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Conflicts of Interest

August 2019

August began with World Breastfeeding Week, and for at least the U.S., continues as National Breastfeeding Month.  In that spirit, I would like to share two journal articles discussing conflicts of interest (COI).

woman questioning

In her Journal of Human Lactation editorial (2019), Elizabeth Brooks, JD, IBCLC, FILCA summarized by saying, "Healthcare providers are subjected to influence, persuasion, and marketing by commercial interests that have billions [of dollars] to spend to build brand recognition and perpetual market share. Effective techniques work on subconscious decision-making centers in the brain and are designed to obfuscate [to confuse or bewilder] dispassionate analysis and displace it with emotion-based loyalties. As respected members of the public- and medical-health community, HCPs resist the notion that they can be influenced against their primary duty of care to the patient/client. It is nearly impossible to eradicate its influence. Therefore, recognizing that these influences exist is the first step to diminishing their impact. Refusing any-and-all financial entanglements with commercial interests (full sequestration) considerably reduces conflicts of interest. Compelling (and complying with) academic, institutional, and journal requirements to fully disclose all financial entanglements permits colleagues to better assess articles, research, and teaching sessions.”

Grummer-Strawn et al, (2019) presented a research study whose objectives state, "Professional paediatrics associations play an important role in promoting the highest standard of care for women and children. Education and guidelines must be made in the best interests of patients. Given the importance of breastfeeding for the health, development, and survival of infants, children and mothers, paediatric associations have a particular responsibility to avoid conflicts of interest with companies that manufacture breast-milk substitutes (BMSs). The objective of this study was to investigate the extent to which national and regional paediatric associations are sponsored by BMS companies.” And the results? "Overall, 68 (60%) of the 114 paediatric associations with a website or Facebook account documented receiving financial support from BMS companies.”

Oh my--60%? As Brooks showed in her editorial, HCPs are influenced by the formula industry, whether consciously or at the subconscious level. If more than half of the global pediatric associations owe at least some of their allegiance to the industry, where does that leave the health and welfare of infants, children, and mothers?

To quote Grummer-Strawn et al., "Paediatric associations should function WITHOUT [emphasis mine] the influence of commercial interests.”

I'd enjoy hearing your thoughts on COIs and the infant feeding industry.

 

Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC

Professional Development Educator

 

References:

Brooks, E. (2019). Does truthful advertising ever pass "the smell test” in a peer-reviewed journal? Journal of Human Lactation. https://doi.org/10.1177/0890334419868163

Grummer-Strawn, L.M., Holliday, F., Jungo, K.T. and Rollins, N. (2019). Sponsorship of national and regional professional paediatrics associations by companies that make breast-milk substitutes: Evidence from a review of official websites. BMJ Open; 9:e029035. https://bmjopen.bmj.com/content/9/8/e029035.abstract

 

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