. And then in August we've got fan favorite Rachel O'Brien coming back and we're gonna do a deeper dive into cash pay. Coming back, we're gonna like take a little trip back in time to, before all these insurance companies were. Playing nights with us and right when it used to be just money and that was the only option.

Leah: There was no question of doing it any other way. We had one choice and boy was it cleaner those days. Yes, it was. It was so neat, tidy, walkout with everything taken care of. Now it's definitely more complex, but I can't wait to have that conversation too. 'cause I think it's, you know, good reminders about all the options we do have, you know.

Annie: Yep. And get us talking about marketing, which is one of our favorite things to talk about here on Lactation Business Coaching podcast is just the importance of marketing, the importance of marketing in an ethical WHO code compliant way. Absolutely. So we will see you all soon. Thanks everybody.

Leah: Bye.

Annie: Bye.