National lactation organization investigates consultant's practices in Idaho

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The national body that certifies lactation consultants is investigating whether a consultant in Boise, Idaho, has been inappropriately pushing an unproven procedure on new mothers struggling to breastfeed, according to a letter reviewed by The New York Times.

The lactation consultant, Melanie Henstrom, was featured in an investigation by The Times that examined the explosion of an unproven medical procedure, cone biopsies, to treat breastfeeding pain in new mothers. The practice involves inserting a small plastic cone into the woman's nipple to try to stretch the areola and reduce pain.

The investigation found that Ms. Henstrom had been promoting the biopsies to patients at St. Luke's Boise Medical Center, where she worked, and had even created and sold her own version of the device, called the Mammary Plexus Expander.

In a letter sent to Ms. Henstrom on July 15 and reviewed by The Times, the International Board of Lactation Consultant Examiners and the International Lactation Consultant Association said they were investigating claims that she had engaged in "unethical, improper, and unsafe" behavior.

The organizations cited reviews of her social media posts and concerns that she had used the device on women without informing them that it was experimental and that she had failed to obtain their informed consent. The associations also said they were investigating whether Ms. Henstrom had used her position at the hospital to "encourage colleagues to promote, utilize and/or develop" the device, which the letter said would be a violation of the code of ethics for lactation consultants.

St. Luke's Boise Medical Center said in a statement that Ms. Henstrom had stopped working at the hospital on July 2.

"Based on the ongoing investigation by the I.B.L.C.E. and I.L.C.A. and the findings of The New York Times' investigation, St. Luke's believes Ms. Henstrom's actions violate our organization's standards of ethical behavior, and our commitment to our patients and community, which we take very seriously," the statement said.

A spokesperson for St. Luke's said that Ms. Henstrom had been providing lactation services at the hospital for nearly 30 years and that her work had helped many women successfully breastfeed their babies.

"As health care providers, we are always striving to do better and be better for our patients and our community," the spokesperson said. "In this case, we believe Ms. Henstrom's actions violated the standards of ethical behavior expected of our clinicians."

Ms. Henstrom did not respond to requests for comment.

The Times' investigation, published in June, found that although cone biopsies were billed as a fast, cheap and painless way to treat breastfeeding discomfort, there was no evidence that they worked.

In interviews, women who had undergone the procedure said it had caused them severe pain and bruising and had not relieved their breastfeeding symptoms.

Some doctors and lactation consultants said the procedure could actually harm the breastfeeding process by causing inflammation and scarring in the areola, which can make it harder for babies to latch on to the breast.

Dr. Susan Jovanovic, a pediatrician and breastfeeding specialist in California, said that she had removed Ms. Henstrom from a prominent lactation organization's directory of consultants after The Times' article was published.

"She betrayed the trust of the breastfeeding community and put mothers at risk," Dr. Jovanovic wrote on Twitter. "Great that there is an actual investigation happening."

Some of the women who spoke to The Times had accused Ms. Henstrom of using sexualized language and images on social media to promote the biopsy procedure and her own version of the device, which she sold on her personal website for $25.

The Times' investigation found that at least a dozen other hospitals around the country had sold or given Ms. Henstrom's device to patients, often without telling them that it was not a standard medical treatment.

One hospital, Beaumont Hospital in Royal Oak, Mich., had given out Ms. Henstrom's expanders to patients and also sold the devices to hospitals across the United States.

After The Times' article was published, Beaumont Hospital stopped distributing the devices, a hospital spokesperson said.

"We regret if any mothers experienced discomfort or injury as a result of this product," the spokesperson said. "We have stopped using the product immediately and are notifying other hospitals that have received the product from us."

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