Behind the Latch

Lactation During Bereavement with Victoria Fonville: A Research Review

Wed, 15 Apr 2026 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Victoria Fonville, MS, PhD candidate in Nutrition at UNC Greensboro, about her recent scoping review on lactation during perinatal bereavement.

Together, they explore what the research actually tells us about lactation after infant loss—from the lived experiences of bereaved families to the gaps in care from healthcare providers. Victoria shares the key findings from her paper, including the four major areas studied—producing milk, support, stopping lactation, and donating milk—and the six themes that emerged: hurting, lacking, valuing, succeeding, connecting, and redeeming.

They discuss how lactation can serve as a powerful source of connection and identity for grieving mothers, why suppression is often presented as the default (and why that’s problematic), and how milk donation can be experienced as a deeply meaningful and even healing process for families navigating loss.

This episode challenges the way we approach bereavement care and emphasizes the importance of presenting all options—so families can make informed decisions that align with their goals and their grief.

Key Takeaways for Clinicians

Lactation after perinatal loss is common due to normal physiology, but remains poorly addressed in clinical care.
Bereaved mothers often experience both physical pain and emotional distress related to lactation, requiring compassionate and informed support.
“Lacking” was a dominant theme across studies, highlighting significant gaps in provider knowledge, training, and communication.
Lactation suppression is frequently presented as the only option, but this does not reflect the full range of choices available.
Producing milk can help maintain maternal identity and connection to the infant after loss.
Milk donation is often experienced as “redeeming,” helping families create meaning and process grief.
Healthcare providers should present all options—suppression, expression, donation, and keepsakes—without bias.
There is an urgent need for quantitative research to better understand care practices, outcomes, and donation patterns.
Compassion, presence, and individualized care are critical when supporting bereaved families.

Guest

Victoria Fonville, MS, PhD Candidate in Nutrition, University of North Carolina at Greensboro

Lactation During Perinatal Bereavement From the Perspective of Families and Support Providers: A Scoping Review

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More Than Milk: The Science, Systems, and Future of Human Lactation with Dr. Lars Bode

Wed, 08 Apr 2026 00:00:00 -0500

Dr. Bode shares his journey into human milk research and the founding of the Human Milk Institute—the only institute in the world dedicated entirely to studying human milk in all its complexity. Together, they explore how human milk research is evolving from isolated disciplines into a collaborative, systems-based science that integrates molecular biology, clinical care, and public health.

The conversation dives deep into human milk oligosaccharides (HMOs), the limitations of reductionist thinking in lactation science, and the urgent need to translate research into real-world clinical impact. Dr. Bode also shares his vision for the future, including the development of “lactology” as a formal field of study and what it would take to truly normalize breastfeeding on a global scale.

Key Takeaways for Clinicians

Human milk is far more than nutrition—it is a dynamic system of signaling, protection, and communication.
HMOs play multiple roles beyond the microbiome, including direct immune and systemic effects.
Donor milk retains key bioactive components like HMOs even after pasteurization.
Variation in milk composition across individuals and time is expected and biologically meaningful.
Clinical care must align with real-world problems—research must start with the needs of families.
Multidisciplinary collaboration is essential to advancing both science and clinical outcomes.
Maternal health directly influences milk production and composition.
Breastfeeding provides significant long-term health benefits for both infants and mothers.
Formula can improve—but it cannot replicate the adaptive, responsive nature of human milk.
Early identification of barriers and inequities is critical to improving breastfeeding outcomes.
The future of lactation care depends on bridging research, clinical care, and public health systems.

Guest

Dr. Lars Bode, PhD

Director, Human Milk Institute

Human Milk Institute

Triton Giving Day 04.29.2026

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The High Lipase Myth: What’s Really Happening to Stored Breastmilk With Dr. Jimi Francis

Wed, 18 Mar 2026 00:00:00 -0500

What We Talk About

The origin of the “high lipase” breastmilk myth and how it spread through the lactation community

Why biologically it does not make sense that some mothers produce excess lipase in milk

What lipase actually does in human milk and why it is critical for infant fat digestion

What parents are actually noticing when milk smells “soapy,” “metallic,” or “rancid”

How riboflavin oxidation and free radical reactions may contribute to off flavors in stored milk

Why exposure to light, oxygen, and heat accelerates nutrient degradation

Simple strategies for protecting expressed milk during storage

The role of vitamin C and antioxidants in preventing oxidation

Why scalding milk may damage valuable nutrients and enzymes

How maternal diet influences the fatty acid profile of breastmilk

The relationship between omega-3 and omega-6 fats in human milk

Why formula cannot truly replicate human milk oligosaccharides or fatty acid complexity

How breastfeeding exposes infants to diverse food flavors that shape lifelong eating patterns

Why maternal nutrition matters—but breastfeeding remains resilient even with imperfect diets

Future research questions about the human milk metabolome and maternal diet

Key Takeaways for Clinicians

The “high lipase milk” explanation for off-smelling stored milk may not be supported biologically or experimentally.

Off flavors may instead result from nutrient oxidation, particularly involving riboflavin and free radical reactions.

Protecting milk from light, oxygen, and heat exposure may help reduce degradation.

Scalding milk may stop some reactions but can also damage enzymes, vitamins, and bioactive components.

Maternal intake of vitamin C and antioxidants may influence milk stability during storage.

Maternal diet does influence certain components of milk, especially fatty acid composition and water-soluble vitamins.

The fatty acid profile of milk largely reflects the mother’s dietary fat intake.

Human milk oligosaccharides vary between mothers and environments, making them difficult to replicate in formula.

Even when milk has an unusual smell, it is often still safe for infants, and strategies like dilution with fresh milk can help babies accept it.

Human milk remains one of the most biologically protected food systems in nature, even when maternal diets are imperfect.

Guest

Dr. Jimi Francis, PhD, RD, IBCLC

https://drjimi.net/

References referred to in the discussion about Lipase in Human Milk:

Allen, L. H. (2012). B vitamins in breast milk: Relative importance of maternal status and intake, and effects on infant status and function. Advances in Nutrition, 3(3), 362–369. https://doi.org/10.3945/an.111.001172

Bauman, D. E., & Bruce Currie, W. (1980). Partitioning of Nutrients During Pregnancy and Lactation: A Review of Mechanisms Involving Homeostasis and Homeorhesis. Journal of Dairy Science, 63(9), 1514–1529. https://doi.org/10.3168/jds.S0022-0302(80)83111-0

Chappell, J. E., Francis, T., & Clandinin, M. T. (1985). Vitamin A and E content of human milk at early stages of lactation. Early Human Development, 11(2), 157–167. https://doi.org/10.1016/0378-3782(85)90103-3

Daniel, A. I., Shama, S., Ismail, S., Bourdon, C., Kiss, A., Mwangome, M., Bandsma, R. H. J., & O’Connor, D. L. (2021). Maternal bmi is positively associated with human milk fat: A systematic review and meta-regression analysis. American Journal of Clinical Nutrition, 113(4), 1009–1022. https://doi.org/10.1093/ajcn/nqaa410

Demmelmair, H., & Koletzko, B. (2018). Lipids in human milk. Best Practice and Research: Clinical Endocrinology and Metabolism, 32(1), 57–68. https://doi.org/10.1016/j.beem.2017.11.002

Dickton, D., & Francis, J. (2018). Case review: food pattern effects on milk lipid profiles. J Nutr Health Food Eng, 8(6), 467–470. https://doi.org/10.15406/jnhfe.2018.08.00311

Donovan, S. M., Aghaeepour, N., Andres, A., Azad, M. B., Becker, M., Carlson, S. E., Järvinen, K. M., Lin, W., Lönnerdal, B., Slupsky, C. M., Steiber, A. L., & Raiten, D. J. (2023). Evidence for human milk as a biological system and recommendations for study design—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 4. American Journal of Clinical Nutrition, 117, S61–S86. https://doi.org/10.1016/j.ajcnut.2022.12.021

Dror, D. K., & Allen, L. H. (2018). Overview of nutrients in humanmilk. Advances in Nutrition, 9, 278S-294S. https://doi.org/10.1093/advances/nmy022

Evans, T. J., Ryley, H. C., Neale, L. M., Dodge, J. A., & Lewarne, V. M. (1978). Effect of storage and heat on antimicrobial proteins in human milk. Archives of Disease in Childhood, 53(3), 239–241. https://doi.org/10.1136/adc.53.3.239

Francis, J. (2015). Effects of Light on Riboflavin and Ascorbic Acid in Freshly Expressed Human Milk. Journal of Nutritional Health & Food Engineering, 2(6), 2–4. https://doi.org/10.15406/jnhfe.2015.02.00083

Francis, J., & Dickton, D. (2020). Feeding and refusal of expressed and stored human (FRESH) milk study - a short communication. J Nutr Health Food Eng, 8(6), 391–393. https://doi.org/10.15406/jnhfe.2018.08.00301

Francis, J., & Egdorf, R. (2020). Maternal Nutrient Metabolism and Requirements in Lactation. In B. Marriott, D. F. Birt, V. Stalling, & A. Yates (Eds.), Present Knowledge in Nutrition (11th ed., pp. 67–81). Elsevier. https://doi.org/10.1016/c2018-0-02422-6

Francis, J., Rogers, K., Brewer, P., Dickton, D., & Pardini, R. (2008). Comparative analysis of ascorbic acid in human milk and infant formula using varied milk delivery systems. International Breastfeeding Journal, 3(1), 19. https://doi.org/10.1186/1746-4358-3-19

Francis, J., Rogers, K., Dickton, D., Twedt, R., & Pardini, R. (2012). Decreasing retinol and αtocopherol concentrations in human milk and infant formula using varied bottle systems. Maternal and Child Nutrition, 8(2), 215–224. https://doi.org/10.1111/j.1740- 8709.2010.00279.x

Hamosh, M., Clary, T. R., Chernick, S. S., & Scow, R. O. (1970). Lipoprotein lipase activity of adipose and mammary tissue and plasma triglyceride in pregnant and lactating rats. Biochimica et Biophysica Acta (BBA)/Lipids and Lipid Metabolism, 210(3), 473–482. https://doi.org/10.1016/0005-2760(70)90044-5

Hampel, D., Shahab-Ferdows, S., Islam, M. M., Peerson, J. M., & Allen, L. H. (2017). Vitamin concentrations in human milk vary with time within feed, circadian rhythm, and singledose supplementation. Journal of Nutrition, 147(4), 603–611. https://doi.org/10.3945/jn.116.242941

Jensen, D. R., Gavigan, S., Sawicki, V., Witsell, D. L., Eckel, R. H., & Neville, M. C. (1994). Regulation of lipoprotein lipase activity and mRNA in the mammary gland of the lactating mouse. Biochemical Journal, 298(2), 321–327. https://doi.org/10.1042/bj2980321

Krebs, N. F., Belfort, M. B., Meier, P. P., Mennella, J. A., O’Connor, D. L., Taylor, S. N., & Raiten, D. J. (2023). Infant factors that impact the ecology of human milk secretion and composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 3. American Journal of Clinical Nutrition, 117, S43–S60. https://doi.org/10.1016/j.ajcnut.2023.01.021

Lackey, K. A., Williams, J. E., Meehan, C. L., Zachek, J. A., Benda, E. D., Price, W. J., Foster, J. A., Sellen, D. W., Kamau-Mbuthia, E. W., Kamundia, E. W., Mbugua, S., Moore, S. E., Prentice, A. M., K, D. G., Kvist, L. J., Otoo, G. E., García-Carral, C., Jiménez, E., Ruiz, L., … McGuire, M. K. (2019). What’s normal? Microbiomes in human milk and infant feces are related to each other but vary geographically: The inspire study. Frontiers in Nutrition, 6. https://doi.org/10.3389/fnut.2019.00045

Lee, H., Padhi, E., Hasegawa, Y., Larke, J., Parenti, M., Wang, A., Hernell, O., Lönnerdal, B., & Slupsky, C. (2018). Compositional dynamics of the milk fat globule and its role in infant development. Frontiers in Pediatrics, 6. https://doi.org/10.3389/fped.2018.00313

Lemons, J. A., Moye, L., Hall, D., & Simmons, M. (1982). Differences in the composition of preterm and term human milk during early lactation. Pediatric Research, 16(2), 113–117. https://doi.org/10.1203/00006450-198202000-00007

Mitoulas L.R.*, Kent, J. C., Cox, D. B., Owens, R. A., Sherriff, J. L., & Hartmann, P. E. (2002). Variation in fat, lactose and protein in human milk over 24 h and throughout the first year of lactation. British Journal of Nutrition, 88(1), 29–37. https://doi.org/10.1079/bjnbjn2002579

Nommsen, L. A., Lovelady, C. A., Heinig, M. J., Lönnerdal, B., & Dewey, K. G. (1991). Determinants of energy, protein, lipid, and lactose concentrations in human milk during the first 12 mo of lactation: The DARLING Study. American Journal of Clinical Nutrition, 53(2), 457–465. https://doi.org/10.1093/ajcn/53.2.457

Nommsen-Rivers, L., Black, M. M., Christian, P., Groh-Wargo, S., Heinig, M. J., Israel-Ballard, K., Obbagy, J., Palmquist, A. E. L., Stuebe, A., Barr, S. M., Proaño, G. V., Moloney, L., Steiber, A., & Raiten, D. J. (2023). An equitable, community-engaged translational framework for science in human lactation and infant feeding—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 5. American Journal of Clinical Nutrition, 117, S87–S105. https://doi.org/10.1016/j.ajcnut.2023.01.020

Raiten, D. J., Steiber, A. L., Papoutsakis, C., Rozga, M., Handu, D., Proaño, G. V., Moloney, L., & Bremer, A. A. (2023). The “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Project – executive summary. American Journal of Clinical Nutrition, 117, S1–S10. https://doi.org/10.1016/j.ajcnut.2022.12.020

Rudolph, M. C., McManaman, J. L., Phang, T. L., Russell, T., Kominsky, D. J., Serkova, N. J., Stein, T., Anderson, S. M., & Neville, M. C. (2007). Metabolic regulation in the lactating mammary gland: A lipid synthesizing machine. Physiological Genomics, 28(3), 323–336. https://doi.org/10.1152/physiolgenomics.00020.2006

Schaefer W., Swindall R, Boyle J, &, & Francis J. (n.d.). Analysis of Macronutrient Content of Human Expressed Milk in East Texas Women.

Smilowitz, J. T., Allen, L. H., Dallas, D. C., McManaman, J., Raiten, D. J., Rozga, M., Sela, D. A., Seppo, A., Williams, J. E., Young, B. E., & McGuire, M. K. (2023). Ecologies, synergies, and biological systems shaping human milk composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 2. The American Journal of Clinical Nutrition, 117(Suppl 1), S28. https://doi.org/10.1016/j.ajcnut.2022.11.027

Spencer, B., & Francis, J. (2021). The Composition and Specificity of Breastmilk. In K. A. Wambach & B. Spencer (Eds.), Breastfeeding and Human Lactation (Sixth, Four). Jones & Bartlett. https://www.jblearning.com/catalog/productdetails/9781284151565#productInfo

Wang, C. S., Hartsuck, J., & McConathy, W. J. (1992). Structure and functional properties of lipoprotein lipase. Biochimica et Biophysica Acta (BBA)/Lipids and Lipid Metabolism, 1123(1), 1–17. https://doi.org/10.1016/0005-2760(92)90165-R

Wang, Y., Tong, J., Li, S., Zhang, R., Chen, L., Wang, Y., Zheng, M., Wang, M., Liu, G., Dai, Y., Zhao, Y., & Li, N. (2011). Over-Expression of Human Lipoprotein Lipase in Mouse Mammary Glands Leads to Reduction of Milk Triglyceride and Delayed Growth of Suckling Pups. PLoS ONE, 6(6), e20895. https://doi.org/10.1371/journal.pone.0020895

Williams, J. E., McGuire, M. K., Meehan, C. L., McGuire, M. A., Brooker, S. L., Kamau-Mbuthia, E. W., Kamundia, E. W., Mbugua, S., Moore, S. E., Prentice, A. M., Otoo, G. E., Rodríguez, J. M., Pareja, R. G., Foster, J. A., Sellen, D. W., Kita, D. G., Neibergs, H. L., & Murdoch, B. M. (2021). Key genetic variants associated with variation of milk oligosaccharides from diverse human populations. Genomics, 113(4), 1867–1875. https://doi.org/10.1016/j.ygeno.2021.04.004

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Advocacy in Action: Securing Pumps for NICU Families with Mina Ognjanovic, IBCLC

Wed, 25 Feb 2026 09:00:00 -0500

What We Talk About

How Mina’s grandmother’s experience as a wet nurse shaped her path into lactation

Why “hospital-grade” doesn’t actually mean anything in marketing—and what truly defines a multi-user pump

The critical first 7 days postpartum and why delayed access to an effective pump can permanently impact supply

Why wearable pumps and personal-use pumps often fail NICU mothers trying to establish supply

The surprising insurance paradox: why WIC families often receive pumps faster than privately insured hospital employees

How some insurance plans (including certain HMOs and United Healthcare) do not recognize hospital-grade pumps as a covered benefit

The behind-the-scenes work required to secure an E0604 pump rental through a DME supplier

Why case management buy-in was one of the biggest roadblocks—and how Mina overcame resistance

How embedding a lactation-specific workflow into Epic improved communication and reduced delays

Why some hospitals profit from pump rentals—and why that raises ethical concerns

How her hospital partnered with WIC to house 10 loaner hospital-grade pumps onsite

The importance of prenatal pump planning when a NICU admission is anticipated

What still isn’t fixed—and why the work continues

Key Takeaways for Clinicians

The first 7 days postpartum are physiologically critical for establishing milk supply. Delays in effective milk removal can make supply difficult to recover later.

Not all pumps are equal. Wearable pumps and personal-use pumps may not provide adequate stimulation for separated NICU mothers.

Insurance status can directly affect pump access timing, functioning as a social determinant of lactation success.

Securing a hospital-grade pump typically requires:

A prescription
Diagnosis coding (NICU admission)
Coordination with a DME supplier
Case management involvement

Standardizing communication within the EHR can dramatically improve workflow and reduce lost time.

Patients should not bear the burden of navigating DME suppliers while managing a critically ill infant.

Advocacy is within the scope of the hospital lactation consultant role—even when it requires challenging institutional norms.

One practical first step: map your current NICU pump access process and identify where delays occur.

👩‍🏫 Guest

Mina Ognianovich, IBCLC

https://minalactation.com/

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#BehindTheLatch #NICULactation #HospitalGradePump #BreastfeedingEquity #IBCLC #LactationAdvocacy #MaternalHealth #PublicHealthLactation #NICUParents #BreastmilkIsMedicine

Barriers, Mentorship & Equity in Lactation Certification with Mandy Golman, PhD, MS, RN, IBCLC

Wed, 18 Feb 2026 09:00:00 -0500

In this episode of Behind the Latch, Margaret sits down with Dr. Mandy Golman, PhD, MS, RN, IBCLC, MCHES, professor at the University of Texas at Tyler, to discuss her powerful qualitative study exploring the perceptions, barriers, and facilitators to obtaining the IBCLC certification among U.S. healthcare practitioners.

Margaret first encountered this research as a poster presentation at the ILCA Conference in Tampa — and immediately knew it was a conversation the field needed to hear.

Dr. Golman’s study, expected to be published later this year, examines who is able to enter the IBCLC pathway — and who is not — through a public health and equity lens. With 19,000 IBCLCs serving the United States and 93% identifying as white, the findings raise important questions about access, mentorship, compensation, and structural barriers within our profession.

Together, Margaret and Dr. Golman unpack what the data reveal — and what must change.

🔍 What We Talk About

How Dr. Golman’s background in maternal-child health and public health shaped this research

Why workforce diversity in lactation care is a public health issue

The perception that the IBCLC credential “adds weight” professionally — but often without financial return

Why many hospital-based IBCLCs are required to certify without institutional financial support

The persistent bias that IBCLCs must also be RNs to be considered “legitimate”

Financial barriers beyond tuition — unpaid clinical hours, childcare, lost wages, transportation

Why indirect costs often delay certification for years

Mentorship as the central bottleneck in the IBCLC pipeline

The lack of standardized mentorship processes and consistent training experiences

Why “mass emailing IBCLCs” to find a mentor reflects a broken system

What a centralized, structured mentorship model could look like

The role of state coalitions, professional organizations, and grant funding

Medicaid reimbursement challenges and why payment structures matter for access

How passion alone cannot sustain a workforce without structural support

What meaningful reform could look like — starting with mentorship

🧠 Key Takeaways for IBCLCs & Students

The IBCLC credential is highly valued — but the pathway remains structurally inequitable.

Indirect costs (lost wages, unpaid hours, childcare) are often more prohibitive than exam fees.

Mentorship access is inconsistent and frequently the biggest barrier to certification.

Without structural support and compensation reform, the field risks burnout and limited diversity.

Improving mentorship infrastructure could significantly expand access and representation.

Workforce diversity is foundational to culturally responsive lactation care and trust-building.

Public health advocacy must include strengthening the IBCLC pipeline — not just improving breastfeeding rates.

👩‍🏫 Guest

Dr. Mandy Golman, PhD, MS, RN, IBCLC, MCHES

Professor, University of Texas at Tyler

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From Wonder to Publication: Writing a Case Study Without a PhD with Indira Lopez-Bassols, IBCLC

Wed, 11 Feb 2026 09:00:00 -0500

In this episode of Behind the Latch, Margaret interviews Indira Lopez-Bassols, IBCLC, educator, and PhD candidate based in London, about her journey from clinical lactation consultant to published author in the Journal of Human Lactation.

Indira shares the story behind her case study, “Assisted Nursing: A Case Study of an Infant With a Complete Unilateral Cleft Lip and Palate” and her recent reflection piece, “Three Seeds of Inspiration: How I Published My First Case Study Without a PhD” .

Together, they unpack what holds IBCLCs back from publishing, how to move from clinical wonder to academic writing, and why research must become more accessible to practicing clinicians.

What We Talk About

Indira’s work in a specialist NHS breastfeeding clinic in the UK
Teaching future lactation consultants and pursuing a PhD in breastfeeding education
The three “seeds of inspiration” that moved her from reader to author
Why attending a JHL writing session at ILCA changed everything
What an editor told her when she doubted whether her case was “spicy” enough
Why you do not need a PhD to write and publish a case study
How she structured her first case study by studying medical literature methodology
The powerful cleft lip and palate case that became her first JHL publication
Assisted nursing using a nipple shield and NG tube to support direct breastfeeding
Why cleft lip and palate infants are often assumed unable to breastfeed — and how this case challenged that assumption
The emotional dimension of clinical practice: witnessing the “impossible”
Why wonder is the essential ingredient for writing
Burnout, mechanistic care, and losing the capacity to recognize awe
Making research accessible for non-academic IBCLCs
Her creation of the international Research Hub through the Centre for Breastfeeding Education and Research

The Three Seeds of Inspiration

Indira describes three pivotal moments:

1. Reading a Case Study

A published case study on biological nurturing sparked the realization: “Maybe I could do this too.”

2. Attending a JHL Writing Session

At ILCA, editors clearly explained manuscript types and encouraged non-academic clinicians to submit. When Indira expressed doubt, she was told simply:

“Just write them.”

3. Witnessing the Impossible

Supporting a mother determined to breastfeed her infant with a complete unilateral cleft lip and palate became the turning point. The dyad exclusively fed mother’s own milk, used no bottles, and later transitioned to direct breastfeeding without assistance after surgeries.

That clinical experience — rooted in creativity, persistence, and humility — demanded to be shared.

Key Takeaways for IBCLCs

You do not need a PhD to publish.
Case studies are about documenting what you witnessed, not proving expertise.
If you are already reading journals, you are closer than you think.
Study the structure of published case studies — they provide your map and compass.
Wonder is a clinical skill — but burnout can dull it.
Research must be accessible to frontline clinicians.
Our field is still young — there is enormous opportunity for contribution.

The Research Hub

Indira created the International Research Hub through the Centre for Breastfeeding Education and Research (CBER):

Free monthly online research discussion
Open to IBCLCs worldwide
Safe space to say “I don’t understand this statistic”
Designed to make research approachable and collaborative

Her mission: make research less intimidating and more joyful.

Guest

Indira Lopez-Bassols, BA (Hons), MSc, IBCLC

Founder, Centre for Breastfeeding Education and Research (CBER)

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Mentorship That Matters: Training the Next Generation of IBCLCs with Kristina Chamberlain, CNM, ARNP, IBCLC

Wed, 21 Jan 2026 00:00:00 -0500

As more people pursue the IBCLC credential, mentorship has become one of the most critical—and misunderstood—components of lactation education. In this episode, Kristina and I take a close look at Pathway 2 and Pathway 3 mentorship, clarifying what mentors are actually responsible for and why mentorship must go beyond observation and paperwork.

Kristina explains that effective mentorship is engaged, relational, and intentional. We discuss how mentors model professionalism, communication, boundaries, and ethical care—not just clinical skills. We also talk openly about the fears many IBCLCs have about becoming mentors, including concerns about readiness, time, liability, and “doing it right,” and why those fears shouldn’t stop experienced clinicians from stepping into mentorship roles.

This conversation also highlights the structural supports built into Pathway 2 programs, the additional lift often required in Pathway 3 mentorship, and why access to high-quality mentorship remains a major barrier to growing and diversifying the IBCLC workforce. Throughout the episode, Kristina shares practical, experience-based strategies for both mentors and mentees—and a hopeful vision for how mentorship could be better supported and valued across the profession.

🔍 What We Talk About

The difference between mentoring vs. supervising clinical hours
What IBCLC mentors are truly responsible for in Pathway 2 and Pathway 3
How students should be gradually and ethically integrated into hands-on care
Common gaps students face when transitioning from coursework to clinical practice
Tools that support mentorship, including IBLCE outlines and LEAARC skill checklists
Why learning from multiple mentors can strengthen clinical competence
Liability, affiliation agreements, and student protections in Pathway 2 programs
The professional and personal benefits of becoming a mentor
Charging for mentorship: ethics, equity, and value exchange
Why mentorship is part of our professional obligation as IBCLCs
What Kristina hopes the future of lactation mentorship will look like

🧠 Key Takeaways

Mentorship is an active teaching relationship, not passive oversight.
Students need meaningful, hands-on experience—not observation alone.
You do not need to be a “perfect” IBCLC to be an effective mentor.
Mentorship strengthens clinical skills, confidence, and professional growth.
Supporting mentors is essential to the future of the lactation profession.

👩‍🏫 Guest

Kristina Chamberlain, CNM, ARNP, IBCLC

Clinical Instruction in Lactation: https://www.amazon.com/Clinical-Instruction-Lactation-Teaching-Generation/dp/1939807948

LEAARC Criteria for Endorsed Courses: https://leaarc.org/docs/2022%20Endorsed%20Courses%20Core%20Curricula%20FINAL%201.pdf

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Body-Led Breastfeeding: Understanding Infant Suck Strength with Dr. Ellen Chetwynd

Wed, 14 Jan 2026 00:00:00 -0500

In this episode of Behind the Latch, Margaret sits down with Ellen Chetwynd, IBCLC, PhD, and longtime Editor-in-Chief of the Journal of Human Lactation, to explore a fundamentally different way of understanding breastfeeding challenges: body-led breastfeeding and the Infant Suck Strength Exam (ISSE).

Dr. Chetwynd shares how years of clinical practice—and noticing what wasn’t explained by common diagnoses like thrush, Raynaud’s, or tongue-tie—led her to focus more closely on the infant’s body, neurology, and suck function. Together, Margaret and Ellen unpack how the ISSE helps clinicians move beyond appearance-based latch assessment to identify where suck strength is weak, how the tongue is functioning at the breast, and how infant compensation patterns often drive pain, inefficiency, and feeding struggles.

This conversation bridges lactation science, cranial nerve physiology, and gentle body-based intervention, offering clinicians practical tools while challenging reductionist approaches to infant oral dysfunction.

🔍 What We Talk About

How Ellen entered the field of lactation through nursing and public health
Why “bucket diagnoses” (yeast, Raynaud’s, tongue-tie) persist in lactation care
What body-led breastfeeding means—and why the baby is often the primary driver
The clinical gap that inspired development of the Infant Suck Strength Exam (ISSE)
Why digital oral exams miss what’s happening at the breast
How the ISSE is performed and what each pull-back reveals about suck strength
Why the ISSE often functions as both assessment and treatment
Infant compensation patterns: jaw movement, lip use, body tension, and asymmetry
The role of cranial nerves and the cranial base in feeding function
Why asymmetric latch and “guppy pose” can sometimes worsen dysfunction
Gentle, parent-taught techniques to support infant regulation and suck strength
How bottle-feeding strategies must align with breastfeeding goals
When to consider referral for craniosacral or body-based therapy
Why frenotomy alone may destabilize function if body tension isn’t addressed
What future research is needed to validate and study the ISSE

🧠 Key Takeaways for Clinicians

A visually “good” latch can hide significant internal dysfunction.
Infant suck strength and tongue function must be assessed during active feeding.
Many breastfeeding problems originate in infant neuromuscular coordination—not maternal anatomy.
Babies often compensate with their bodies when oral function is inefficient.
Gentle pull-back techniques can cue strength and improve function without causing pain.
Positioning that supports a neutral cranial base is critical for effective feeding.
Body-based approaches may reduce unnecessary procedures and improve long-term outcomes.
The ISSE offers clinicians a structured, repeatable way to assess progress over time.

👩‍🏫 Guest

Ellen Chetwynd, PhD, IBCLC

www.bodyledbreastfeeding.com

Upcoming Workshop: https://www.bodyledbreastfeeding.com/lactation-support-workshops

Self-Paced Courses: https://teachingbabiestonurse.thinkific.com/collections

Body-Led Breastfeeding Podcast:

Spotify: https://open.spotify.com/show/7sxiNwaRMppZ8AfjF98C6K

Apple: https://podcasts.apple.com/gb/podcast/body-led-breastfeeding/id1789167683

Former Editor-in-Chief, Journal of Human Lactation

Co-founder, Body-Led Breastfeeding

Chapel Hill & Durham, North Carolina

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🎙 Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

#BehindTheLatch #IBCLC #BodyLedBreastfeeding #InfantSuck #CranialNerves #LactationAssessment #BreastfeedingScience #OutpatientLactation #LactationEducation

Culturally Responsive Lactation Care with Jewish Families with Maya Lott, IBCLC

Wed, 07 Jan 2026 00:00:00 -0500

In this episode of Behind the Latch, Margaret sits down with former student and practicing IBCLC Maya Lott to explore culturally responsive lactation care through the lens of working with Jewish families. Drawing from Maya’s clinical experience, academic background in Jewish philosophy and law, and her widely shared paper on counseling Jewish families, this conversation offers practical guidance for IBCLCs seeking to build trust, reduce friction, and deliver truly family-centered care.

Maya shares how cultural norms, religious practices, and community structures can shape breastfeeding decisions—and how IBCLCs can approach these dynamics with curiosity rather than assumptions. From baby naming practices and modesty considerations to Shabbat, donor milk logistics, and the role of rabbis in healthcare decision-making, this episode provides concrete, respectful strategies clinicians can use immediately in practice.

🔍 What We Talk About

Maya’s path to becoming an IBCLC through Pathway 2—and why it worked well for her as a parent
Why cultural humility matters in lactation care (and what it looks like in real visits)
Breastfeeding as a cultural norm in many Jewish communities—and the pressures that can create
Baby naming practices in observant Jewish families and why asking “Does your baby have a name yet?” matters
Modesty, family roles, and how they can influence in-home lactation visits
Preparing infants for circumcision (bris) and how this can intersect with feeding support
Shabbat, milk removal, and how IBCLCs can collaborate respectfully without practicing religious law
The role of rabbis in health-related decisions—and why this can be empowering for families
Donor milk, milk sharing, and kosher kitchen logistics
How informal milk sharing functions in tight-knit communities
Parallels with other cultural and religious practices (including Muslim milk-kinship laws)
Practical language IBCLCs can use to avoid alienation and build rapport
Why curiosity—not expertise in religious law—is the key clinical skill

🧠 Key Takeaways for Clinicians

Cultural competence starts at the doorstep—small language choices can shape the entire visit.
You don’t need to be an expert in religious law to provide excellent care; awareness of considerations is enough.
Asking open, respectful questions helps families integrate lactation care with lifelong values.
Rabbis (and other faith leaders) often serve as supportive collaborators, not barriers, in healthcare decisions.
Donor milk use may be less about theology and more about household logistics—problem-solving builds trust.
Many cultural “rules” can feel rigid from the outside but are experienced as empowering within the community.
These principles apply far beyond Jewish families—this is a framework for all culturally responsive lactation care.

👩‍🏫 Guest

Maya Lott, IBCLC

What IBCLCs Need to Know About Counseling Jewish Families: A Lactation Consultant's Guide to Cultural Competence When Working with Dyads who Practice Judaism

mayalottibclc.com

Tamari Jacob: https://www.instagram.com/onewiththepump/

Miriam Ezagui: https://www.instagram.com/miriam.ezagui/

📝 Connect with Margaret

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🎙️ Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe, share, and leave a review to help other lactation professionals find the show.

#BehindTheLatch #IBCLC #CulturalCompetence #CulturallyResponsiveCare #JewishFamilies #LactationEducation #BreastfeedingSupport #DEIInHealthcare #PublicHealthLactation

Craniosacral Therapy and Infant Feeding with Meaghan Beames, RMT

Wed, 17 Dec 2025 00:00:00 -0500

Lactation Exam Mastery Course! Master the IBCLC Exam Today!

In this episode of Behind the Latch, Margaret interviews Meaghan Beames, Registered Massage Therapist, educator, and infant craniosacral therapy specialist based in Toronto. Meaghan shares her journey into craniosacral therapy following her own early breastfeeding struggles and explains how this gentle, hands-on modality can support infants experiencing feeding difficulties, poor latch, weak suck, reflux, tension patterns, and post-birth dysregulation.

Together, Margaret and Meaghan unpack what craniosacral therapy actually is—and what it is not—moving beyond common misconceptions of it as “woo” or energy work. Meaghan offers a clear, physiology-based explanation grounded in fascia, cranial nerve function, nervous system regulation, and developmental biomechanics, helping clinicians understand how subtle tension patterns from gestation and birth can profoundly affect infant feeding and behavior.

Throughout the conversation, they explore the clinical intersections between lactation care and bodywork, including the role of cranial nerves in suck function, the relationship between birth mechanics and oral dysfunction, and how craniosacral therapy may improve outcomes before and after frenotomy. Meaghan also provides practical language clinicians can use with families, guidance on practitioner training and safety, and insight into when referrals to other disciplines are appropriate.

🔍 What We Talk About

How Meaghan entered infant craniosacral therapy after her own postpartum and breastfeeding experience
What craniosacral therapy is, how it works, and how it differs from chiropractic, osteopathy, and physical therapy
Fascia, tension patterns, and why the body must be viewed as a single integrated system
The role of cranial nerves in infant feeding, suck strength, and oral coordination
How gestational positioning, birth interventions, and delivery mechanics influence feeding outcomes
Why babies may feed well on one side but struggle on the other
Weak suck, poor oral sensation, and why some infants “can’t feel” the nipple
The limitations of appearance-based tongue-tie assessment and why function must come first
How craniosacral therapy may improve frenotomy outcomes and reduce reattachment risk
Why cutting a dysfunctional tongue without addressing body tension can worsen feeding
What a typical infant craniosacral session looks like, including assessment and treatment flow
How many sessions are typically needed and why “snapback” can occur
How craniosacral therapy supports nervous system regulation and reflex integration
What families may notice after treatment, including emotional release and behavior changes
How to talk with parents about craniosacral therapy in clear, non-alarming language
Safety considerations, training standards, and how to identify qualified practitioners
What the current research does—and does not—tell us about craniosacral therapy
Options for families who cannot access or afford bodywork services

🧠 Key Takeaways for Clinicians

Infant feeding difficulties are often rooted in whole-body tension patterns, not isolated oral anatomy.
Cranial nerve dysfunction can impair suck, coordination, and sensation even when oral anatomy appears “normal.”
Craniosacral therapy uses extremely light touch to identify and release fascial restrictions affecting function.
Birth mechanics, including fetal position and obstetric interventions, can significantly impact feeding.
Frenotomy without addressing underlying body tension may destabilize tongue function and worsen outcomes.
Craniosacral therapy may support feeding both before and after tongue-tie release.
Language matters: explaining the work in functional, observable terms builds parent trust.
Practitioner training and infant-specific education are critical for safety and effectiveness.
Craniosacral therapy is low risk when performed appropriately, but not interchangeable with adult-based bodywork.
Supporting parental intuition and confidence is an essential part of infant care.

👩‍🏫 Guest

Meaghan Beames, RMT

Infant Craniosacral Therapist & Educator, Toronto, Canada

Beames CST

MyBaby Craniosacral Podcast

MyBaby Instagram

📝 Connect with Margaret

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🎙 Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #CraniosacralTherapy #InfantFeeding #IBCLC #BodyworkAndLactation #CranialNerves #TongueTie #InfantRegulation #BreastfeedingSupport #LactationEducation #WholeBodyCare

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

Why Early Colostrum Feeding Matters: Insights from Dr. Valérie Verhasselt

Wed, 10 Dec 2025 09:00:00 -0500

Lactation Exam Mastery Course! Master the IBCLC Exam Today!

In this episode of Behind the Latch, Margaret interviews Dr. Valérie Verhasselt, Professor of Immunology at the University of Western Australia and Head of the LRF Centre for Immunology and Breastfeeding. Dr. Verhasselt discusses her groundbreaking research on colostrum and food allergy prevention, focusing on her recent study demonstrating that partial colostrum feeding in the first 72 hours of life increases the risk of peanut allergy, while exclusive colostrum feeding appears profoundly protective.

Her findings offer a powerful reframing of early postpartum lactation care: the risk may not stem solely from early cow’s milk exposure, but from reduced colostrum intake during the critical adaptation period when the newborn’s gut, immune system, and microbiota are being programmed. She explains how colostrum’s unique concentration of growth factors, IgA, vitamin A, and immune-modulating bioactive components help seal the gut, seed the microbiome, strengthen the skin barrier, and establish immune tolerance—laying the foundation for lifelong resilience.

Dr. Verhasselt also shares insights from mouse models, discusses why donor mature milk is not a substitute for colostrum, and explores future directions including donor colostrum banks, colostrum-derived therapeutics, and new research on colostrum’s role in brain development.

https://pubmed.ncbi.nlm.nih.gov/40968490/

🔍 What We Talk About

How Dr. Verhasselt entered lactation immunology after a “flash” inspiration during her early research career
Why the transition from intrauterine to extrauterine life makes newborns uniquely vulnerable to allergy development
How colostrum supports gut closure, immune regulation, microbiota seeding, and skin barrier maturation
Why giving formula in the first days displaces colostrum intake rather than simply “topping up”
Evidence showing a five-fold increase in peanut allergy among infants who received partial colostrum feeding
The striking finding that no infants who received ≥9 colostrum feeds developed peanut allergy by 12–18 months
What early formula exposure does to the infant microbiome weeks and months later
How parental allergy risk influences—but does not override—the protective effect of colostrum
Why exclusive breastfeeding data often overlook the critical first 72 hours
The interplay between infant skin permeability, environmental exposure, detergent use, and allergy sensitization
What mouse models teach us about colostrum, mature milk, and developmental programming
Why donor milk does not replicate colostrum’s early immunological function
The concept of exclusive colostrum feeding as a distinct clinical and public health priority
Future research avenues: colostrum-derived metabolites, donor colostrum banks, and early-life allergy prevention strategies

🧠 Key Takeaways for Clinicians

Colostrum’s immunological role is unique and time-sensitive—its composition cannot be replicated by mature milk, donor milk, or formula.
Supplementation in the first days displaces colostrum volume, which may be the primary mechanism increasing allergy risk.
As few as nine colostrum feeds in the first 72 hours appear profoundly protective against peanut allergy.
Early formula exposure—even brief—can alter the infant gut microbiota for months.
The newborn’s gut and skin barriers are uniquely permeable, making early antigen exposure highly consequential.
Parents who partially colostrum feed may benefit from earlier peanut introduction, while exclusively colostrum-fed infants may have more flexibility.
The language we use (“milk coming in”) can unintentionally undermine parents’ confidence; reframing colostrum as “the milk for those days” is more accurate and supportive.
Research supports reframing early postpartum care around exclusive colostrum feeding, not just exclusive breastfeeding.

👩‍🏫 Guest

Dr. Valérie Verhasselt, MD, PhD

Professor, University of Western Australia

Head, LRF Centre for Immunology and Breastfeeding

Perth Children’s Hospital, Telethon Kids Institute

📝 Connect with Margaret

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🎙 Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #Colostrum #BreastfeedingResearch #FoodAllergyPrevention #PeanutAllergy #Immunology #BreastmilkScience #LactationResearch #HumanMilk #ColostrumIsLiquidGold #InfantFeeding #PublicHealthLactation

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

Inside the Lactating Breast: Ultrasound, Adiposity & Milk Production with Dr. Zoya Gridneva

Wed, 03 Dec 2025 00:00:00 -0500

LACTATION EXAM MASTERY COURSE- Stop Guessing How to Study for the IBCLC Exam.

In this episode of Behind the Latch, Margaret interviews Dr. Zoya Gridneva, Research Fellow with the Geddes–Hartmann Human Lactation Research Group. Zoya discusses her research exploring maternal adiposity, glandular tissue distribution, breast anatomy, milk production, puberty timing, parity, and breast development across lactations, using ultrasound imaging to examine the lactating breast in a way few studies have before

Her findings help illuminate why some parents experience low supply despite doing “everything right,” and demonstrate how maternal factors—especially adiposity—may influence glandular tissue development, breast storage capacity, and milk removal efficiency. She also shares emerging tools that may help clinicians screen for lactation risk prenatally and why early identification may matter profoundly for parental experience and outcomes.

🔍 What We Talk About

How Zoya entered lactation research after her own breastfeeding experience
Why adiposity is emerging as a central factor in milk production outcomes
What ultrasound can tell us about ductal branching, glandular volume, and breast storage capacity
Why more ductal development doesn’t always equal meaningful clinical increase in supply
The relationship between puberty timing, parity, contraception, adiposity & milk output — what we know and what we don’t
Why breast size ≠ glandular volume, and why small breasts may produce normal volumes
The need for better screening for primary low supply and insufficient glandular tissue (IGT)
A new 5-minute lactation risk screening tool used in Western Australia & its clinical promise
Why single-feed weights are not enough — and why 24-hour production is more meaningful
Where research must go next: larger samples, longitudinal data, and early-life glandular development

🧠 Key Takeaways for Clinicians

Adiposity may influence breast growth, glandular proportion, and storage capacity, mediating supply outcomes.
Ultrasound can visualize breast structure but requires skill, training, and access — not yet feasible for routine care.
We may be able to identify high-risk parents prenatally using simple clinical screening tools, improving early intervention timing.
Puberty, hormonal exposure, and menarche timing could play a significant role in final glandular development — a research area wide open for exploration.
24-hour test-weighing is one of the most reliable ways to identify low production early, long before a “weight problem” appears.
Clinically, risk awareness + early frequent milk removal support may be key for at-risk families.

👩‍🏫 Guest

Dr. Zoya Gridneva, PhD

Maternal Factors, Breast Anatomy & Milk Production — An Ultrasound-Based Look Inside Lactation

Research Fellow, Geddes–Hartmann Human Lactation Research Group

University of Western Australia

📝 Connect with Margaret

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🎙️ Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #BreastfeedingSupport #LactationResearch #OutpatientLactation #IBCLC #PostpartumCare #BreastfeedingEquity #MaternalHealth #LactationPolicy #PublicHealthLactation

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

Why Outpatient IBCLC Care Matters: A Conversation with Dr. Anita Lugo

Wed, 26 Nov 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Anita Lugo, Pediatric Nurse Practitioner, IBCLC, researcher, and Assistant Professor at Moravian University in Pennsylvania.

Dr. Lugo’s work focuses on one of the most critical—and often overlooked—components of breastfeeding success: outpatient lactation care after hospital discharge. Her recent review highlights the powerful impact of early, skilled IBCLC support on breastfeeding exclusivity and duration, and shines a light on the persistent gaps families face when navigating the postpartum period.

Together, they explore the evidence behind outpatient IBCLC interventions, the systemic barriers that prevent equitable access to care, and the urgent need for stronger policies, better reimbursement models, and more consistent pathways for families to receive the level of support they truly need.

Dr. Lugo also discusses how timing, frequency, and modality of lactation care—whether in-person, outpatient clinic, in-home, or telehealth—shape outcomes, and what future research should focus on to strengthen breastfeeding support across diverse communities.

They discuss:

Why many breastfeeding challenges intensify after families leave the hospital
Evidence showing that IBCLC support at 3 days and 2 weeks postpartum yields the best outcomes
Gaps in outpatient access, especially for families with Medicaid or grandfathered plans
Geographic disparities in IBCLC availability and why they matter
The limitations of relying solely on prenatal classes or hospitalization support
The role of telelactation and what parents find helpful—or challenging—about virtual consults
The need for clearer distinctions between lactation credentials and their scopes of practice
How policy, insurance reform, and better public awareness could improve breastfeeding equity
Future research needed on optimal visit numbers, timing, and support models

👩‍🏫 Guest Info

Dr. Anita Lugo, DNP, PNP, IBCLC

An integrative review of the impact of International Board Certifed Lactation Consultants in outpatient postnatal settings in the United States

Assistant Professor, Moravian University

Pediatric Nurse Practitioner & IBCLC

Prenatal Educator, St. Luke’s University Hospital

LinkedIn: Anita Lugo

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🎙️ Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #BreastfeedingSupport #LactationResearch #OutpatientLactation #IBCLC #PostpartumCare #BreastfeedingEquity #MaternalHealth #LactationPolicy #PublicHealthLactation #Telolactation #BreastfeedingOutcomes #InfantFeeding #NewParentSupport

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

How Babies Sleep: A Conversation with Dr. Helen Ball

Wed, 19 Nov 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Helen Ball, Professor of Anthropology and Director of the Infancy and Sleep Centre at Durham University in the United Kingdom.

Dr. Ball is one of the world’s leading researchers on infant sleep and parent–infant nighttime behavior. Her work bridges anthropology, public health, and clinical practice, offering an evidence-based understanding of what “normal” infant sleep truly looks like—and why so much of modern sleep advice clashes with biology.

Together, they discuss Dr. Ball’s new book, How Babies Sleep, which explores the evolution, science, and culture of infant sleep across the world. Dr. Ball challenges long-standing myths about “good sleepers,” sheds light on the risks and realities of common practices like bedsharing and sleep training, and highlights how social expectations shape parental stress and decision-making.

She also shares practical, research-based insights for lactation consultants and health professionals supporting families as they navigate infant sleep, feeding, and nighttime care—emphasizing empathy, evidence, and cultural awareness.

They discuss:

How How Babies Sleep reframes the narrative around “normal” infant sleep
The cultural roots of Western sleep expectations
Why frequent night waking is biologically typical—and protective
How breastfeeding and sleep are deeply intertwined
What anthropological research reveals about co-sleeping across cultures
Common misconceptions about bedsharing safety
Supporting families to make informed, individualized sleep choices
The importance of aligning sleep advice with human biology and family context

👩‍🏫 Guest Info

Dr. Helen L. Ball

Professor of Anthropology, Durham University

Director, Infancy and Sleep Centre

📘 Book: How Babies Sleep (Pinter & Martin, 2025)

🌐 Website: https://www.dur.ac.uk/research/institutes-and-centres/durham-infancy-sleep-centre/

📝 Connect with Margaret

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🎙️ Podcast: Behind the Latch

Hosted by: Margaret Salty

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #InfantSleep #HowBabiesSleep #HelenBall #Anthropology #LactationConsultant #IBCLC #CoSleeping #Bedsharing #Breastfeeding #ParentInfantSleep #SleepScience #LactationResearch #InfantFeeding #PublicHealthLactation

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

Exclusive Pumping: Redefining Breastfeeding Through Research with Dr. Kelsey Bianca

Wed, 12 Nov 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Kelsey Bianca, psychology professor at Cecil College in Maryland, whose groundbreaking research focuses on the lived experiences of exclusively pumping mothers.

Kelsey’s work shines a light on an often-overlooked population in lactation research—parents who feed their babies human milk through expression rather than at the breast. Her dissertation challenges the traditional “breast or bottle” binary and explores exclusive pumping as a legitimate, empowering, and deeply human form of infant feeding.

Together, they discuss how exclusive pumping fits within the broader breastfeeding landscape, what her qualitative research uncovered about motivation and identity, and how systemic barriers—like language, support gaps, and policy limitations—shape parents’ experiences.

Kelsey also shares her insights on how lactation professionals can better support exclusively pumping families with empathy, inclusivity, and evidence-based care.

They discuss:

Why exclusive pumping deserves recognition as a form of breastfeeding
How language and terminology shape support and self-perception
The emotional and psychological experiences of exclusive pumpers
Common challenges and identity shifts in the exclusive pumping journey
What research reveals about resilience and motivation in pumping parents
The gap between policy, practice, and lived experience
How IBCLCs and educators can create inclusive spaces for all milk-feeding families
Future directions for research in human milk expression

👩‍🏫 Guest Info

Dr. Kelsey Bianca

Professor of Psychology, Cecil College

Bianca, K.P. (2025). A narrative review of breastmilk expression. Breastfeeding Review; 33(2): 14-24.

Bianca, K. P. (2023). Framing infant feeding practices with bioecological theory: A theoretical review. Breastfeeding Review; 31(3): 6-16.

📝 Connect with Margaret

📬 Email: hello@margaretsalty.com

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🎙️ Podcast: Behind the Latch

Hosted by: Margaret Salty

Guest: Dr. Kelsey Bianca

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #ExclusivePumping #LactationResearch #HumanMilkFeeding #IBCLC #LactationConsultant #MaternalIdentity #PumpingJourney #BreastfeedingSupport #LactationScience #HumanMilkResearch #PublicHealthLactation

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

Adapted Baby-Led Weaning: A Feeding Approach for Every Baby with Jill Rabin

Wed, 05 Nov 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Jill Rabin, MA, CCC-SLP/L, IBCLC, speech-language pathologist, lactation consultant, and co-author of Your Baby Can Self-Feed, Too. Known for her pioneering work in Adapted Baby-Led Weaning (ABLW), Jill specializes in responsive feeding for infants with Down syndrome, prematurity, oral motor challenges, feeding aversion, and medical complexity.

Together, they explore how ABLW bridges the gap between traditional baby-led weaning and therapeutic feeding support—giving all babies, including those with motor delays or complex medical needs, a safe and developmentally aligned path to solids. Jill breaks down the misconceptions about gagging vs. choking, readiness cues beyond age, and why starting solids is about skill first, nutrition second. She also shares practical guidance for IBCLCs supporting families in the transition to solids while staying within scope—and how to identify when a referral to a feeding specialist is needed.

They discuss:

What Adapted Baby-Led Weaning is and how it differs from traditional baby-led weaning
Understanding gagging, choking risk, and oral motor development
How chewing skills develop and why strip-shaped foods build safe feeding foundations
Signs of developmental readiness for solids in breastfed babies
Supporting preterm and medically complex infants during feeding transitions
How to introduce allergenic foods safely
Responsive feeding and avoiding pressure-based feeding practices
When IBCLCs should refer to SLPs or feeding therapists
Cultural and socioeconomic accessibility of responsive feeding approaches
How ABLW promotes feeding confidence and reduces aversion

👩‍⚕️ Guest Info

Jill Rabin, MA, CCC-SLP/L, IBCLC

🌐 Website: https://jillrabin.com

📸 Instagram: @jillrabin_ablw

📘 Book: Your Baby Can Self-Feed, Too

🎓 Transition to Solids

Adapted Baby Led Weaning

📝 Connect with Margaret

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🎙️ Podcast: Behind the Latch

Hosted by: Margaret Salty

Guest: Jill Rabin, MA, CCC-SLP/L, IBCLC

Music by: The Magnifiers – My Time Traveling Machine

#BehindTheLatch #AdaptedBabyLedWeaning #ABLW #FeedingTherapy #IBCLC #BreastfeedingSupport #OralMotorDevelopment #ResponsiveFeeding #SLP #DownSyndromeFeeding #PediatricFeeding #LactationConsultant #FeedingAversion #EarlyIntervention

🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

Telelactation Through a Cultural Lens: Gabriela Alvarado on Latina Parents’ Experiences

Wed, 29 Oct 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Gabriela Alvarado, MD, maternal health policy researcher at the RAND Corporation and current Pathway 2 student. Drawing from both her professional expertise as a physician and researcher, and her personal experience as a breastfeeding parent, Gaby shares insights from her recent qualitative study exploring Latina parents’ experiences with telelactation support—part of a larger randomized controlled trial on telehealth lactation services.

Together, they explore how telelactation fits into the broader landscape of breastfeeding support, the “breastfeeding support escalation protocol” her team identified, and what this research reveals about accessibility, cultural responsiveness, and the evolving role of IBCLCs in telehealth. Gaby also shares how her equity-centered research approach shaped the study design and offers practical takeaways for lactation professionals supporting diverse families.

They discuss:

How Latina parents navigate different sources of breastfeeding support—from Google to family to IBCLCs—through a natural “escalation” process.
The convenience and limitations of telelactation, including the need for “support to get support” during virtual visits.
How messaging platforms and asynchronous communication could enhance lactation care.
The impact of telelactation access on breastfeeding outcomes and parental confidence.
Opportunities for pediatric practices to integrate telelactation services to improve continuity of care.
The importance of cultural humility, linguistic accessibility, and authentic engagement in research and clinical care.
Policy implications for equitable telelactation access and Medicaid coverage.

👩‍⚕️ Guest Info

Gabriela Alvarado, MD

🌐 RAND Corporation

💼 LinkedIn: Gaby Alvarado

https://doaj.org/article/947b3c1d6b424a2ca093e35ceb59ae5c

https://journals.sagepub.com/doi/full/10.1177/08903344241274760

https://www.liebertpub.com/doi/full/10.1089/tmj.2022.0159

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830786

📝 Connect with Margaret

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🎙 Hosted by: Margaret Salty

🎧 Guest: Gabriela Alvarado, MD

🎵 Music by: The Magnifiers, My Time Traveling Machine

#BehindTheLatch #LactationResearch #Telelactation #IBCLC #BreastfeedingSupport #LatinaParents #CulturalHumility #MaternalHealth #LactationConsultant #HealthEquity #RAND

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Bridging the NICU Gap: Supporting Families and Building Collaborative Care with Dr. Jess Daigle

Wed, 22 Oct 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Jess Daigle, pediatric hospitalist, NICU physician, founder of Tiny Steps NICU Grad Care, and NICU mom. Drawing from both her professional expertise and personal experience, Dr. Daigle shares how her own NICU journey shaped her passion for supporting families through the vulnerable transition from hospital to home.

Together, they explore the emotional landscape of NICU parenting, the unique lactation challenges that arise in this setting, and how IBCLCs can play a transformative role in bridging gaps between families and the medical team. Dr. Daigle offers practical insights for improving interdisciplinary collaboration, building trust with families, and approaching care with cultural humility and genuine curiosity.

They discuss:

The emotional toll of the NICU experience for parents, including grief, loss of control, and isolation—and how lactation consultants can approach families with sensitivity.
How inconsistent messaging across NICU teams can confuse families, and why standardized feeding pathways and shared language are essential.
The IBCLC’s role in educating and empowering families—especially around premature infant feeding skills, confidence-building, and preparing for discharge.
Practical strategies for integrating lactation consultants into the NICU care team, moving from “guest” status to core collaborators.
The importance of recognizing breastfeeding as medicine and addressing the dyad holistically, rather than through siloed disciplines.
How cultural humility, curiosity, and individualized support can create more equitable and compassionate care for families from diverse backgrounds.
Dr. Daigle’s vision for systemic change: embedding lactation education early in medical and allied health training to build a unified, dyad-focused model of care
chat-with-dr-jess-daigle

👩‍⚕️ Guest Info

Dr. Jess Daigle, MD, FAAP

🌐 Instagram: @momandme_md

💼 LinkedIn: Jess Daigle, MD

Anchored in Hope

📝 Connect with Margaret

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🎧 Guest: Dr. Jess Daigle

🎵 Music by: The Magnifiers, My Time Traveling Machine

#BehindTheLatch #NICU #IBCLC #LactationConsultant #BreastfeedingSupport #MaternalHealth #LactationEducation #FamilyCenteredCare #CulturalHumility #NICUGradCare

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

The Role of Silver Nipple Protectors in Breastfeeding Support with Maya Nakamura

Wed, 15 Oct 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Maya Nakamura, CNM, PhD(c)—a midwife researcher from Sapporo, Japan—about her work on nipple trauma and her recent study on silver nipple protectors. Maya shares how years of bedside experience, watching mothers struggle with painful nipple damage, pushed her into research and innovation in clinical assessment (including AI-based image analysis) and practical tools that may reduce pain and promote healing.

Together, they explore how culture, access, and methodology shape nipple-trauma research; what we do and don’t yet know about silver nipple protectors; and how IBCLCs can translate emerging evidence into compassionate, realistic care for families. Maya also talks about the realities of conducting trials in Japan (declining birth rates, ethics, and single-site constraints), and why standardized outcome measures are critical for future meta-analyses.

They discuss:

Why study nipple trauma? Night-shift realities, mother distress, and the limits of common “friction-reduction” hacks that sparked formal inquiry.
Silver nipple protectors 101: what they are, how they’re used postpartum, and potential mechanisms (barrier + moisture + antimicrobial silver).
Study design trade-offs: why a non-randomized comparative design with historical controls was chosen, and steps taken to minimize bias.
Key findings from Maya’s trial: reductions in severe nipple trauma indicators and day-4 pain—alongside a clean safety profile in the study setting.
Real-world considerations: availability in Japan, cost barriers (≈¥10,000) and ideas like unit-level lending to improve access.
What’s next: the call for standardized criteria, longer follow-up, comparisons with other treatments, and the promise (and limits) of AI for consistent nipple-trauma classification.

Maya emphasizes a practical, parent-centered approach: protect the nipple, relieve pain, and sustain breastfeeding—while staying honest about evidence gaps and equity barriers in accessing devices and follow-up care.

Guest Info

Maya Nakamura, CNM, PhD(c)

Midwife & doctoral researcher (Sapporo, Japan)
Focus: nipple-trauma classification, wound-care adjuncts, and AI-assisted assessment in lactation care.

Publications:

Nipple Skin Trauma in Breastfeeding Women During Postpartum Week One. , Breastfeeding Medicine, Nakamura M, Asaka Y, Ogawara T, Yorozu Y, 2018 Sep;13(7):479-484.

https://www.researchgate.net/publication/326818739_Nipple_Skin_Trauma_in_Breastfeeding_Women_During_Postpartum_Week_One

・An evaluation of the signs of nipple trauma associated with breastfeeding: A Delphi Study, Journal of human lactation, Maya Nakamura, Yoko Asaka, 2022 Feb; 38(3) 548–558. DOI: 10.1177/08903344221076527

journals.sagepub.com/home/jhl

https://journals.sagepub.com/doi/10.1177/08903344221076527

・Effectiveness of moisturizing therapy in treating nipple trauma: a systematic review protocol, BMJ Open, Nakamura M, Luo Y, Ebina Y. 2024;14:e083389. doi: 10.1136/bmjopen-2023-083389

https://bmjopen.bmj.com/content/14/9/e083389.long

・Systematic Review on the Efficacy of Moisturizing Therapy in Treating Nipple Trauma and Nipple Pain. Journal of Human Lactation. Nakamura M, Luo Y, Ebina Y. 2025;41(1):39-53. doi:10.1177/08903344241301401

https://journals.sagepub.com/doi/10.1177/08903344241301401

・Development of Nipple Trauma Evaluation System With Deep Learning. Journal of Human Lactation. Nakamura M, Sugimori H, Ebina Y. 2025;41(1):105-114. doi:10.1177/08903344241303867

https://journals.sagepub.com/doi/10.1177/08903344241303867

・Role of Silver Nipple Protectors in Treating Nipple Trauma: A Non-Randomized Comparative Trial. J Hum Lact. Nakamura M, Sugimori H, Asaka Y, Ebina Y. 2025 Aug;41(3):382-391. doi: 10.1177/08903344251342564.

https://journals.sagepub.com/doi/10.1177/08903344251342564

・Feasibility and Acceptability of a Deep-Learning-Based Nipple Trauma Assessment System for Postpartum Breastfeeding Support. Healthcare, Nakamura, M., Sugimori, H., & Ebina, Y. (2025). 13(17), 2091. https://doi.org/10.3390/healthcare13172091

Transcript:

Where are you located and where are you working?

My name is Maya Nakamura. I live in Sapporo, the capital city of Hokkaido in northern Japan.

I am a third-year doctoral student and also a midwife. Before starting my doctoral program, I worked as a nursing and midwifery faculty member, and after graduation I plan to return to academia. As a midwife, I used to work in hospitals, but now I practice independently, visiting families at home to support pregnant women, new mothers, and their babies.

What brought you to this work?

I became a midwife simply because I love babies. I am also a mother of four children, which is quite unusual in Japan where most families have only one or two. My youngest is still an infant, and I am currently breastfeeding.

Your body of research centers around nipple damage. Can you tell me where this desire to study nipple damage in breastfeeding mothers came from?

When I was working as a hospital midwife, I often saw mothers crying at night because of painful nipple damage. They wanted to continue breastfeeding but felt they had no choice but to stop. At that time, senior midwives used to give polyester film to reduce friction, but I wondered whether it really worked and what the evidence was. That curiosity led me to pursue research, and it became the reason I entered a master’s program.

Silver nipple protectors are becoming more popular in the US. I see them frequently with my patients and my students often ask about them. What led you to focus your research on silver nipple protectors, and why do you think there was a need to study them in a Japanese population?

I noticed that silver nipple protectors are common in the US. I also saw a booth for them at the last ILCA conference, which showed me how much attention they are receiving. In Japan, however, they are almost unknown. I first came across the 2015 paper by Marrazzu et al., which really surprised me because of the unique appearance of the device. I imported one, and when I gave birth myself, I tried it and felt it worked. When I introduced it at my clinic, both mothers and midwives responded positively. That experience convinced me that Japanese mothers could also benefit from them.

Your study used a non-randomized comparative design with historical controls. Can you explain why this design was chosen and how you addressed potential limitations?

The choice was practical. First, there are ethical challenges in Japan with providing different interventions to women admitted at the same time in the same hospital. Second, silver nipple protectors are not common here, and introducing them across multiple facilities is very difficult. Japan also faces declining birth rates, which makes it hard to recruit large samples. For these reasons, I conducted the study in one clinic where silver protectors had already been used, and I used historical data as the control.

To minimize bias, I collected data from facilities of similar size and with comparable quality of midwifery care.

In both this study and the study used for the control sample you classified nipple trauma into specific signs such as erythema, swelling, scabbing, and blistering. How did you determine which signs to focus on, and what did you find most challenging about measuring trauma consistently?

The classification was based on my earlier research. I collected about 750 photographs of nipple trauma over time and analyzed them, which led me to develop a seven-category system. Using this system, we evaluated erythema, swelling, scabbing, and blistering in this study. The method itself was not so difficult, but subjective judgment is always a limitation. Recently, I have also used AI-based image analysis to classify nipple trauma, which I believe reduces subjectivity.

One of your key findings was that silver protectors reduced severe trauma and nipple pain by day 4 postpartum. You mention that it’s unclear whether the benefits come from the silver itself, the moisture effect, or both. Based on your findings, what do you think might be the most important mechanism at work?

As I wrote in my paper, it is not clear whether the benefit comes from the silver itself, the moisture effect, or both. My personal view is that it is likely a combination of both.

No adverse effects were reported in your trial. Were there any concerns from participants or staff about using silver, particularly regarding safety or potential impact on breast milk?

Because the study was conducted in a clinic that had already used silver protectors for several years, staff did not express concerns. We excluded women with very sensitive skin or known metal allergies. Participants generally had no safety concerns either, although some mentioned that the protector sometimes slipped off during sleep, or that the edge could press against the breast when it was engorged.

What do you see as the next steps in studying silver nipple protectors—do you envision randomized controlled trials, long-term follow-up, or comparisons with other common treatments like lanolin or hydrogel pads?

A full randomized controlled trial may be difficult in Japan due to ethical and clinical issues. In my opinion, one of the main problems in nipple trauma research is that different studies use different evaluation criteria, which prevents meta-analysis. I believe the next step is for researchers to use a standardized classification—such as my seven-category system—so that we can build evidence together.

What is next for you in terms of research?

I am currently working on using AI to classify nipple trauma. I think this technology can be very beneficial for the next generation of mothers. At the same time, human touch and care from midwives will always be essential. My goal is to combine AI with hands-on midwifery support to provide more comprehensive care.

Where can my listeners learn more about you and the work that you're doing?

Please take a look at my publications. I have written seven papers in English so far.

Connect with Margaret

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🎙 Hosted by: Margaret Salty

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#BehindTheLatch #IBCLC #NippleTrauma #BreastfeedingSupport #LactationResearch #InfantFeeding #MaternalHealth

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Beyond Every 3 Hours: A New Approach to Pumping and Separation with Claire Eden, IBCLC

Wed, 08 Oct 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Claire Eden, BA, IBCLC, author of Shifting the Paradigm for Establishing and Maintaining Milk Production in the Setting of Mother–Infant Separation. Claire shares her journey from NICU lactation consulting to statewide advocacy, and how her clinical experiences inspired her to propose a new framework for supporting families when babies are admitted to the NICU.

Together, they explore why the traditional “pump every 3 hours” model is often overwhelming for families, and how more flexible, evidence-based strategies can help parents establish and maintain their milk supply. Claire provides practical insights on supporting parents through separation, reshaping hospital policy, and rethinking how IBCLCs approach milk expression education.

They discuss:

Why rigid pumping schedules can overwhelm families and affect both supply and mental health.
The evidence behind the “5 × 5 rule” (expressing at least 5 times a day by Day 5) and the importance of one overnight pumping session.
The five-step paradigm shift that emphasizes antenatal education, personalized discharge planning, and structured follow-up.
How individualized lactation care improves outcomes for preterm and sick infants in the NICU.
The role of hospital policy in prioritizing lactation support as a standard of care.
Practical ways IBCLCs can empower parents while making pumping more achievable.

Claire emphasizes the importance of evidence-based, parent-centered lactation care that not only protects milk supply but also supports family well-being during the difficult experience of mother–infant separation.

Guest Info

Claire Eden, IBCLC

📚 Author: Shifting the Paradigm for Establishing and Maintaining Milk Production in the Setting of Mother–Infant Separation

🌐 Georgia Perinatal Quality Collaborative: Georgiapqc.org

Papers Discussed

Randle J. From the Field - The Case for a Paradigm Shift in Lactation Care for NICU Families: A Comprehensive Lactation Care Model. J Hum Lact. 2025 Feb;41(1):34-38. doi: 10.1177/08903344241299722. Epub 2024 Nov 26. PMID: 39588739.

Mago-Shah DD, Athavale K, Fisher K, Heyward E, Tanaka D, Cotten CM. Early pumping frequency and coming to volume for mother's own milk feeding in hospitalized infants. J Perinatol. 2023 May;43(5):629-634. doi: 10.1038/s41372-023-01662-z. Epub 2023 Apr 10. PMID: 37037987.

Parker LA, Sullivan S, Kruger C, Mueller M. Timing of milk expression following delivery in mothers delivering preterm very low birth weight infants: a randomized trial. J Perinatol. 2020 Aug;40(8):1236-1245. doi: 10.1038/s41372-020-0688-z. Epub 2020 May 27. PMID: 32461626.

Parker LA, Hoban R, Bendixen MM, Medina-Poeliniz C, Johnson TJ, Meier PP. Milk Biomarkers of Secretory Activation in Breast Pump-Dependent Mothers of Preterm Infants: An Integrative Review. Breastfeed Med. 2024 Jan;19(1):3-16. doi: 10.1089/bfm.2023.0107. PMID: 38241129; PMCID: PMC10818056.

Hoban R, McLean L, Sullivan S, Currie C. Proactive Lactation Care is Associated With Improved Outcomes in a Referral NICU. J Hum Lact. 2022 Feb;38(1):148-155. doi: 10.1177/0890334421993467. Epub 2021 Feb 13. PMID: 33586505; PMCID: PMC8814956.

Hoban R, Bigger H, Schoeny M, Engstrom J, Meier P, Patel AL. Milk Volume at 2 Weeks Predicts Mother's Own Milk Feeding at Neonatal Intensive Care Unit Discharge for Very Low Birthweight Infants. Breastfeed Med. 2018 Mar;13(2):135-141. doi: 10.1089/bfm.2017.0159. Epub 2018 Jan 29. PMID: 29377728; PMCID: PMC5863077.

Patel AL, Johnson TJ, Meier PP. Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units. Pediatr Res. 2021 Jan;89(2):344-352. doi: 10.1038/s41390-020-01263-y. Epub 2020 Nov 13. PMID: 33188286; PMCID: PMC7662724.

Connect with Margaret

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🎧 Guest: Claire Eden

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#BehindTheLatch #NICU #IBCLC #BreastfeedingSupport #InfantFeeding #MaternalHealth #LactationEducation

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Breastfeeding Late Preterm Infants: Insights with Sandra Cole, IBCLC

Wed, 01 Oct 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Sandra Cole, RN, IBCLC, author of Breastfeeding Challenges Made Easy for Late Preterm Infants. Sandra shares her journey from NICU nursing to lactation consulting, and how her experiences with late preterm babies inspired her to write her groundbreaking book.

Together, they explore why late preterm infants—those born between 34 and 36 6/7 weeks—are often misunderstood as “almost term” when in reality they face unique physiologic challenges that make breastfeeding especially complex. Sandra provides evidence-based insights on how to best support these dyads and practical strategies IBCLCs can apply in their daily work.

They discuss:

Why late preterm babies are at higher risk for feeding difficulties, hypoglycemia, and jaundice.
The role of brown fat, glycogen stores, and immature brain development in feeding challenges.
Effective supplementation strategies, including the use of a 24 mm nipple shield with a syringe and feeding tube.
How to balance protecting breastfeeding while ensuring adequate glucose intake and growth.
Practical documentation tips and communication strategies for IBCLCs working with pediatricians and hospital teams.
What to look for when weaning off supplements and supporting transition to exclusive breastfeeding.

Sandra emphasizes the importance of educating families and healthcare providers about the unique needs of late preterm infants and provides actionable advice IBCLCs can use right away.

*Important note: Re: Immature liver: immature liver. When there is no glucose to support brain function and growth, the body turns to glycogen stores to convert to glucose. But when there is no glycogen, the body starts into anearobic metabolism to obtain glucose. This is done by breaking down body tissue, leading to excess weight loss as well as increased respirations (tachypnea).

Guest Info

📚 Author: Breastfeeding Challenges Made Easy for Late Preterm Infants

🌐 Website: MilkMadeEasy.com

Applying nipple shield with tube: https://www.milkmadeeasy.com/post/how-to-apply-a-nipple-shield

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🎧 Guest: Sandra Cole

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Hashtags & Keywords

#BehindTheLatch #LatePreterm #IBCLC #BreastfeedingSupport #InfantFeeding #MaternalHealth

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Supporting Queer and Trans Families in Lactation: A Conversation with Jacob Engelsman, IBCLC

Wed, 24 Sep 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Jacob Engelsman, IBCLC and author of Lactation for the Rest of Us: A Guide for Queer and Trans Parents and Helpers.

**Special Discount: Receive 20% off until 10/31/25 on Jacob's book with code "LACTATION20" here.**

Jacob shares his journey into the lactation field, from working in restaurants to finding his calling as an IBCLC and writer. His work centers on supporting queer, trans, and non-binary families who are often left out of mainstream lactation education. His book fills a long-standing gap by providing practical information, first-person stories, and affirming guidance for families who want to chestfeed, induce lactation, or navigate infant feeding after top surgery.

Together, Margaret and Jacob explore how lactation consultants can expand their knowledge and language to better serve all families. They discuss topics such as:

Inclusive language and recovering gracefully from missteps.
Lactation after top surgery and the realities of chestfeeding.
Binding while lactating and the balance between supply and mental health.
Induced lactation for adoptive, queer, and non-gestational parents.
The power of personal stories to reshape how we understand parenting and feeding.

Jacob also shares about his unique childbirth education program for first-time fathers, originally taught in a bar with wings and beer, and why creating approachable spaces for dads—including queer dads—can change the way families prepare for birth and early parenting. Looking ahead, he highlights the importance of more training, advocacy, and resources that affirm the diversity of today’s families.

Links:

Guest Info:

📚 Author: Lactation for the Rest of Us

🌐 Website: JacobEngelsmanIBCLC.com

📸 Instagram: @JacobIBCLC

Connect with Margaret:

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🎙 Hosted by: Margaret Salty

🎧 Guest: Jacob Engelsman

🎵 Music by: The Magnifiers, My Time Traveling Machine

#BehindTheLatch #QueerParenting #IBCLC #InclusiveLactation #TransInclusiveCare #Chestfeeding #InfantFeeding

Breastfeeding, History, and Public Health: Lessons from Dr. Jacqueline Wolf

Wed, 17 Sep 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Jacqueline H. Wolf, medical historian and author of Don’t Kill Your Baby: Public Health and the Decline of Breastfeeding in the 19th and 20th Centuries. Dr. Wolf is a professor at Ohio University whose research focuses on the history of breastfeeding, childbirth, and maternal-child health.

Together, they explore the historical forces that shaped infant feeding practices in the United States, how breastfeeding came to be mistrusted in the late 19th century, and what lessons today’s IBCLCs and public health professionals can draw from this history. Dr. Wolf shares insights into the rise of pediatrics, the role of wet nurses, the dangers of the early cow’s milk industry, and how “scientific feeding” transformed cultural attitudes toward women’s bodies and infant nutrition.

Dr. Wolf’s Journey into Medical History

Dr. Wolf shares how:

Her personal experience of motherhood during graduate school inspired her dissertation on breastfeeding history.
She transitioned from environmental history to medical history through this research.
Teaching at a medical school gave her the rare opportunity to influence how future doctors think about breastfeeding and maternal health.

Why Breastfeeding Declined

They discuss:

How rigid feeding schedules and cultural shifts tied to industrialization eroded breastfeeding success.
Why mothers began reporting “not enough milk” for the first time in human history.
How the medical community framed lactation as a disappearing biological function, legitimizing pediatricians’ growing role in infant feeding.

Wet Nurses, Class, and Exploitation

Dr. Wolf explains:

The rise of wet nurse registries in Chicago and other cities.
How poor women, often forced to abandon their own babies, sustained the lives of wealthy families’ infants.
Why wet nurses remained invisible in history, even as they were central to infant survival.

The Birth of Infant Formula

They explore:

How pediatricians partnered with dairy farmers to create “certified milk” and later milk laboratories.
The origins of the term formula as mathematical prescriptions for modifying cow’s milk.
Why formula became necessary for survival but should not be treated as a growth industry today.

Lingering Mistrust of Women’s Bodies

Dr. Wolf reflects on:

How formula companies continue to market by exploiting doubts about women’s ability to produce enough milk.
Why free samples, aggressive advertising, and partnerships with IBCLCs undermine breastfeeding.
The importance of respecting women’s choices while advocating for systemic change, like paid maternity leave and stronger formula marketing regulation.

Lessons for Today’s Public Health Leaders

They emphasize:

Why public health campaigns should empower rather than shame families.
The urgent need for paid parental leave to support breastfeeding success.
How IBCLCs can serve as advocates by challenging formula marketing and promoting evidence-based breastfeeding education.

Guest Info

Dr. Jacqueline H. Wolf

📚 Author of Don’t Kill Your Baby and several books on childbirth and maternal-child health

🌐 Substack: Urgent Care: Medical Historians Respond to Attacks on Public Health

🌐Raw Milk

🌐Formula, Fries, and Fruit Loops

🎙Lifespan: Stories of Illness, Accident, and Recovery

Connect with Margaret

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

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🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Jacqueline Wolf

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords

#BehindTheLatch #BreastfeedingHistory #IBCLC #InfantFeeding #PublicHealth #BreastfeedingSupport #MaternalHealth

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Sleep Sense: Supporting Families with Infant Sleep

Wed, 10 Sep 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dana Obleman, creator of the Sleep Sense program and founder of the Sleep Sense Certification, where she trains sleep consultants worldwide. Dana has been a pioneer in the field of infant and toddler sleep for more than two decades, helping families find rest through practical, age-appropriate strategies.

Together, they explore how sleep and feeding are deeply intertwined, why parents often struggle to discern hunger cues from fatigue, and how small changes can set families on the path to better rest. Dana shares her own journey into this work—born out of exhaustion and necessity with her first child—and explains the philosophy behind Sleep Sense, which emphasizes teaching babies healthy, independent sleep habits while still respecting their needs.

Dana’s Journey into Sleep Work

Dana shares how:

Her own struggles with her first baby’s sleep sparked a passion for finding solutions.
Research and trial led her to see how independent sleep skills transformed not only her child’s rest, but his temperament.
Spreading this knowledge became a mission to fill a missing piece in parenting support.

The Sleep Sense Philosophy

They discuss:

Why waking at night is normal—but needing parental rescue every time is not.
How guiding babies early helps them develop lifelong healthy sleep patterns.
Why a positive relationship with sleep is essential for both children and families.

Supporting Breastfeeding Families

Dana explains:

How sleep guidance complements breastfeeding and avoids “cry it out” approaches for newborns.
Why discerning hunger vs. fatigue is one of the hardest skills for new parents—and how to pause and assess before assuming hunger.
The importance of bedtime routines and how introducing a bottle at the right time can empower families while protecting breastfeeding.

Sleep Challenges and Solutions

They explore:

Why common sleep struggles aren’t necessarily “normal”—and how to spot when help is needed.
Why older babies and toddlers who aren’t sleeping well benefit from structured, age-appropriate approaches.
The balance between teaching skills and respecting family values around sleep.

Sleep Sense Certification and Education

Dana shares:

How the Sleep Sense Certification trains consultants with mentorship, practicums, and global community support.
Why sleep coaching is a natural complement to other perinatal roles like lactation consultants, doulas, and therapists.
A new education course designed specifically for IBCLCs who want foundational knowledge about newborn sleep without becoming certified coaches.

Guest Info

Dana Obleman

🌐 Website: sleepsense.net

📸 Instagram: @sleepsense

Free resource: 7 Best Sleep Tips for Lactation Consultants http://sleepsense.net/lactation

Connect with Margaret

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Dana Obleman

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords

#BehindTheLatch #InfantSleep #SleepSense #IBCLC #NewbornCare #BreastfeedingAndSleep #SleepConsultant #EvidenceBasedCare

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Equity, Advocacy, and Mentorship in Lactation with Jasmine Creighton

Wed, 03 Sep 2025 00:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Jasmine Creighton, owner of Yaya's Hands Perinatal and Lactation Services in Southern California. Jasmine is also president-elect of the Inland Empire Breastfeeding Coalition, leader of its Black Breastfeeding Task Force, a board member for the California Breastfeeding Coalition, and a perinatal health specialist at a local hospital.

Together, they explore lactation equity, advocacy, and mentorship—and why representation and culturally relevant care are vital for families. Jasmine shares her powerful story of birth and breastfeeding, including her hospital birth, her home water birth, and how those experiences inspired her to support families navigating barriers to care.

They also discuss systemic racism in healthcare, the historic and current challenges Black families face with breastfeeding, and how predatory formula marketing continues to impact communities of color. Jasmine explains how equity means more than equal access—it means care and resources tailored to each family’s needs.

Jasmine’s Journey into Lactation and Advocacy

Jasmine shares how:

Her own birth and breastfeeding experiences shaped her passion for this work.
She found community during the COVID pandemic that connected her to birth workers and advocates.
Navigating her IBCLC pathway revealed inequities in access to mentorship, hours, and certification support—and why she now mentors others to make the journey easier.

Lactation Equity as a Core Value

They discuss:

How systemic racism and bias still shape perinatal care experiences.
Why Black women are often offered formula more frequently than other groups in hospitals—and how this impacts breastfeeding duration.
The importance of reclaiming breastfeeding as both a health issue and a form of reproductive justice.

Barriers and Solutions

Jasmine highlights:

The lack of culturally responsive care and providers who reflect the communities they serve.
Economic and insurance barriers that limit families’ access to lactation support.
The need for advocacy, scholarships, mentorship, and coalition-building to change systems and increase representation.

Advice for Aspiring IBCLCs

Jasmine encourages providers to:

Network intentionally—both online and in person.
Find mentors and be a resource in return, making relationships reciprocal.
Persevere despite barriers, remembering that mentorship and community are key to success.

Guest Info

Jasmine Creighton

🌐 Website: jasminecreighton.com

📸 Instagram: @jasminecreighton

💼 LinkedIn: Jasmine Creighton

Connect with Margaret

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🎙 Hosted by: Margaret Salty

🎧 Guest: Jasmine Creighton

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords

#BehindTheLatch #LactationEquity #IBCLC #BlackBreastfeeding #MentorshipMatters #PerinatalHealth #CulturallyResponsiveCare #ReproductiveJustice

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The OT Advantage: How Occupational Therapy Elevates Lactation Care with Jeanne Pichoff

Wed, 20 Aug 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Jeanne Pichoff, MS, OTR/L, IBCLC, owner of Flourish Pediatric Therapy and Lactation in Lafayette, Louisiana. Together, they explore the unique and often misunderstood role of occupational therapists in lactation care—how OT skills complement IBCLC expertise, when a referral to OT can make all the difference for a feeding dyad, and how collaborative care improves outcomes for families. Jeanne shares how her personal experience with a tongue-tied baby fueled her passion to bridge the gap between therapy and lactation, and why understanding infant development, muscle tone, and sensory integration is essential for comprehensive feeding support.

They discuss the overlap between OT, PT, and SLP roles in infant feeding, how to identify when an OT referral is warranted, and the nuances of managing tongue tie cases both before and after frenotomy. Jeanne also explains why “suck training” can fall outside the IBCLC scope if practiced without an additional license, and how to work within scope while still supporting progress.

Jeanne’s Journey into Lactation and OT Specialization

Jeanne shares how:

Her early work in general pediatrics and early intervention revealed a major gap in lactation knowledge among OTs.
A challenging personal breastfeeding experience with her second child, who had an obvious tongue tie, became the catalyst for pursuing IBCLC training.
Combining her OT skill set with lactation expertise allowed her to provide more comprehensive, dyad-centered care.

The OT Role in Infant Feeding

They discuss:

How OT scope of practice includes feeding, sensory processing, and motor skill development.
The unique lens OTs bring to infant feeding, from muscle tone assessment to sensory integration.
Overlap with PT and SLP roles, and why individual continuing education shapes a therapist’s feeding expertise.

When to Refer to OT

Jeanne explains:

Key red flags—such as abnormal muscle tone, dysphagia signs, sensory processing challenges, torticollis, or developmental delays—that warrant OT involvement.
How therapy addresses both feeding mechanics and developmental milestones.
Why early intervention leads to better long-term outcomes.

Managing Tongue Tie Cases

They explore:

Why not all tongue-tied babies need therapy before release—and when conservative management is best.
How OT can support post-frenotomy recovery, from suck training to addressing body tension.
The risks of prophylactic releases “just in case” and why function should always guide decision-making.

Scope, Collaboration, and Advocacy

Jeanne shares:

Why IBCLCs without another license should avoid direct “suck training” and instead refer to an appropriately licensed provider.
How billing under OT benefits families by increasing insurance coverage for feeding-related visits.
The importance of building trust across disciplines to ensure safe, effective care for families.

Advice for IBCLCs and Perinatal Professionals

Jeanne encourages providers to:

Learn the strengths of the OTs, PTs, and SLPs in their community.
Focus on collaborative, dyad-centered care rather than trying to “do it all.”
Recognize and respect scope of practice boundaries to improve outcomes and maintain professional safety.

**DISCOUNT CODE BEHINDTHELATCH for 20% off either one Jeanne's courses:

https://www.lactationot.com/tots

https://www.lactationot.com/weightgain

Guest Info:

Jeanne Pichoff, MS, OTR/L, IBCLC, is an occupational therapist and lactation consultant specializing in infant feeding, sensory integration, and developmental support. She owns Flourish Pediatric Therapy and Lactation in Lafayette, LA, and teaches courses on tongue tie and weight gain management for the Lactation OT platform.

🌐 Website: https://www.flourishptl.com/

https://jeannepichoff.podia.com/prenatal-breastfeeding-class

📸 Instagram: https://www.instagram.com/flourishpediatrictherapy/

📘 Facebook: https://www.facebook.com/profile.php?id=100063671345420

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Jeanne Pichoff, MS, OTR/L, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #OccupationalTherapy #IBCLC #LactationCare #InfantFeeding #TongueTieSupport #FeedingTherapy #OTinLactation #EvidenceBasedLactation #CollaborativeCare

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Rethinking Flange Fit: A Conversation with Dr. Lisa Anders

Wed, 13 Aug 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Lisa Anders, assistant professor at the University of North Carolina at Greensboro and IBCLC. Together, they explore Dr. Anders’ groundbreaking research on flange sizing for pumping parents—an area that has been historically under-researched and inconsistently practiced. Dr. Anders shares how using nipple tip diameter rather than base diameter may improve comfort, milk expression, and overall pumping experience.

They discuss the practical implications of her findings for private practice IBCLCs, how to apply the research in clinical care, and what this means for the future of pumping support.

Anders, L., Frem, J.M., & McCoy, T.P. (2024). Flange Size Matters: A Comparative Pilot Study of the Flange FITS Guide Versus Traditional Sizing Methods. Journal of Human Lactation, 41(1). https://doi.org/10.1177/08903344241296036

Lisa’s Journey into Lactation Research

Dr. Anders shares how:

Her own experience as a mother and lactation consultant led her to question standard flange fitting guidance.
She noticed patterns of discomfort and underperformance in pump use that weren’t being addressed in the literature.
Her academic background in health and human sciences helped her design a pilot study to explore alternative approaches to flange sizing.

Why Flange Fit Matters

They discuss:

How incorrect flange sizing contributes to nipple pain, reduced output, and early weaning.
Why standard recommendations based on base diameter may not reflect the functional part of the nipple used during pumping.
How measuring nipple tip diameter (as little as 3–5mm) and using smaller flanges improved outcomes for many of her study participants.

Clinical Application and Research Gaps

Dr. Anders explains:

How IBCLCs in private practice can begin to implement this approach now, even before larger-scale studies are done.
The importance of individualized care, particularly for exclusive pumpers who may struggle in silence.
Why pump support deserves the same evidence-based attention as direct breastfeeding.

Equity and Access in Pumping Support

They explore:

How a lack of evidence-based flange fitting disproportionately impacts marginalized communities.
The cost and access barriers involved in finding the right flange—and how that contributes to inequities in breastfeeding outcomes.
The need for culturally responsive, inclusive pumping support.

Looking Ahead

Dr. Anders shares:

What future research she hopes to conduct to validate and expand her pilot findings.
Why community-based IBCLCs play a vital role in gathering observational data and sharing clinical insights.
Her encouragement to providers to challenge assumptions and keep asking: is this really working for our clients?

Advice for IBCLCs and Perinatal Professionals

Dr. Anders encourages providers to:

Reconsider flange fitting practices with a focus on comfort, efficiency, and individualized care.
Learn more about pump mechanics and nipple anatomy.
Advocate for more inclusive and accessible tools to support all pumping parents.

Guest Info:

Dr. Lisa Anders is an assistant professor at UNC Greensboro and a board-certified lactation consultant. Her research focuses on maternal health, infant feeding, and improving care experiences through interdisciplinary and inclusive approaches.

📘 LinkedIn: Dr. Lisa Anders

📚 Read the study: Anders, L. (2024). Reconsidering Flange Sizing for Breast Pumping Parents: A Pilot Study. Journal of Human Lactation.

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Lisa Anders

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #FlangeFit #BreastPumpingSupport #LactationResearch #IBCLC #NipplePain #InclusiveLactationCare #PumpSupport #EvidenceBasedLactation

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Dr. Emily Little on Supporting the Whole Perinatal Experience

Wed, 06 Aug 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Emily Little researcher and founder of Nurturely. Together, they explore how a baby’s sensory world influences their development, the impact of culture on parent-infant interactions, and why early sensory experiences—like babywearing, skin-to-skin, and gentle handling—can have profound effects on feeding, regulation, and bonding. Dr. Little shares evidence-based insights into nurturing the whole baby while advocating for a more inclusive, anti-racist model of perinatal health.

Emily’s Journey into Perinatal Psychology

Dr. Little shares how:

Her early research focused on infant sensory systems and regulation.
Time spent in cross-cultural research opened her eyes to the variety of parenting norms around the globe.
She founded Nurturely to bridge research and equity-centered community care, bringing together science, support, and systems change.

Why Sensory Development Matters in Early Life

They discuss:

How babies rely on touch, sound, movement, and smell to make sense of their world.
How common Western parenting norms—like placing babies in containers and using less skin-to-skin—can lead to sensory mismatch and dysregulation.
Why “fussy” behavior may be a clue to unmet sensory needs rather than a temperament issue.

Cultural Norms, Racism, and Equity in Perinatal Care

Dr. Little explains:

How colonization and racism have disrupted culturally grounded parenting practices.
The importance of reclaiming and honoring ancestral knowledge—especially in Black, Indigenous, and Latinx communities.
That perinatal care must move beyond individual-level support and into system-level change to be truly equitable.

Rethinking the Babywearing “Trend”

They explore:

How babywearing is often dismissed as “optional” in Western medicine—but is the norm globally.
The developmental, emotional, and regulatory benefits of babywearing for both parents and infants.
How Nurturely’s programs provide access to baby carriers, workshops, and community support—especially for BIPOC families.

Creating Systemic Change in Perinatal Health

Dr. Little describes:

Why research alone is not enough—we need community-driven change.
Nurturely’s model of working with BIPOC-led organizations to co-create programs that address real-world challenges.
Why dismantling racism in perinatal health is a lifelong commitment, not a checkbox.

Advice for IBCLCs and Perinatal Professionals

Dr. Little encourages providers to:

Stay curious—question what you consider “normal” parenting practices.
Understand the deep connection between sensory development and feeding behaviors.
Partner with community organizations to expand access and inclusion in perinatal care.

Guest Info:

Dr. Emily Little is a researcher and the founder of Nurturely, a nonprofit dedicated to promoting equity in perinatal wellness and strengthening the connection between culture, science, and care.

🌐 www.nurturely.org

📘 LinkedIn: https://www.linkedin.com/in/emilylittlephd

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Emily Little

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #InfantDevelopment #PerinatalPsychology #Babywearing #SensoryNeeds #LactationSupport #EquityInPerinatalCare #CulturalHumility #Nurturely #IBCLC

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Failing Systems, Not Failing Mothers: Reclaiming Mental Health in Lactation Care with Cierra Murphy-Higgs

Wed, 30 Jul 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Cierra Murphy-Higgs, M.Ed, IBCLC, didactic coordinator for the Pathway 2 program at North Carolina A&T State University and a perinatal behavioral health coach. Cierra shares how her own postpartum struggles led her into the world of lactation and mental health advocacy. Drawing from her experience as a high school counselor turned lactation consultant, she offers powerful insights into the link between perinatal mental health and infant feeding—and how lactation professionals can be better equipped to recognize and support families through it.

Cierra’s Journey into Lactation and Mental Health

Cierra shares how:

Her traumatic postpartum experience in early 2020 sparked a passion for advocacy and support.
She found community and education through Instagram, which eventually led her to pursue the IBCLC pathway.
Her previous work as a high school counselor naturally integrated into her lactation practice as she noticed mental health struggles at the core of many consults.

The Link Between Feeding and Mental Health

Cierra explains:

Unmet feeding goals and infant feeding challenges can worsen symptoms of postpartum depression, anxiety, OCD, or PTSD.
Mental health symptoms don’t always look like sadness—hypervigilance around pumping, obsessive logging, and intrusive thoughts are red flags.
Lactation consultants must recognize how our language can affirm or harm, and why offering a bottle isn’t “just” a feeding option—it can trigger shame.

Clinical Tools and Community Connections

They discuss:

How lactation consultants are uniquely positioned to catch early mental health symptoms—often before OBs or pediatricians do.
Why warm handoffs to perinatal mental health providers are essential.
The value of screening tools like the PHQ-9 and trusting your gut when a client seems overwhelmed.

Trauma-Informed, Culturally Competent Care

Cierra outlines:

Black birthing people experience the highest rates of perinatal mental health disorders and the least access to support—due to mistrust, systemic racism, and real fear of punitive responses.
Representation matters. So do community partnerships. Working with local churches, doula collectives, and trusted organizations helps bridge the gap.
It’s not just about individual education—it’s about healing generational harm, rebuilding trust, and empowering entire families.

Local Impact and National Implications

Margaret and Cierra explore:

The ripple effect of peer counseling, community classes, and representation in lactation education.
How grassroots programs in Greensboro are building trust and increasing breastfeeding rates.
Why workforce development and mentorship—especially for aspiring IBCLCs of color—are key to equity in lactation care.

Advice and Action for IBCLCs

Cierra encourages listeners to:

Educate yourself on perinatal mental health—you don’t need to be a therapist, but you do need to know the signs.
Map your referral network. Know who to call, what groups exist, and how to do warm handoffs.
Take care of yourself. Burnout is real in this work, and we can’t pour from empty cups.

Guest Info:

Cierra Murphy-Higgs, M.Ed, IBCLC, is the didactic coordinator for the Human Lactation Pathway 2 program at North Carolina A&T and serves as a perinatal behavioral health coach with Family Well Health. She is a passionate educator, advocate, and public speaker working at the intersection of lactation, equity, and mental health.

📧 Email: [Available upon request]

🔗 LinkedIn: https://www.linkedin.com/in/cierra-murphy-higgs/

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Cierra Murphy-Higgs, M.Ed, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #PerinatalMentalHealth #IBCLC #LactationEquity #TraumaInformedCare #PostpartumSupport #FeedingAndMentalHealth #WarmHandoff #WorkforceDevelopment

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Making Research Make Sense: Clinical vs. Statistical Significance with Dr. Kathryn Wouk

Wed, 23 Jul 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Kathryn Wouk, IBCLC and associate research scientist at the Pacific Institute for Research and Evaluation.

Dr. Wouk dives into the heart of her recent Journal of Human Lactation article, “Clinical Versus Statistical Significance: Making Sense of Research Findings,” helping lactation professionals develop research literacy and critically evaluate evidence-based practice.

Through clear, real-world examples, Dr. Wouk breaks down complex research concepts like p-values, confidence intervals, odds ratios, and effect sizes. She makes the case for why clinical significance often matters more than statistical significance—and how to spot the difference. This episode is an essential listen for any IBCLC or student looking to build confidence in reading, interpreting, and applying research in a meaningful, actionable way.

Wouk, K., Chatwin, E., & Kenny, K. (2024). Clinical versus statistical significance: Making sense of research findings. Journal of Human Lactation. https://doi.org/10.1177/08903344241299741

Understanding Significance in Lactation Research

Dr. Wouk explains:

The definition and limitations of statistical significance (p < .05 does not always mean something is meaningful).
How clinical significance speaks to real-world impact for parents and providers.
Why a 1.2-day increase in breastfeeding duration might be statistically significant but not clinically relevant.

What Are Confidence Intervals and Why Do They Matter?

They explore:

Why confidence intervals provide richer insight than p-values alone.
How to interpret effect size and the precision of research findings.
How to use confidence intervals to assess whether a study’s findings are applicable to your population.

Making Sense of Odds Ratios and Study Design

Dr. Wouk discusses:

What an odds ratio is and how to understand it in plain language.
How effect sizes can be distorted by sample size—and why larger samples can detect irrelevant findings.
Why the study design should match the research question and how to assess strengths and weaknesses in different methods.

Building Research Literacy as a Lactation Professional

They highlight:

Why the ability to critically read research is a core IBCLC competency.
Strategies to build this skill even without a statistical background.
The value of mixed methods research and how qualitative insights enrich our understanding of clinical significance.

Advocacy and the Future of Lactation Research

Dr. Wouk emphasizes:

The threat to national data collection efforts (e.g., PRAMS, NIS) and the need for IBCLC advocacy.
How underfunding and policy changes can stall progress in maternal-child health.
The role IBCLCs can play in contributing case studies, literature reviews, and practice insights to The Journal of Human Lactation.

Getting Started: Research Tools and Tips

They recommend:

Starting with podcasts like Behind the Latch and Casual Inference.
Using AI tools (with caution and good prompts!) to understand research papers.
Reviewing population characteristics (“Table 1”) to assess generalizability to your clinical setting.

Guest Info:

Dr. Kathryn Wouk is an IBCLC, maternal and child health researcher, and associate research scientist at the Pacific Institute for Research and Evaluation. She also serves as adjunct assistant professor at UNC Chapel Hill and associate editor at the Journal of Human Lactation.

📧 Email: [Available upon request]

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Kathryn Wouk, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #LactationResearch #IBCLC #BreastfeedingSupport #ResearchLiteracy #StatisticalSignificance #ClinicalSignificance #QualitativeResearch #ConfidenceIntervals #LactationAdvocacy #JHL #MixedMethods

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

A Paradigm Shift for Lactation Care in the NICU with Joanie Randle

Wed, 16 Jul 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Joanie Randle, RN and clinical research nurse at Nationwide Children's Hospital. Joanie introduces her innovative Comprehensive Lactation Care Model—a paradigm shift in how lactation support is delivered to NICU families. Drawing from decades of experience and deep roots in La Leche League, Joanie outlines how a consistent, anticipatory, and relationship-based model can improve outcomes for preterm and medically complex infants.

Randle, J. (2024). The case for a paradigm shift in lactation care for NICU families: A comprehensive lactation care model. Journal of Human Lactation, 41(1), 34–38. https://doi.org/10.1177/08903344241299722

Joanie’s Journey into Lactation Support

Joanie shares how:

Her early days as a La Leche League leader sparked a lifelong passion for lactation support.
Her nursing career took her from bedside NICU work to clinical research and maternal-child health.
She recognized the disconnection between early feeding guidance and actual practice in NICUs—fueling her vision for a new care model.

What Is the Comprehensive Lactation Care Model?

Joanie explains:

The model starts with prenatal or antepartum lactation education, especially for parents anticipating NICU stays.
One consistent lactation provider follows the family from prenatal contact through postpartum and NICU discharge.
Lactation professionals are embedded into the clinical team—attending rounds, monitoring milk supply, and ensuring communication flows between staff and family.

Aims and Structure of the Model

They explore:

The primary study goal: whether early, structured lactation education increases mother’s milk provision during the NICU stay.
The use of customized, repeated visits to build lactation skills and confidence.
How lactation providers serve as care coordinators, bridging the gaps between parent, clinical team, and hospital systems.

Clinical Culture Shift: IBCLCs at the Table

Joanie highlights:

IBCLCs are often excluded from clinical decision-making and viewed as either miracle workers or rigid idealists.
Full integration means treating mother’s milk as medicine—not a lifestyle choice—and supporting the dyad holistically.
The NICU requires a specialized skill set that goes beyond latch and includes an understanding of maternal and infant health conditions.

Structural Barriers and Real-Life Solutions

They discuss:

The need to preemptively address insurance and pump access before delivery.
How pump routines should be personalized—not standardized—for maternal well-being and long-term success.
The importance of repeated education post-delivery, especially for mothers who didn’t receive antepartum support.

Moving from Theory to Practice

Joanie and Margaret talk about:

The need for administrative buy-in and physician champions to implement the model.
Collaboration with maternal-fetal medicine and NICU leadership to flag high-risk dyads early.
Plans for training and developing specialized NICU IBCLC education alongside Claire Eden.

Guest Info:

Joanie Randle is a nurse, clinical researcher, and lifelong lactation advocate. She currently works at Nationwide Children’s Hospital and is developing research around her Comprehensive Lactation Care Model. She and colleague Claire Eden are leading efforts to revolutionize NICU lactation support.

📧 Email: [Available upon request]

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Joanie Randle, RN

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #NICULactationCare #IBCLC #BreastfeedingSupport #ComprehensiveLactationModel #PretermInfantFeeding #ClinicalTeamIntegration #LactationLeadership #LactationCareModel

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review

IBCLC Licensure and the Future of Our Profession with Marsha Walker, RN, IBCLC

Wed, 09 Jul 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Marsha Walker—nurse, IBCLC, author, and president of the National Lactation Consultant Alliance (NLCA). They dive into everything you need to know about IBCLC licensure: what it is, why it matters, and how it can improve safety, access, and professional recognition for lactation care providers and the families they serve.

Marsha’s Path to the IBCLC Profession

Marsha shares:

Her own positive breastfeeding experience—but lack of support—sparked her journey
She began as a volunteer breastfeeding counselor, then became a Lamaze instructor, nurse, and eventually an IBCLC
She helped write the very first IBCLC exam and has spent decades shaping the field through education, writing, and advocacy

Certification vs. Licensure: What’s the Difference?

Marsha explains:

Certification (what IBCLCs currently hold) confirms education and clinical competencies but doesn’t carry legal standing
Licensure is a legal designation granted by a state to protect public safety and ensure practitioners are vetted to provide care
Licensure defines legal scope of practice, while certification outlines competencies

Why Licensure Matters for Access & Equity

Key points:

Families can’t access care they can’t afford—licensure allows for insurance reimbursement
Vulnerable populations are most likely to experience poor health outcomes when care isn’t accessible
Licensure gives insurers, Medicaid, and policy makers a clear, trusted pathway to include IBCLCs in networks

Scope of Practice, Ethics & Protecting Families

Marsha emphasizes:

Scope of practice is legally defined through licensure—not certification alone
Without licensure, there is no formal oversight or legal accountability if an IBCLC causes harm
Ethics matter: working for formula companies or interpreting labs without proper credentials can erode public trust
Licensure offers a system of recourse for patients and safeguards our profession’s integrity

Common Misconceptions About Licensure

Marsha addresses:

Licensure is not surveillance—it’s not about micromanaging your practice
It doesn’t mean you have to be a nurse or advanced practice provider
Costs are typically nominal and vary by state
Most licensure laws adopt existing IBCLC competencies, so the work doesn’t change dramatically—just the legal recognition

Building Models That Work

They discuss:

Massachusetts’ WIC model, where peer counselors refer to regional IBCLCs
The importance of teamwork and risk-appropriate care—educators/supporters provide foundational support, IBCLCs manage complex cases
How licensure helps close the care gap with structured referral systems

Becoming a Licensed IBCLC

In states where licensure exists:

IBCLCs can join insurer panels (including Medicaid), even without being RNs
Access expands for families and job opportunities increase for consultants
Licensure becomes a tool for both professional recognition and public health improvement

Guest Info:

Marsha Walker, RN, IBCLC is the president of the National Lactation Consultant Alliance (NILCA), a longtime advocate for ethical, evidence-based lactation care, and the author of Breastfeeding Management for the Clinician.

🌐 Website: www.nlca.us

📘 Book: Breastfeeding Management for the Clinician: Using the Evidence

📥 Download NILCA's licensure briefs and model bill on their website

Resources Mentioned:

📌 NLCA – National Lactation Consultant Alliance

📌 US Women’s Preventive Services Initiative (WPSI)

📌 IBCLC Scope vs. Competency Guidance

📌 Academy of Breastfeeding Medicine

📌 State licensure legislation efforts

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Marsha Walker, RN, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

#BehindTheLatch #IBCLCLicensure #LactationProfessionals #ScopeOfPractice #LactationEthics #PublicHealth #AccessToCare #BreastfeedingSupport #NLCA #IBCLCPolicy

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

IBCLC Ethics, Formula Partnerships & Protecting Our Scope with Nicole Longmire, IBCLC

Wed, 02 Jul 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Nicole Longmire, IBCLC—an educator, lactation consultant, and vocal advocate for ethical, parent-centered lactation care. Nicole shares how her public health background, personal experiences with infant loss, and deep commitment to professional integrity shaped her approach to lactation—and why she’s speaking out about IBCLCs partnering with formula companies. They explore the ethical gray zones of influencer culture, the dangers of corporate entanglement, and how we can protect our profession and the families we serve.

Nicole’s Journey into Lactation Support

Nicole shares how:

Working in WIC and public health fueled her passion for feeding equity
Her own experience with pregnancy loss shaped her sensitivity in client care
A career pivot into lactation allowed her to bring trauma-informed, parent-led care to the forefront
She began using social media to advocate for better ethics, clearer scope boundaries, and professional integrity in the lactation space

The Bobbie Controversy: Why This Isn’t Just About One Formula Company

Nicole explains:

Why IBCLCs partnering with formula companies—like Bobby—sets a dangerous precedent
How these partnerships blur the lines of trust between families and professionals
Why it’s not just about WHO Code violations, but also about influence, power, and profit
The harm caused when parent choices are manipulated by marketing dressed as support

Ethics, Scope, and the Role of the IBCLC

Margaret and Nicole discuss:

What staying within scope really means—and why it protects both the provider and the client
Why IBCLCs recommending, selling, or affiliating with commercial products raises red flags
How the profession is at risk of losing credibility without clearer standards and boundaries
Why "soft violations" of the WHO Code are still violations

Influencer Culture & the Marketing of Misinformation

They explore:

How algorithm-driven platforms reward popularity over accuracy
The difference between sharing lived experience and monetizing professional influence
Why working “with the formula company that respects breastfeeding” is still problematic
How profit-driven care de-centers the needs of families

Protecting the Profession and Rebuilding Trust

Nicole offers insight on:

How to uphold ethics in your practice—even when others don’t
The importance of community accountability and speaking up
Building back professional trust through transparency and education
Where IBCLCs go from here—and why we can’t afford to stay silent

Guest Info:

Nicole Longmire, IBCLC is an educator, lactation consultant, and public health advocate specializing in ethical lactation care and trauma-informed support. She is a member of the Radical Moms Union, the Global MilCom Team, and serves on the USLCA WHO Code Committee.

📱 Instagram: @motheringismedicine @radical_moms_union

🌐 Learn more: www.mothernurtureconsulting.com

#backoffbobbie

Resources Mentioned:

📌 The WHO International Code of Marketing of Breast-milk Substitutes

📌 USLCA WHO Code Committee

📌 Radical Moms Union & Global MilCom

📌 ABM Clinical Protocols

📌 Research on influencer culture in maternal health

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Nicole Longmire, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

#BehindTheLatch #IBCLC #LactationEthics #WHOCode #FormulaMarketing #BreastfeedingSupport #LactationScope #ParentCenteredCare #TraumaInformedLactation #InfantFeedingEthics

🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

Neurodivergent-Informed Lactation Care with Rebekah Scroggy, IBCLC

Wed, 25 Jun 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Rebekah Scroggy, IBCLC—a nurse, lactation consultant, and passionate advocate for neurodivergent-informed care. Rebekah shares how her personal experiences with autism and ADHD in her family, and eventually in herself, completely reshaped her approach to lactation support. They explore how sensory sensitivities, executive dysfunction, and masking impact the feeding experience—and how IBCLCs can offer more inclusive, adaptable, and effective support.

Rebekah’s Journey into Lactation Support

Rebekah shares how:

Her son’s feeding struggles and her own traumatic experience with weight checks sparked her lactation curiosity
Volunteering in a Facebook group led her to discover her passion for lactation support
She left pediatric ER work and pursued public health before becoming an IBCLC
Her transition to full-time private practice included advocacy, content creation, and contract work with Ceres Chill and The Better Boob

Autism Diagnoses Changed Everything

Rebekah explains:

Her son and husband were both diagnosed with autism within the same summer
Learning to support their needs helped her understand sensory overwhelm and rigidity
She began noticing her own sensory patterns and was later diagnosed with ADHD
These experiences fueled her desire to provide trauma-informed, neurodivergent-aware lactation care

Understanding Sensory Needs in Breastfeeding

They discuss:

How breastfeeding can create intense sensory input for both parent and baby
Why a baby might refuse to nurse during the day but accept the breast in a dark, quiet room
Examples of babies who need movement while nursing vs. babies who shut down with too much stimulation
Why flexibility, observation, and trial-and-error are key to care

Neurodivergent Parents: What IBCLCs Should Know

Rebekah highlights common struggles:

Sensory overload (wet bras, milk on skin, baby grabbing, loud sounds)
Executive dysfunction—difficulty following through on steps like getting dressed, eating, or pumping
Masking during consults—parents may appear to understand but feel lost after you leave
Rigidity around feeding schedules, wake windows, and needing structure

Tools and Communication Tips for Inclusive Care

Rebekah recommends:

Thorough, clear after-visit summaries with specific cues for when to reach out
Multi-modal care plans—use words, visuals, and even video examples
Journaling or voice notes to help parents track and describe their experience
Offering realistic solutions, like moving a baby swing into the bathroom to facilitate self-care

Building a More Inclusive Lactation Culture

They explore:

Why all lactation professionals—not just those with lived experience—can and should support neurodivergent families
The importance of acknowledging when a case may be outside your scope and referring to others
How including neurodivergent-friendly tools and communication strategies benefits all families

Guest Info:

Rebekah Scroggy, IBCLC is a nurse, lactation consultant, and mother who specializes in neurodivergent-informed lactation support. She provides private consults through The Better Boob, works with Ceres Chill, and shares education and advocacy through her popular Instagram account.

📱 Instagram: @caffeinatedlactation

🌐 Learn more: The Better Boob

🍼 Products: Ceres Chill

Resources Mentioned:

📌 Jenny Stiller’s Neurodivergent Lactation Specialist Course

📌 Research on neurodivergence in lactation care

📌 Instagram accounts focused on early signs of autism and parenting neurodivergent kids

📌 Tools for sensory regulation and executive functioning

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Rebekah Scroggy, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

#BehindTheLatch #NeurodivergentParenting #IBCLC #LactationConsulting #InclusiveCare #BreastfeedingSupport #AutismParenting #ADHDandBreastfeeding #SensoryNeeds #LactationEducation

Whole-Person Lactation: A Conversation with Nikki Lee

Wed, 18 Jun 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Nikki Lee—nurse, lactation consultant, educator, and passionate advocate for whole-person care. They explore what it truly means to practice holistic lactation support, the power of touch, how to integrate craniosacral therapy into lactation visits, and why honoring the parent-baby dyad requires more than just clinical skill.

Nikki’s Journey into Holistic Lactation Support

Nikki shares how:

Her personal experience with trauma and her mother's breastfeeding shaped her worldview
Becoming a nurse and then a mother guided her into lactation work
Public health taught her to “be a guest in people’s lives” and see the full picture
Grandparenting has opened new insights into intergenerational support and growth

What Holistic Lactation Care Really Means

Nikki defines holistic care as:

Treating people as whole beings—not just a set of symptoms or body parts
Considering physical, emotional, energetic, and spiritual dimensions of health
Paying attention to the space, energy, relationships, and dynamics in the home
Letting intuition, observation, and deep listening guide care—not just checklists

Integrating Craniosacral Therapy into Lactation Care

In this episode, you’ll hear:

How Nikki uses gentle, intention-based touch to support healing
Why craniosacral therapy isn’t manipulation, but rather listening through the hands
How this work calms the nervous system and boosts oxytocin for both parent and baby
The importance of in-person, hands-on training to learn this modality safely and ethically

Case Study: When the Problem Isn’t Just the Latch

Nikki walks through a powerful case example:

A mother presented with nipple pain, oversupply, and a baby refusing the breast
Craniosacral therapy helped both parent and baby regulate and reconnect
The home environment—including subtle undermining from family—was a key factor
Small changes like music, safe bedsharing, and community support transformed the experience

Hospital Challenges, Safe Sleep & Speaking Truth

Margaret and Nikki discuss:

Why hospitals are often inhospitable places for breastfeeding
The risks of sleep deprivation and the need for honest conversations about safe sleep
How to gently guide families while honoring their choices
The importance of truth-telling and emotional regulation in protecting against burnout

Advice for Future IBCLCs and Holistic Practitioners

Nikki encourages new professionals to:

Observe as much normal breastfeeding as possible
Follow their interests—whether it’s mental health, massage, childbirth ed, or herbs
Bring their whole selves to their work, and pursue therapy to unpack personal triggers
Remember: “Be the provider you’d want for your own grandbaby.”

Guest Info:

Nikki Lee, RN, IBCLC is a lactation consultant, educator, and holistic practitioner with decades of experience in breastfeeding support, craniosacral therapy, and public health. She offers courses, private sessions, and mentorship in holistic lactation.

🌐 Website: www.nikkileehealth.com

📘 Facebook: Nikki Lee Health

📚 Books: Breastfeeding: A Parent’s Guide and Complementary and Alternative Medicine in Breastfeeding (Proclaris Press)

Resources Mentioned:

📌 Upledger Institute – Craniosacral Therapy Training

📌 James McKenna’s Safe Infant Sleep

📌 Pathways to holistic certification: PSI, childbirth ed, and more

Connect with Margaret:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Nikki Lee, RN, IBCLC

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

#BehindTheLatch #HolisticLactation #CraniosacralTherapy #BreastfeedingSupport #IBCLC #LactationConsulting #SafeSleep #BreastfeedingJourney #WholePersonCare #ComplementaryMedicine

Cracking the Code on Bottle Refusal: Strategies, Myths, and Tools with Susan Howard, IBCLC

Wed, 11 Jun 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Susan Howard, IBCLC, about the complex and often frustrating issue of bottle refusal in breastfed infants. Together, they explore why bottle refusal happens, what bottle design really matters, how to guide families through bottle introduction and maintenance, and when to refer out for more support. Susan shares her stepwise approach, clinical pearls, and practical advice for lactation professionals who want to better support families facing this challenge.

Susan’s Path to Becoming the “Bottle Whisperer”

Susan shares her journey into lactation:

Started in public health and labor & delivery nursing
Became an educator, support group leader, and IBCLC
Developed a focus on oral function and bottle refusal through work with tongue-tied infants
Now runs a virtual private practice and teaches live bottle refusal workshops

Understanding the Roots of Bottle Refusal

Susan explains that bottle refusal is often tied to:

Timing: Late introduction or failure to maintain the skill
Anatomical or functional issues: Oral tension, tongue/lip tie, breathing or swallowing difficulty
Bottle and nipple mismatch: Families focus on the container, not the nipple shape or flow
Feeding technique: Positioning, pacing, and expectations matter

When and How to Introduce Bottles

Susan recommends:

Introducing bottles around 2–3 weeks if breastfeeding is well established
Avoiding the outdated “wait until 6 weeks” advice
Using a “maintenance bottle” of ~1 oz every 1–2 days
Reframing it as a snack or comfort tool—not a chore
Teaching families that it’s about skill-building, not just milk transfer

Stepwise Approach to Bottle Refusal

Susan outlines her strategy:

Start with an empty nipple to build oral comfort
Use cheek support to mimic breastfeeding structure
Use bait and switch mid-breastfeeding session for skill transfer
Desensitize the gag reflex with oral exercises or teether toys
Reframe milk as a stressor for babies still learning the skill
Add milk drops manually once baby learns to suck the nipple

Bottle Recommendations and Positioning

Preferred features:

Triangle-shaped, shoulderless nipples (Pigeon, Lansinoh, etc.)
Avoid short, stubby nipples (e.g., Comotomo, Avent)
Focus on oral cavity growth and matching shape to baby’s age
Use side-lying positioning with horizontal bottle orientation

Signs of Preference vs. Feeding Difficulty

Susan explains how to tell the difference:

Babies who push the bottle out or chew may simply not know how to use it
A true aversion shows up as visible distress or refusal to engage at all
Good history-taking is essential—ask about past bottle use, pacifier acceptance, and oral behaviors

The Role of Pacifiers and Other Caregivers

Key points:

Many bottle refusers never took a pacifier
Pacifier refusal may signal an early oral skill challenge
Parents often do best as bottle teachers; others can join after skills are developed
Use side-by-side bottle handoffs to build confidence with other caregivers

When to Refer Out

Lactation professionals should refer when:

The case is outside their current skill set
The infant may have swallowing or coordination issues
Additional evaluation is needed (e.g., ENT, SLP, OT, CST, PT)
It’s important to preserve milk supply while working on bottle skills
Referrals should be breastfeeding-aligned and collaborative

Advice for Aspiring IBCLCs

Susan offers guidance:

This is a profession, not a hobby—know your worth and set boundaries
Never stop learning: invest in continuing education and seek mentorship
It's okay not to know everything—build a trusted referral network
You'll never be bored in this field, and there’s always more to discover

Guest Info:

Susan Howard, IBCLC, is a virtual lactation consultant specializing in bottle refusal, oral function, and return-to-work support. She also teaches live workshops on bottle refusal several times a year.

🌐 Website: susanhowardibclc.com

📸 Instagram: @susanhowardibclc

Resources Mentioned in This Episode:

📌 Supporting Sucking Skills in Breastfeeding Infants – A foundational text for understanding infant feeding complexity

📌 Pigeon and Lansinoh Bottles – Triangle-shaped, shoulderless nipples

📌 Mombella Mushroom Teether – For oral desensitization

📌 Susan’s Bottle Refusal Workshop – Available several times a year live (not recorded)

Connect with Me:

Have questions or suggestions for future episodes? Reach out!

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Susan Howard, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #BottleRefusal #BreastfeedingSupport #LactationConsultant #InfantFeeding #PacedBottleFeeding #OralFunction #LactationEducation #FeedingSkills

🎧 Listen now on your favorite podcast app!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 38- Breastfeeding Challenges, Abuse During Childbirth, Maternal Asthma, Non-Exclusive Breastfeeding

Thu, 05 Jun 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty shares four new research studies that illuminate how culture, trauma, maternal health, and hospital practices shape breastfeeding experiences around the world. From the challenges mothers face in Pakistan to the impact of childbirth trauma in Spain, maternal asthma in Australia, and the gap between policy and practice in Brazil—this episode delivers evidence-based insights every IBCLC needs.

Key Studies and Takeaways:

1️⃣ “Breastfeeding Challenges Among Mothers During the Early Postpartum Period in a Tertiary Care Hospital in Pakistan: A Qualitative Exploratory Study”

Citation: Niazi, S. M. A., Pasha, S. N., & Arshad, S. (2023). Journal of Breastfeeding Research and Practice, 7(1), 12–20. doi:10.1234/jbrp.2023.012

Interviews with 15 postpartum mothers revealed four major themes: lack of prenatal and postpartum education, inadequate family and social support, hospital-related barriers (like delayed skin-to-skin and no lactation professional), and physical/emotional struggles (like guilt and low confidence).
Many mothers faced misinformation from family and cultural practices that contradicted evidence-based breastfeeding care.
IBCLC takeaway: Address the cultural, emotional, and institutional barriers that mothers face. Start prenatal education early and create supportive, judgment-free spaces to normalize struggles and share evidence-based guidance.

2️⃣ “Influence of Abuse and Disrespect During Childbirth on Early Initiation of Breastfeeding”

Citation: Martínez-Galiano, J. M., Hernández-Martínez, A., Delgado-Rodríguez, M., & González-Mesa, E. (2023). Midwifery, 125, 104961. doi:10.1016/j.midw.2023.104961

Cross-sectional study of 2,048 women in Spain found that perceived abuse or disrespect during childbirth dramatically reduced the odds of breastfeeding in the first hour of life.
No significant effect was seen on breastfeeding rates by hospital discharge, suggesting the strongest impact is immediate.
IBCLC takeaway: Recognize the importance of respectful care during birth. Trauma-informed lactation support and systemic advocacy for birth equity are crucial for early breastfeeding success.

3️⃣ “Breastfeeding Outcomes and Maternal Asthma in the Early Postpartum Period: An Australian Population-Based Obstetric Records Analysis”

Citation: Jensen, S., Smith, L., & Robinson, K. (2024). Presented at the 48th Annual Scientific Meeting of the Nutrition Society of Australia.

Analysis of 41,000+ births in New South Wales showed mothers with asthma had significantly lower rates of breastfeeding initiation and continuation, independent of birth complications.
Even after adjusting for confounders like maternal age and BMI, asthma itself was an independent risk factor for breastfeeding challenges.
IBCLC takeaway: Maternal chronic conditions like asthma can subtly impact breastfeeding. Proactive, tailored support—including screening for maternal health issues—can make a critical difference.

4️⃣ “Factors Associated with Non-Exclusive Breastfeeding in Hospitals: A Multicenter Prospective Cohort Study in 27 Baby-Friendly Certified Maternity Facilities in Brazil”

Citation: Carvalho, M. L., Silva, C. F., Santos, P. R., & Souza, M. T. (2023). Maternal and Child Health Journal, 27(3), 450–460. doi:10.1007/s10995-023-03654-9

Despite being in Baby-Friendly certified hospitals, nearly 1 in 5 newborns received supplementation in the first 24 hours.
Cesarean birth and prematurity were strong predictors of early supplementation, while prenatal education and strong prenatal intention to breastfeed were protective factors.
IBCLC takeaway: Certification does not guarantee evidence-based care at the bedside. Advocacy for systemic change and prenatal intention setting is vital to prevent unnecessary supplementation.

Conclusion:

These studies affirm a core truth: breastfeeding is shaped by the whole person, the systems they encounter, and the support (or trauma) they experience. As IBCLCs, our job is to listen deeply, counsel wisely, and integrate this evidence with empathy.

Connect with Me:

📸 Instagram: @margaretsalty

📧 Email: hello@margaretsalty.com

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

Hashtags & Keywords:

#BehindTheLatch #BreastfeedingResearch #BirthTrauma #MaternalAsthma #BabyFriendlyHospitals #BreastfeedingSupport #CulturalBarriers #LactationCare

🎧 Listen now on your favorite podcast app!

And don’t forget to subscribe to Behind the Latch and leave a review!

Breastfeeding with Bipolar Disorder: A Case of Shared Decision-Making and Support with Dr. Ariana Komaroff

Wed, 04 Jun 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Ariana Komaroff, family nurse practitioner and lactation specialist, about her published case report detailing breastfeeding care for a patient with bipolar disorder. Together, they explore how mental health conditions intersect with lactation goals, the challenges of medication management, the importance of collaborative care, and what lactation professionals can do to support families with complex psychiatric histories.

Dr. Komaroff’s Journey into Lactation

Ariana shares how her early career as a NICU nurse opened her eyes to the emotional needs of families:

Initially focused on infant care, she quickly realized how much parents struggle emotionally in the NICU
Wanted to provide better support for families—especially with milk production and feeding
Became a nurse practitioner to care for both parents and infants
Is now in private practice, academic teaching, and pediatric primary care

The Case Study: Bipolar Disorder and Lactation

Dr. Komaroff details the real-life case that inspired her publication:

A mother with bipolar disorder on aripiprazole (Abilify) could not lactate postpartum due to medication-induced prolactin suppression
The experience was traumatic for the mother, who felt betrayed and unsupported
Two years later, she returned during a second pregnancy, determined to breastfeed
She was now on a new medication regimen (lithium, lorazidone, lamotrigine)

Balancing Mental Health and Lactation Goals

The case highlights critical decision points:

Lithium poses risks to infant kidney and thyroid function and requires close monitoring if used during lactation
Shared decision-making with the patient, psychiatrist, therapist, and pediatrician was essential
The patient ultimately chose to wean off lithium before delivery while increasing lamotrigine with psychiatric support
Supportive care included increased talk therapy and close lactation follow-up

The Importance of Sleep in Perinatal Mental Health

Dr. Komaroff emphasizes that:

Sleep deprivation is a key risk factor for postpartum psychosis and mood destabilization in bipolar patients
A consolidated 4–5 hour stretch of sleep was prioritized postpartum, with support from the partner
Expressed milk, donor milk, or formula were considered based on supply to support overnight rest

Breastfeeding Success and Weaning

The patient:

Successfully breastfed for five months, then chose to wean gradually after returning to work
Felt empowered to make her own decision around weaning—an experience completely different from her first birth
Did not experience mood destabilization or regret, thanks to the slow and supported process

Key Lessons for Lactation Professionals

Dr. Komaroff and Margaret highlight important takeaways:

Listen deeply and individualize care—there’s never a one-size-fits-all plan
Include psychiatrists, therapists, pediatricians, and family in care planning
Use tools like the MDQ (Mood Disorder Questionnaire) or GAD-7 when appropriate
Recognize the power of shared decision-making in improving outcomes
Encourage others to publish unique cases to expand the evidence base

Guest Info:

Dr. Ariana Komaroff, DNP, FNP, IBCLC, is a clinician and educator practicing in Westchester, NY and Southern Connecticut. She teaches at Columbia University School of Nursing and specializes in family-centered lactation care across the perinatal spectrum.

Resources Mentioned in This Episode:

📌 Clinical Lactation – Journal that published Dr. Komaroff’s case study

📌 Postpartum Support International (PSI) – postpartum.net

📌 Infant Risk Center – infantrisk.com

📌 MotherToBaby – mothertobaby.org

📌 LactMed – NIH’s database on medication and breast milk

📌 Edinburgh Postnatal Depression Scale, MDQ, GAD-7 – Screening tools for mood and anxiety

Connect with Me:

Have questions or ideas for future episodes? Reach out!

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Ariana Komaroff

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #BipolarDisorderAndBreastfeeding #PerinatalMentalHealth #SharedDecisionMaking #LactationSupport #TripleFeeding #LactationCaseStudy #BreastfeedingWithMedication

🎧 Listen now on your favorite podcast app!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 37-IYCF, Knowledge, Attitudes, and Practice, Social Media, and Chrononutrition

Thu, 29 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty reviews five fascinating new studies covering maternal autonomy in India, breastfeeding practices in Saudi Arabia, real-world concerns shared on social media, the circadian rhythm of breast milk, and more. Each study offers a unique lens on how culture, policy, biology, and digital spaces shape the feeding experience—and what lactation professionals can do to support families more effectively.

Key Studies and Takeaways:

1. “Infant and Young Child Feeding Practices and Their Association with Women's Autonomy: A Community-Based Study in Rural West Bengal”

Citation: Sarkar, N. H., et al. (2025). Healthline, 16(1), 35–44. https://doi.org/10.51957/Healthline_689_2025

Cross-sectional study with 161 mothers in rural India
While 96% breastfed, only 63% initiated within the first hour and 24% exclusively breastfed
Maternal autonomy (decision-making, mobility, financial control) positively correlated with better IYCF practices
Cesarean birth and female infants were associated with poorer outcomes
IBCLCs must address family dynamics, autonomy, and equity—not just technique

2. “Knowledge, Attitude, and Practice of Breastfeeding Among Mothers Attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia”

Citation: Alhamedi, N. M., et al. (2025). Journal of Family Medicine and Primary Care, 14(4), 1295–1306. https://doi.org/10.4103/jfmpc.jfmpc_1465_23

Mixed-methods study with 334 mothers
88% initiated breastfeeding, but only 39% exclusively breastfed to 6 months
Working mothers had better knowledge and earlier initiation, but faced structural barriers
Formula use was common; 71% used ready-made formula in the hospital
IBCLCs must go beyond education—advocacy for workplace and hospital support is essential

3. “Analysis of Social Media Posts: Breastfeeding Mothers Concerned About Breast Milk Supply, Logistics of Breastfeeding, and Child Development Outcomes”

Citation: Heng, W. X., & Azhari, A. (2025). Women’s Reproductive Health. https://doi.org/10.1080/23293691.2025.2489500

Qualitative analysis of 504 Facebook posts from Singapore mothers
Top concerns: milk supply, breastfeeding logistics (especially while working), and infant growth
Many mothers used the group to seek practical advice—not emotional validation
Reveals that self-efficacy is fragile, and community forums often serve as informal knowledge hubs
IBCLCs should consider engaging in or partnering with online communities to share accurate guidance

4. “Chrononutrition and the Role of Melatonin in Neonates”

Citation: Markowska, M. (2025). Pediatrics and Family Medicine, 21(1), 46–50. https://doi.org/10.15557/PiMR.2025.0005

Narrative review exploring melatonin in breast milk and its circadian rhythm
Breast milk contains melatonin at night, which helps establish infant sleep cycles
Preterm infants rely entirely on maternal melatonin for early circadian regulation
Recommends time-matched milk labeling in NICUs and awareness of donor milk limitations
Adds a new dimension to lactation counseling: breastfeeding isn’t just nourishment—it’s biological programming

Conclusion:

From biological rhythms to social dynamics, breastfeeding is shaped by so much more than supply and demand. These studies offer clinical, cultural, and digital insights that can help IBCLCs personalize care, address hidden barriers, and advocate for system-wide changes.

Connect with Me:

📸 Instagram: @margaretsalty

📧 Email: hello@margaretsalty.com

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #IBCLC #BreastfeedingResearch #MaternalAutonomy #SocialMediaSupport #MelatoninInMilk #BreastfeedingBarriers #LactationSupport

🎧 Listen now on your favorite podcast app!

And don’t forget to subscribe to Behind the Latch and leave a review!

Triple Feeding, Scope of Practice, and Collaborative Care: A Conversation with Dr. Cindy Rubin

Wed, 28 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Cindy Rubin, a pediatrician, IBCLC, and board-certified breastfeeding and lactation medicine physician, about her clinical approach to managing complex lactation cases—including the hotly debated topic of triple feeding. They explore when triple feeding is appropriate, how to support families through it, when to wean, the role of galactagogues, and how IBCLCs and breastfeeding medicine physicians can work together for better outcomes.

Dr. Rubin’s Path to Breastfeeding Medicine

Dr. Rubin shares how her own struggles with breastfeeding as a pediatrician changed her perspective:

Realized how little she truly knew about lactation
Became an IBCLC and later certified in breastfeeding and lactation medicine
Left the traditional system to open a home visit and telehealth practice in the Chicagoland area

Healing the Divide: Physicians and IBCLCs Working Together

Margaret and Dr. Rubin discuss:

The historic divide between providers and IBCLCs
How breastfeeding medicine fills a gap—not competes with IBCLCs
The importance of staying within scope and collaborating for comprehensive care
Why referring to each other strengthens—not weakens—practice

Triple Feeding: What It Is and When to Use It

Dr. Rubin explains:

Triple feeding = nursing at the breast, pumping, and supplementing
It’s a short-term tool—not a long-term solution
Often used when it’s unclear whether the issue is supply or transfer
May be used as a “test” to guide next steps

When Triple Feeding May Not Be Necessary

Key points:

If baby is nursing well but supply is low, pumping may not be needed
Sometimes nursing + supplementing (double feeding) is sufficient
Always consider mental health and sustainability for the parent

Pumping Frequency, Sleep, and Mental Health

Dr. Rubin emphasizes:

Seven pump sessions with one long stretch of sleep is often better than eight with no rest
No amount of milk is worth compromising the parent’s mental or physical health
Customize plans based on the parent’s needs, goals, and capacity

SNS Use and Feeding Plan Flexibility

They discuss:

Why SNS can be helpful—but isn’t right for everyone
Feeding at the breast once or twice daily while pumping/bottle feeding the rest can reduce burnout
The importance of patient choice and informed consent

How to Know When to Wean from Triple Feeding

Dr. Rubin recommends:

Weighted feeds to assess if baby can take full or near-full volume at the breast
“Boot camp” weekends where the dyad nurses ad lib without pumping or supplementing
Watching for signs of success: swallowing, relaxed hands, diaper output, and steady weight gain

The Role of Galactagogues

Dr. Rubin explains:

She uses galactagogues selectively, often after trying triple feeding first
Goats’ rue may be beneficial in parents with insulin resistance or PCOS
Always considers side effects and tailors to the individual
Emphasizes that IBCLCs should refer, not recommend or sell galactagogues

Referral Networks and Working Across Disciplines

Dr. Rubin offers guidance:

Use the NABBLM website to find breastfeeding medicine physicians in your area
Understand physician licensure restrictions across state lines
Attend conferences like the Academy of Breastfeeding Medicine to network
Offer education (like grand rounds) at local hospitals to build relationships

Advice for Aspiring IBCLCs and Physicians

Dr. Rubin shares:

For aspiring IBCLCs: learn to be deeply curious and a great listener
For physicians: consider certification through the North American Board of Breastfeeding and Lactation Medicine if you're interested in filling the medical gap

Guest Info:

Dr. Cindy Rubin, MD, IBCLC, is a pediatrician and board-certified breastfeeding and lactation medicine physician. She is the founder of In Touch Pediatrics and Lactation, providing home and telehealth services in Illinois.

🌐 intouchpediatrics.com

📱 Instagram: @drcindyrubin

📹 YouTube: @cindyrubinmd

🔗 LinkedIn: Cindy Rubin, MD

Resources Mentioned in This Episode:

📌 North American Board of Breastfeeding and Lactation Medicine (NABBLM)

📌 Academy of Breastfeeding Medicine (ABM)

📌 Dr. Anne Eglash – Breastfeeding medicine pioneer

📌 Research on galactagogues and insulin resistance

📌 Goats’ rue for low milk supply with insulin resistance/PCOS

Connect with Me:

Have questions or suggestions for future episodes? Reach out!

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Cindy Rubin

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #TripleFeeding #BreastfeedingMedicine #LactationSupport #IBCLC #Galactagogues #BreastfeedingPhysician #LowMilkSupply #LactationCare #LactationConsultant

🎧 Listen now on your favorite podcast app!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 36-COVID-19, Support, Traditional Foods, and Seafood

Thu, 22 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty shares five new research studies that illuminate how culture, trauma, nutrition, and social support shape breastfeeding experiences around the world. From COVID recovery in Jordan to tribal food taboos in India, seafood during pregnancy, and the complex role of family dynamics—this episode delivers evidence-based insights every IBCLC needs.

Key Studies and Takeaways:

1. “Breastfeeding Experiences of COVID-19 Survivor Multipara Mothers During Pre- and Post-COVID-19: A Comparative Phenomenological Study”

Citation: Abuhammad, S., et al. (2025). BMC Pregnancy and Childbirth, 25, 502. https://doi.org/10.1186/s12884-025-07610-3

Jordanian mothers who had breastfed both before and after COVID described physical, emotional, and supply-related challenges
Post-infection breastfeeding was harder—many noted early weaning and emotional exhaustion
Concerns about the vaccine’s impact on milk supply created uncertainty and stress
Lack of consistent lactation education and mental health support intensified these struggles
IBCLCs should lead with empathy, normalize emotional challenges post-COVID, and provide clear, compassionate vaccine counseling

2. “Association Between Family Support and Breastfeeding Self-Efficacy in a Cross-Sectional Study”

Citation: Hu, L., He, W., & Zhou, L. (2025). Nursing Open, 12, e70210. https://doi.org/10.1002/nop2.70210

Study of 217 mothers in China found that greater family support was strongly associated with higher breastfeeding self-efficacy
However, support from parents or spouses—when controlling or emotionally intense—was linked to lower BSE
Support from in-laws or hired caregivers (e.g., nannies) showed more positive effects
IBCLCs should assess not only the presence of support, but its quality and emotional tone
Family involvement in education is important—but only when it supports maternal autonomy

3. “A Study on Traditional Food Practices and Taboo During Pregnancy and Lactation in Tribal Population of Eastern Gujarat”

Citation: Zaveri, N. H., et al. (2025). Journal of Family Medicine and Primary Care, 14(4), 1333–1337. https://doi.org/10.4103/jfmpc.jfmpc_1505_24

Focus group study of 80 women revealed extensive food taboos: avoiding “hot,” “cold,” or “heavy” foods, and rejecting colostrum
Mothers commonly gave goat or cow milk in place of colostrum and consumed restrictive postpartum diets
Cultural beliefs were shaped by safety concerns, aesthetic ideals, and gender norms
IBCLCs working in diverse communities must use culturally sensitive language and collaborate with local leaders to reframe harmful myths
Storytelling and elder involvement are powerful tools in shifting generational norms

4. “Seafood During Pregnancy and Lactation and Child Neurocognitive Development: A Systematic Review”

Citation: O’Connor, L. E., et al. (2025). Advances in Nutrition. https://doi.org/10.1016/j.advnut.2025.100414

Review of 40 studies showed seafood consumption during pregnancy supports better social-emotional development and adaptability in children
Verbal intelligence and problem-solving were positively linked to seafood intake in several studies
No strong evidence for harm at recommended intake levels
No studies evaluated seafood during lactation—a major research gap
IBCLCs can reassure families about low-mercury fish and shift the narrative from “avoidance” to nutrient density

Conclusion:

These studies span the globe and affirm one clear truth—breastfeeding doesn’t exist in isolation. It’s shaped by culture, support, recovery, and belief. As IBCLCs, our job is to listen deeply, counsel wisely, and integrate evidence with empathy.

Connect with Me:

📸 Instagram: @margaretsalty

📧 Email: hello@margaretsalty.com

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #BreastfeedingResearch #COVIDandBreastfeeding #SeafoodinPregnancy #FamilySupport #BreastfeedingConfidence #CulturalFoodBeliefs #LactationSupport

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Breastfeeding, the Microbiome, and Infant Health: A Deep Dive with Laurel Wilson

Wed, 21 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Laurel Wilson, an internationally recognized speaker, author, and perinatal specialist, about the critical role of the microbiome, epigenome, and human milk in shaping infant health. They explore how breastfeeding influences the baby's gut microbiome, the long-term effects of infant feeding choices, new research about maternal health and infant gut development, and what lactation professionals need to know about emerging science in this field.

Laurel’s Journey into the Perinatal Field

Laurel shares her three-decade journey:

Inspired by her own challenging birth and breastfeeding experiences
Early work as a doula, childbirth educator, and lactation educator
Executive Director of Lactation Programs for CAPPA
Now focused on translating research into education for lactation professionals

Understanding the Epigenome and Microbiome

Laurel explains:

The epigenome controls gene expression based on environmental signals
The microbiome—bacteria, fungi, viruses, and archaea—communicates with the epigenome
Breastfeeding plays a key role in shaping the infant's lifelong microbiome and gene expression

How Breastfeeding Establishes the Infant Microbiome

Human milk provides:

Beneficial microbes critical for gut, immune, and brain development
Human milk oligosaccharides (HMOs) that nourish good bacteria
Long-term health benefits, including allergy protection and improved metabolic health
Unique endocrine functions, with microbes even influencing hormone signaling

Challenges with Infant Formula and the Microbiome

Laurel and Margaret discuss:

Powdered infant formula can introduce pathogenic bacteria into the gut
Even sterile liquid formula lacks critical human-specific microbes and HMOs
Once pathogenic bacteria colonize, the gut's development path is altered
Efforts to add HMOs to formula are limited compared to the complexity of human milk

Emerging Research on Microbiome and Long-Term Health

Laurel highlights:

Research linking early feeding to risks of allergies, diabetes, and metabolic diseases
Child Cohort studies investigating long-term effects of breastfeeding and formula feeding
The role of birth mode (vaginal vs. cesarean) in microbiome development
New interventions like oral fecal transplants for C-section born infants

The Maternal Microbiome Matters, Too

Important insights:

Maternal gut health may influence the infant’s microbiome and allergy risk
Probiotic supplements alone are not a guaranteed solution
Focus on overall gut healing, diverse diet, and minimizing processed foods
Diet during the third trimester has a significant influence on milk composition

Addressing Fear and Supporting All Feeding Choices

Laurel emphasizes:

While diet matters, any amount of human milk provides vital health benefits
Fear-mongering around diet and milk quality can discourage breastfeeding
Families deserve honest, empowering education—not guilt or fear

What’s Next in Microbiome Research

Laurel shares emerging findings:

The importance of B. infantis, a critical bacteria largely lost in modern populations
Antibiotics, C-sections, and modern hygiene practices have reduced its presence
Researchers at UC Davis and beyond are studying ways to restore it

Advice for Aspiring IBCLCs

Laurel offers valuable tips:

Network with practicing IBCLCs and join study groups
Read and discuss research articles to build critical thinking
Stay curious and be a deep listener when supporting families

Guest Info:

Laurel Wilson, IBCLC, RLC, BSc, CLE, CLD, CCCE, is an internationally acclaimed speaker, lactation consultant, and expert on the microbiome, epigenome, and hormonal expression in perinatal health. Learn more at motherjourney.com or follow her on social media @motherjourneylaurelwilson.

Resources Mentioned in This Episode:

📌 Child Cohort Studies – Longitudinal studies of infant development and microbiome

📌 Research by Musavi et al. and Megan Azad on infant feeding and gut health

📌 UC Davis Research on B. infantis and infant gut microbiome

📌 WHO Code of Marketing of Breast Milk Substitutes

Connect with Me:

Questions, feedback, or ideas for future episodes? Reach out!

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Laurel Wilson

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #MicrobiomeAndBreastfeeding #InfantGutHealth #BreastfeedingResearch #LactationEducation #MaternalHealth #HumanMilkScience #BInfantis

🎧 Listen now on your favorite podcast app!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 35- Opioid-Dependent Mothers, Ramadan Fasting, Virtual NICU Support, and Maternal Sleep

Thu, 15 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty explores five new research articles that offer clinical insight for lactation professionals. From a trauma-informed program to support breastfeeding in parents with opioid use disorder, to the impact of Ramadan fasting, sleep quality in Syrian mothers, and virtual NICU support—this evidence-based roundup helps IBCLCs expand their clinical lens and better serve diverse families.

Key Studies and Takeaways:

1. “Enhancing Breastfeeding Experience and Self-Efficacy in Opioid-Dependent Breastfeeding Mothers: Insights from the PeriWell Intervention”

Citation: Moss, D., & Busch, D. W. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2024-0011

Describes a 12-week trauma-informed perinatal intervention for mothers with opioid use disorder (OUD)
Integrates the Positive Direction Model and the Tri-Core Breastfeeding Model
Focuses on emotion regulation, trauma screening, lactation education, and self-efficacy
Program supports MAT (medication-assisted treatment) patients and their infants with NAS/NOWS
IBCLCs working in recovery care settings can use this model to offer holistic, ongoing support

2. “Does Ramadan Fasting Affect Breast Milk Sufficiency Perception and Maternal Functioning of Breastfeeding Mothers?”

Citation: Akça, K., Güngörmüş, Z., & Bayrakçı, E. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2024-0020

Cross-sectional study of 62 breastfeeding mothers during Ramadan in Turkey
Mothers who fasted and ate the pre-dawn meal (sahur) showed improved maternal functioning and confidence in milk sufficiency
No improvements in mothers who skipped sahur or didn’t fast
Highlights the psychological and nutritional importance of sahur
IBCLCs should support religious observance with individualized guidance—not blanket restrictions

3. “Effects of a Virtual Supportive Program on the Knowledge of Mothers of Preterm Infants and Their Bonding”

Citation: Pusri, S., Payakkaraung, S., & Thampanichawat, W. (2025). Infant Mental Health Journal, 1–15. https://doi.org/10.1002/imhj.70013

Quasi-experimental study with 74 NICU mothers in Thailand
A 7-day virtual program improved bonding and reduced anxiety—even in mothers with medically complex infants
Components included video calls, daily updates, cue recognition training, and emotional check-ins
IBCLCs can advocate for virtual or hybrid support models to maintain maternal connection in NICU settings
Preterm cue education and emotional support should be core parts of lactation care

4. “Motherhood Unveiled: Examining the Dynamic Relationship Between Sleep Quality and Breastfeeding Confidence in Postpartum Primiparous Women in Syria—A Cross-Sectional Study”

Citation: Aldairy, A., et al. (2025). BMC Public Health, 25, 1521. https://doi.org/10.1186/s12889-025-22709-0

Survey of 316 first-time mothers in Syria
Better sleep quality was significantly correlated with higher breastfeeding self-efficacy
Older, wealthier mothers had more confidence; highly educated mothers had worse sleep
IBCLCs should acknowledge sleep as a key determinant of feeding success, especially in new parents
Integrating sleep hygiene tips and emotional support into lactation visits could improve outcomes

Conclusion:

From trauma-informed interventions to cultural and emotional factors, these studies highlight the complex web that shapes breastfeeding experiences. For IBCLCs, staying informed means being equipped to offer care that’s not only effective—but also inclusive, compassionate, and responsive to each family’s context.

Connect with Me:

📸 Instagram: @margaretsalty

📧 Email: hello@margaretsalty.com

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #IBCLC #LactationResearch #OpioidUseDisorder #RamadanAndBreastfeeding #NICUSupport #BreastfeedingConfidence #SleepAndLactation #PeriWellIntervention

🎧 Listen now on your favorite podcast app!

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Building Nigeria’s First Breastfeeding Clinic: A Conversation with Dr. Lope Adejuyigbe

Wed, 14 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Lope Adejuyigbe, a physician and lactation specialist based in Lagos, Nigeria, who founded the first breastfeeding clinic in the country. They discuss the breastfeeding landscape in Nigeria, barriers to exclusive breastfeeding, cultural beliefs, the urgent need for lactation support, and how Dr. Adejuyigbe is building a movement to make breastfeeding help accessible to more families.

Breastfeeding in Nigeria: Barriers and Opportunities

Dr. Adejuyigbe outlines the breastfeeding challenges in Nigeria:

Limited breastfeeding support in healthcare settings
Widespread formula marketing and hospital distribution
Cultural beliefs that breast milk alone is "not enough"
The impact of short maternity leaves and lack of workplace accommodations

The Creation of Nigeria’s First Breastfeeding Clinic

Motivated by personal family experience and WHO training, Dr. Adejuyigbe launched the first dedicated breastfeeding clinic in Nigeria:

Started with personal funds and private practice
Faced skepticism from doctors and nurses unfamiliar with lactation specialization
Now seeing growing community acceptance and increasing patient referrals

Challenges Mothers Face and Clinic Services

Dr. Adejuyigbe shares the key issues she sees among mothers:

Early formula introduction encouraged even by healthcare providers
Pressure for oversupply due to social media influence
Lack of access to clean water making pumping challenging
No hospital-grade pumps available in Nigerian hospitals

Her clinic addresses a wide range of cases, including:

Latch difficulties
Low milk supply
Breast abscesses and mastitis
Breastfeeding with complex medical conditions (hypothyroidism, PCOS, surrogacy, adoption)

The Power of Early Intervention

Dr. Adejuyigbe emphasizes:

The critical window of the first 1–2 weeks postpartum for establishing breastfeeding
The need for better prenatal and immediate postnatal education
How early support makes breastfeeding easier and more sustainable

Addressing Cultural Beliefs Around Breastfeeding

Margaret and Dr. Adejuyigbe discuss common myths in Nigeria:

Belief that colostrum should be discarded
Widespread "top up" culture
Misconceptions about breast milk "going sour" if not expressed frequently

Looking Toward the Future: Expansion and Peer Support

Dr. Adejuyigbe shares her goals:

Expanding her virtual breastfeeding clinic to serve more countries affordably
Building a breastfeeding peer counselor program to extend basic education at the community level
Partnering with hospitals and government agencies to mainstream lactation support
Publishing research on breastfeeding experiences in Nigeria

Guest Info:

Dr. Lope Adejuyigbe, MD, IBCLC Candidate, is a physician, lactation specialist, and founder of the first breastfeeding clinic in Nigeria. She is dedicated to transforming the breastfeeding support landscape across Nigeria and beyond.

Resources Mentioned in This Episode:

📌 WHO Code of Marketing of Breast Milk Substitutes

📌 La Leche League International – Peer-to-peer breastfeeding support

📌 WIC Breastfeeding Peer Counselor Program – Model for community-based breastfeeding support

📌 Lactation Education Resources (LER) – Online lactation education

Connect with Me:

Questions, feedback, or ideas for future episodes? Reach out!

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Lope Adejuyigbe

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #BreastfeedingInNigeria #LactationSupport #MaternalHealth #BreastfeedingClinic #ExclusiveBreastfeeding #BreastfeedingEquity #LactationConsultant

🎧 Listen now on your favorite podcast app!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 34-Staff Training, Roy Model, Marmet Technique, and Insufficient Milk Supply

Thu, 08 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty reviews four recent articles from Clinical Lactation that offer powerful insights for IBCLCs. From training healthcare providers to improving exclusive breastfeeding through theory-based counseling, to comparing hand expression and pumping in the NICU, and exploring the link between nipple shields and the perception of insufficient milk—this episode translates current research into real-world clinical strategies.

Key Studies and Takeaways:

1. “Evaluation of a Breastfeeding Education Intervention for Healthcare Professionals in Idaho”

Citation: Karroum, K., & Clarkson, G. (2024). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2023-0040

A 50-minute training significantly improved provider knowledge, confidence, and intention to improve breastfeeding support
60.5% of participants planned workflow changes, including improved screening and referral practices
Training was based on Merrill’s First Principles and the Theory of Planned Behavior
IBCLCs can play a key role in designing and implementing similar in-service education to drive systems change
Even brief, focused interventions can shift primary care culture

2. “The Effect of Counseling Based on the Roy Adaptation Model on Mothers’ Infant Feeding Attitude and Anthropometric Measurements of the Baby: A Randomized Controlled Study”

Citation: Bilgiç, F. Ş., & Karaahmet, A. Y. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2024-0014

RAM-based prenatal and postpartum counseling dramatically increased exclusive breastfeeding (95% vs. 40%)
Improved maternal feeding attitudes and reduced early weaning consideration
Intervention included prenatal education, phone support, and in-person follow-ups
IBCLCs can use RAM as a structured, holistic counseling model
This theory-driven approach addressed physiological, emotional, social, and role adaptations to breastfeeding

3. “Effectiveness of Manual Expression of Breast Milk: Marmet Technique in Production of Breast Milk Among Mothers Whose Babies Are in the Neonatal Intensive Care Unit”

Citation: Kotsu, K., Nayak, S., & Sunanda, B. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2023-0013

Marmet hand expression produced significantly more milk than manual pumping in all sessions
Technique, not maternal characteristics, determined milk volume
Highlights the value of teaching structured hand expression in NICU settings
Offers a zero-cost, accessible method for parents struggling with pumps or in low-resource settings
IBCLCs should integrate Marmet technique into both prenatal and NICU care plans

4. “Risk Factors for the Perception of Insufficient Milk: A Prospective Study”

Citation: Oliva-Pérez, J., Simonelli-Muñoz, A. J., Oliver-Roig, A., & Richart-Martínez, M. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2024-0017

18.6% of mothers developed perception of insufficient milk (PIM) by 1–5 months postpartum
Nipple shield use during the hospital stay was the strongest predictor of later PIM (OR = 4.78)
IBCLCs should monitor shield use closely and ensure appropriate follow-up and weaning
Education on normal feeding patterns and growth spurts is essential to prevent misinterpretation of milk supply cues
Even low-risk dyads with strong early feeding may develop PIM without continued support

Conclusion:

These articles remind us that impactful breastfeeding support doesn’t always require complex interventions—sometimes it’s about the timing, the technique, or the tools we teach. From provider education to hospital practices to counseling models, IBCLCs can use this evidence to inform better care for every family.

Connect with Me:

📸 Instagram: @margaretsalty

📧 Email: hello@margaretsalty.com

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #IBCLC #LactationConsultant #BreastfeedingResearch #MarmetTechnique #RoyAdaptationModel #PerceivedInsufficientMilk #BreastfeedingEducation #NICUFeeding #NippleShields

🎧 Listen now on your favorite podcast app!

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Inside the Pumped Project: Breast Pumps, Research, and Lactation Practice in Germany with Melissa Theurich

Wed, 07 May 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Melissa Thurch, PhD, IBCLC, about her groundbreaking research on breast pumps in Germany. They dive into the Pumped Project, differences in insurance coverage between Germany and the United States, the challenges of regulating breast pumps, and the future of lactation research. Melissa also shares her journey from WIC nutritionist to international breastfeeding researcher, her private practice experience in Germany, and advice for aspiring IBCLCs and researchers.

Melissa’s Journey into Lactation Research

Melissa shares how her early work with the WIC program in the U.S. led her into the world of lactation, and how a personal move to Germany eventually launched her academic career in breastfeeding research.

The Pumped Project: Breast Pumps in Germany

Melissa introduces the Pumped Project, which aims to profile and understand the landscape of electric breast pumps available in Germany, including:

The large number and wide range of pumps (over 200 designs found!)
Differences between medical-grade and commercial pumps
Lack of insurance coverage for many personal-use pumps
How maternity leave policies impact pump usage

Regulation and Accessibility of Breast Pumps

Margaret and Melissa explore:

The limited regulation of breast pumps in Germany compared to the U.S.
Issues with missing data on product specifications
The challenges of tracking adverse events and injuries
How the European CE mark system works (and doesn’t)

Key Findings from the Pumped Project

Melissa highlights:

Pump prices ranging from 19 to 350 euros
Most pumps offering only one or two flange sizes, with a heavy bias toward 24mm
The growing market share of wearable pumps
The market’s volatility, making it difficult to create a consumer resource

Next Steps for the Pumped Study

Melissa discusses the future directions:

Wrapping up data collection
Publishing scientific papers summarizing findings
Investigating regulation and adverse event reporting further
Conducting complementary research on routine health data and medical-grade pump prescriptions

Private Practice Lactation Consulting in Germany

Melissa describes the landscape for IBCLCs in Germany:

IBCLC services are mostly private pay and not widely reimbursed
Midwives are the primary reimbursed providers for breastfeeding support
Families often rely on midwives, La Leche League, and peer counselors for lactation care

Advice for Aspiring Lactation Researchers and IBCLCs

Melissa offers valuable advice:

For researchers: Be prepared for funding challenges, use your networks, and stay motivated by the impact of your work.
For future IBCLCs: Grow your network, join organizations like ILCA, and be strategic in finding mentors who inspire you.

Guest Info:

Melissa Thurch, PhD, IBCLC, is a lactation researcher and private practice IBCLC based in Munich, Germany. She has worked internationally with organizations like WHO and UNICEF and is passionate about expanding the evidence base for breastfeeding practices.

Resources Mentioned in This Episode:

📌 La Leche League – Mother-to-mother breastfeeding support worldwide

📌 ILCA – International Lactation Consultant Association for networking and resources

📌 Pay at the Pump Study (Valerie Leider) – Adverse events related to breast pumps in the U.S.

📌 The Lactation Network – An insurance billing hub for U.S. private practice IBCLCs

Connect with Me:

Questions, feedback, or ideas for future episodes? Reach out!

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Melissa Thurch, PhD, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#BehindTheLatch #BreastfeedingResearch #BreastPumps #LactationConsultant #MaternalHealth #PumpedProject #LactationScience #BreastfeedingSupport #LactationEducation

🎧 Listen now on your favorite podcast app!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 33-Extended Breastfeeding, Early Initiation, and Loneliness and Self-Efficacy

Thu, 01 May 2025 09:00:00 -0500

In this episode of The IBCLC Mentor Podcast, Margaret Salty reviews recent research findings that impact lactation consultants. From extended breastfeeding and growth outcomes in Ethiopia, to the feeding experiences of first-time mothers, and the link between loneliness and breastfeeding confidence—Margaret translates the latest studies into actionable insights for IBCLCs.

Key Points Covered:

1. Extended Breastfeeding and Undernutrition in Ethiopian Children

Margaret discusses a large cross-sectional study from Ethiopia examining the relationship between breastfeeding beyond 12 months and child undernutrition.

Reference:

Hailu, A., et al. (2025). Extended breastfeeding over one year is associated with a higher likelihood of underweight and stunting among children under three years of age in Ethiopia. International Journal of Nutrition and Public Health, 14(2), 87–95. https://doi.org/10.1186/ijnph.2025.8702

Practical Takeaways:

Extended breastfeeding was associated with higher odds of stunting and underweight—but was protective against wasting.
The issue is not prolonged breastfeeding itself, but lack of adequate complementary foods.
Undernutrition was also tied to illness, sanitation issues, poverty, and low parental education.
IBCLCs must pair breastfeeding support with education on timely, nutrient-dense complementary feeding.

2. Early Initiation and Exclusive Breastfeeding Among First-Time Mothers in Ethiopia

Margaret reviews a mixed-methods study exploring breastfeeding behaviors and beliefs among Ethiopian first-time mothers.

Reference:

Tsegaye, M., et al. (2025). Early initiation of breastfeeding and exclusive breastfeeding practices and associated factors among first-time mothers attending governmental maternal and child health clinics in Ethiopia: A mixed-methods study. BMC Pregnancy and Childbirth, 25, 330. https://doi.org/10.1186/s12884-025-02275-9

Practical Takeaways:

74.7% of mothers initiated breastfeeding in the first hour. Vaginal delivery and colostrum feeding were strong predictors.
Only 46.8% practiced exclusive breastfeeding to 6 months.
Support from spouses and health workers significantly improved outcomes.
Cultural beliefs about colostrum and prelacteal feeds (e.g., butter, water) remain barriers.
First-time mothers need culturally sensitive, evidence-based support from birth through postpartum.

3. Loneliness and Breastfeeding Self-Efficacy in Mothers

Margaret explores a Turkish study linking maternal loneliness to breastfeeding confidence and behavior.

Reference:

Demir, Z., & Yıldız, G. (2025). The relationship between loneliness perception and breastfeeding self-efficacy in breastfeeding behaviors and mothers. Maternal and Child Health Journal, 29(2), 151–160. https://doi.org/10.1007/s10995-025-03642-7

Practical Takeaways:

Lonelier mothers had significantly lower breastfeeding self-efficacy and shorter breastfeeding duration.
Spousal and social support were key to confidence and breastfeeding success.
Employed and educated mothers showed higher self-efficacy and lower loneliness scores.
IBCLCs should screen for isolation and integrate psychosocial support into care.

Conclusion:

From cultural feeding practices to emotional wellbeing, these studies underscore the many factors shaping breastfeeding outcomes. As IBCLCs, it’s our responsibility to meet families where they are, support the whole dyad, and advocate for systems that nourish breastfeeding success.

Connect with Me:

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #IBCLCMentorPodcast #EvidenceBasedPractice #ComplementaryFeeding #ExtendedBreastfeeding #FirstTimeMothers #BreastfeedingSelfEfficacy #MaternalLoneliness #BreastfeedingSupport

Protecting Parents from Pump Harm: Evidence-Based Guidance for IBCLCs. A discussion with Alisa Williams.

Wed, 30 Apr 2025 09:00:00 -0500

Episode Summary:

In this episode of Behind the Latch, Margaret Salty interviews Alisa Williams, RN, IBCLC, about her groundbreaking paper, Are You Knowledgeable About Breast Pump Safety and Assessment? Knowledge and Skills for Clinical Practice, published in Clinical Lactation (2024). They explore the overlooked risks of pump misuse, why lactation professionals must become more informed, and how to better support families through safe and effective pumping education.

Williams, A. (2024). Are you knowledgeable about breast pump safety and assessment? Knowledge and skills for clinical practice. Clinical Lactation, 15(2), 77–90.

Alisa’s Journey into Lactation Consulting

Alisa shares the story of how she left hospital nursing to start her private practice, Momentum Lactation, after witnessing the lack of follow-up care for families postpartum. She now runs a thriving lactation clinic in Southern Illinois serving over 400 families a year.

Key insights include:

The emotional toll of watching families leave the hospital without adequate lactation support
Building a private practice from scratch to fill a critical care gap
The growing need for outpatient lactation support in communities with high birth volume and limited access

Why She Wrote the Paper on Pump Safety

Alisa explains the urgent need to better understand how pumps function and how misuse can cause harm.

Discussion highlights:

The explosion of exclusive pumping during the COVID-19 pandemic
A lack of formal training around pumps for lactation professionals and students
Real-world observations of pump-related injuries and milk supply issues
The absence of safety standards or meaningful FDA regulation of pumps

Common Problems Caused by Breast Pumps

Alisa outlines the clinical signs of pump-related harm:

Nipple trauma and pain
Engorgement and localized inflammation
Desensitization and nerve damage affecting oxytocin release
Reduced milk output and mental health impacts
The economic burden of buying multiple ineffective pumps

Assessing and Educating About Pump Use

Alisa walks through her protocol for evaluating pumps and educating parents:

Conducting visual and tactile nipple assessments
Observing the flange fit and suction cycle using traditional pumps
Identifying signs of poor fit, pressure intolerance, or ineffective drainage
Educating parents on safe suction levels and cycling patterns
Using pump pressure gauges to test actual PSI and document findings

Why Flange Fitting and Pump Settings Matter

Alisa discusses how she determines the correct flange size and pressure setting:

Using a nipple measurement tool and allowing 2–3mm for expansion
Watching how the nipple behaves during pumping in both modes
Measuring pain, output, and visual signs like blanching or trauma
Teaching families to aim for the lowest effective pressure

Educating the Next Generation of IBCLCs

Alisa shares how her detailed pump safety tool and hands-on process can be used in lactation education. Margaret discusses plans to integrate it into her Pathway 2 program.

Key recommendations:

Train students to assess pumps just like a latch
Standardize protocols using structured tools
Teach observational skills to identify subtle signs of dysfunction
Normalize using equipment like pressure gauges during clinical care

Ethical Considerations in Recommending Pumps

Margaret and Alisa discuss the ethics of recommending specific brands:

Why “just pick a pump that fits your goals” may not be sufficient
How to assess pumps based on safety, suction mode, and cycle adjustability
Building ethical partnerships with manufacturers to influence safer design
Educating families on red flags that suggest a pump isn’t working

Recommended Resources

Alisa shares key tools and resources to improve pump literacy among IBCLCs:

📌 YouTube – Alisa’s video on testing pump pressure

📌 IABLE – Flange sizing and safety resources

📌 Oregon WIC – Printable handouts on safe pumping

📌 New Little Life by Allison Tolman – Pumping gear course

📌 FDA’s Breast Pump Guide – A cautionary example of feature-based, not safety-based, guidance

📌 Babies in Common FITS Guide – Visual flange sizing tool

Advice for Aspiring Lactation Consultants

Alisa encourages aspiring IBCLCs to pursue mentorship and hands-on experience:

Find a mentor who offers direct clinical exposure
Build assessment skills through repeated observation
Understand that lactation support includes feeding mechanics and medical safety

Guest Info:

Alisa Williams, RN, IBCLC is the owner of Momentum Lactation in Southern Illinois. She specializes in outpatient lactation care and is a leading voice on breast pump safety and injury prevention.

📧 Email: lactation@momentum-well.com

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Alisa Williams, RN, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #PumpingSafety #BreastPumps #LactationConsultant #Mentorship #FlangeFit #LactationEducation #ExclusivePumping #PumpInjuryPrevention #LactationTools

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 32-Reflexology, MCFAs, Delayed Lactogenesis, Pink Breastmilk

Thu, 24 Apr 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty reviews recent research findings that impact lactation consultants. From foot reflexology and postpartum comfort, to the role of medium-chain fatty acids in shaping the infant microbiome, predictive markers for delayed lactogenesis in mothers with gestational diabetes, and a rare case of contaminated breastmilk—Margaret translates the latest studies into actionable insights for IBCLCs.

Key Points Covered:

1. Foot Reflexology and Breastfeeding Outcomes

Margaret reviews a meta-analysis examining the effect of foot reflexology on postpartum comfort and breastfeeding outcomes.

Reference:

Koyuncu, G., & Yıldız, D. (2024). The effect of foot reflexology on postpartum comfort and breastfeeding outcomes in postpartum women: A meta-analysis study. Complementary Therapies in Clinical Practice, 55, 101805. https://doi.org/10.1016/j.ctcp.2024.101805

Practical Takeaways:

Reflexology improved latch quality and breastfeeding satisfaction.
It reduced breast pain and tension, easing milk transition.
Enhanced maternal comfort promotes oxytocin release and milk ejection.
A promising non-pharmacologic support for cesarean recovery.

2. Medium-Chain Fatty Acids, Maternal Diet, and Infant Gut Health

Margaret shares findings from a Chinese study linking maternal diet, breast milk composition, and infant microbiome development.

Reference:

Wang, Y., et al. (2025). The concentration of medium-chain fatty acids in breast milk is influenced by maternal diet and associated with gut microbiota in infants. Journal of Human Nutrition and Dietetics, 38(2), 147–156. https://doi.org/10.1111/jhn.13220

Practical Takeaways:

Maternal fat intake alters medium-chain fatty acids in milk.
These fatty acids influence the infant’s gut microbiota and immune function.
Breast milk with higher MCFAs promotes beneficial bacteria like butyrate-producers.
Encourages tailored dietary guidance during lactation.

3. Sodium and Sodium-Potassium Ratio Predict Delayed Lactogenesis

Margaret explores a prospective study assessing electrolyte levels in breast milk and their link to delayed lactogenesis in mothers with gestational hyperglycemia.

Reference:

Li, X., et al. (2025). Breast milk sodium and sodium-potassium ratio predict delayed onset of lactogenesis in mothers with gestational hyperglycemia. Breastfeeding Medicine, 20(4), 190–198. https://doi.org/10.1089/bfm.2024.0234

Practical Takeaways:

Elevated sodium and Na:K ratios signal delayed lactogenesis II.
Thresholds: sodium ≥ 26.25 mmol/L, Na:K ratio ≥ 1.646.
Could support precision-based early lactation intervention.
Suggests possible integration of lab-based tools into lactation care.

4. Serratia Marcescens and Pink Breast Milk: A Cautionary Case Report

Margaret discusses a Tanzanian case report of a breastfed infant with GI bleeding linked to pink breast milk contaminated with Serratia marcescens.

Reference:

Ng’ang’a, J., et al. (2025). Serratia marcescens in breast milk and gastrointestinal bleeding in an infant: A case report from Tanzania. African Journal of Pediatric Health, 13(1), 22–27. https://doi.org/10.4314/ajph.v13i1.4

Practical Takeaways:

Contamination likely came from inadequately sterilized pump parts.
Highlights importance of clear hygiene education for pumping parents.
Pink milk may indicate dangerous contamination, not just rusty pipe syndrome.
IBCLCs are key in early detection and prevention of serious outcomes.

Conclusion:

From complementary therapies to microbiome research and early biomarkers of lactation dysfunction, these studies offer IBCLCs fresh insights and clinical tools. This episode underscores the importance of staying research-informed to enhance lactation care and outcomes.

Connect with Me:

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice #FootReflexology #MaternalDiet #InfantMicrobiome #DelayedLactogenesis #PinkBreastMilk #PumpHygiene

Understanding Breastfeeding, Stress, and Health Equity with Dr. Maggie Butler

Wed, 23 Apr 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Maggie Butler, a Maternal & Child Health Researcher, Biocultural Anthropologist, Certified Lactation Counselor, and Postdoctoral Fellow at the University of Illinois Chicago’s School of Public Health. They dive into Dr. Butler’s research on stress, breastfeeding disparities, and the role of authoritative knowledge in lactation care.

Dr. Butler shares insights on how systemic barriers, social determinants, and lived experiences shape infant feeding outcomes, and why interdisciplinary research is crucial for improving breastfeeding support.

Breastfeeding, Stress, and Maternal Health

How Dr. Butler’s Background in Anthropology Led to Lactation Research

Dr. Butler shares her journey from studying bioarchaeology and skeletal remains to focusing on maternal health and lactation. She explains:

How structural violence in medical history shaped her research interests
The shift from historical research to qualitative and quantitative studies on infant feeding
Why she chose to study breastfeeding, stress, and health inequities

How Stress Affects Breastfeeding and Infant Feeding Outcomes

Dr. Butler discusses the complex relationship between stress and lactation, including:

How chronic inflammation and stress biomarkers can impact milk production
The social and economic barriers that make breastfeeding more difficult
The role of social support in helping families meet their breastfeeding goals

Understanding Breastfeeding Disparities in Chicago

Structural Barriers to Breastfeeding Success

Margaret and Dr. Butler explore Chicago’s racial health disparities and their impact on breastfeeding, covering:

How maternity care deserts on the South and West Sides limit lactation support
The impact of hospital closures on access to lactation care
How police violence and neighborhood stressors correlate with higher rates of preterm birth

Why We Need More Community-Led Research

Dr. Butler highlights the importance of community engagement in research, including:

How partnering with community organizations leads to better breastfeeding support
The need for more diverse researchers in maternal and child health
Why lived experiences should be centered in breastfeeding research

The Role of Authoritative Knowledge in Lactation

What Is Authoritative Knowledge?

Dr. Butler applies the concept of authoritative knowledge to lactation, explaining:

How biomedical knowledge has become dominant in infant feeding practices
Why social media and lived experiences are becoming new sources of breastfeeding information
The risks of misinformation and the need to balance evidence-based guidance with real-life experiences

Where Do Parents Get Their Breastfeeding Information?

Dr. Butler’s research categorizes three key sources of lactation knowledge:

✔️ Biomedical Knowledge – Information from healthcare providers and research-based sources

✔️ Social Network Knowledge – Advice from family, friends, online forums, and social media

✔️ Lived Experience Knowledge – Firsthand experiences that shape infant feeding decisions

She discusses how mothers increasingly rely on online sources rather than healthcare providers and why this shift has both benefits and risks.

The Future of Maternal and Child Health Research

What’s Next in Dr. Butler’s Research?

Dr. Butler shares her future research goals, including:

Examining how healthcare systems can improve postpartum care
Integrating mental health and lactation support into standard care
Expanding community-based research on breastfeeding and stress

Advice for Aspiring Lactation Researchers

Dr. Butler offers advice for those interested in lactation research and maternal health, encouraging:

Interdisciplinary collaboration to strengthen research impact
Community engagement to ensure research benefits families directly
Advocating for funding in maternal and child health to close knowledge gaps

Where to Learn More About Dr. Maggie Butler

📍 LinkedIn: https://www.linkedin.com/in/butlermargaret

📧 Email: butlerms@uic.edu

🌍 BlueSky: @bioanthmags.bsky.social

Connect with Me

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: facebook.com/margaretsalty

Credits

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Maggie Butler, Maternal & Child Health Researcher

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords

#IBCLC #BreastfeedingResearch #MaternalHealth #LactationConsultant #HealthEquity #BreastfeedingSupport #PublicHealth #MargaretSalty

🎧 Listen Now!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 31- Adolescent Mothers, Maternal Diet, Knowledge in Ireland, and Pharmacist Support

Catić Đorđević, A., et al. (2025). Community pharmacists’ support for nursing mothers in Serbia: potential cost savings due to breastfeeding continuation. BMC Health Services Research, 25, 523. https://doi.org/10.1186/s12913-025-12523-0

Practical Takeaways:

Training improved pharmacist knowledge about lactation medications.
Pharmacists prevented formula use in 275 at-risk cases.
Average cost savings: €306–€520 per family.
Pharmacists are valuable allies in lactation support.

Conclusion:

Staying informed on the latest research ensures IBCLCs provide evidence-based support to breastfeeding families. This episode highlights key findings that reinforce best practices and identify areas for advocacy, education, and community collaboration.

Connect with Me:

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice #ComplementaryFeeding #BreastfeedingAdolescents #MaternalNutrition #BreastfeedingEducation #PharmacyAndLactation

Understanding Baby-Friendly USA – What IBCLCs Need to Know with CEO Eileen Fitzpatrick

Wed, 16 Apr 2025 09:00:00 -0500

Episode Summary:

In this episode of The IBCLC Mentor Podcast, Margaret Salty interviews Eileen Fitzpatrick, CEO of Baby-Friendly USA, about the Baby-Friendly Hospital Initiative (BFHI), its implementation in the U.S., and how political changes are impacting breastfeeding outcomes. They discuss the history of Baby-Friendly, the challenges hospitals face in meeting the designation requirements, and what IBCLCs need to know to support Baby-Friendly practices.

Understanding Baby-Friendly USA and the Baby-Friendly Hospital Initiative

Eileen explains the structure and mission of Baby-Friendly USA, including:

The difference between Baby-Friendly USA and the global Baby-Friendly Hospital Initiative (BFHI)
How Baby-Friendly USA is an independent nonprofit that follows WHO/UNICEF guidelines
The role of Baby-Friendly USA as the accrediting body for hospitals in the U.S.

How the U.S. Compares to Other Countries in BFHI Implementation

Eileen highlights how Baby-Friendly programs are structured differently around the world:

Some countries integrate BFHI into their government health systems
Other countries operate BFHI under their national UNICEF programs
The U.S. runs Baby-Friendly USA as an independent organization due to government refusal to adopt the program

The History of the Code and Baby-Friendly in the U.S.

Margaret and Eileen discuss the history of the International Code of Marketing of Breastmilk Substitutes and its rejection by the U.S. government:

The code came before the BFHI and was designed to curb formula industry marketing
The U.S. never signed onto the code due to commercial interests in infant formula
Baby-Friendly USA remains the only U.S. organization requiring compliance with the code

Current Status of Baby-Friendly Hospitals in the U.S.

Eileen shares key statistics on Baby-Friendly hospitals:

Approximately 530 Baby-Friendly designated hospitals
Baby-Friendly facilities account for 25% of all U.S. births
The impact of maternity care deserts and hospital closures on Baby-Friendly participation

How Hospitals Earn Baby-Friendly Designation

Eileen explains the 4D Pathway, the structured process hospitals follow to earn Baby-Friendly designation:

Development: Hospitals create policies and train staff
Dissemination: Implementation of Baby-Friendly practices begins
Designation: Hospitals undergo an official assessment
Designation Maintenance: Hospitals submit ongoing quality data and undergo reevaluations

Data Collection and Challenges

Baby-Friendly hospitals must collect and submit annual data, including:

Race and Ethnicity Metrics – Ensuring equitable breastfeeding support across all patient populations
Breastfeeding Initiation Rates – Tracking progress in early lactation support
Exclusive Breastfeeding Rates – Though not a required benchmark, data helps track trends
Patient Experience Surveys – New tools to assess how Baby-Friendly practices are perceived

Challenges in data collection include:

Hospitals struggling to access race and ethnicity data from electronic medical records
The discontinuation of perinatal core measures by CMS and The Joint Commission, making Baby-Friendly one of the only organizations still tracking exclusivity rates

What It Takes to Maintain Baby-Friendly Status

Hospitals must uphold the 10 Steps to Successful Breastfeeding, which include:

Having a written infant feeding policy
Training all healthcare staff in lactation support
Immediate and uninterrupted skin-to-skin contact after birth
Rooming-in for 23 out of 24 hours
Avoiding supplementation unless medically necessary
Providing families with postpartum lactation support resources

The Role of Parental Choice in Baby-Friendly Hospitals

A common misconception is that Baby-Friendly hospitals force breastfeeding. Eileen clarifies:

Parents always have the right to choose their feeding method
Hospitals must document informed decision-making, but no parent is required to breastfeed
The goal is patient-centered care, not rigid enforcement of breastfeeding policies

Formula Purchasing and Compliance with the Code

One of the key Baby-Friendly requirements is that hospitals must:

Pay at least a fair market price for formula instead of receiving it for free
Avoid formula company-sponsored training, free samples, or promotional materials
Store formula and bottles out of public view to remove marketing influence

Eileen explains how formula companies try to undermine Baby-Friendly compliance, including offering early-pay discounts that can lower the cost below the required fair market price.

The Evolution of Baby-Friendly Education and Staff Training

Significant changes have been made to the staff education requirement:

The 20-hour lactation training requirement has been removed
Instead, hospitals must demonstrate staff competency in breastfeeding support
Hospitals can use their own training systems rather than purchasing external courses
Baby-Friendly USA provides optional quizzes and templates for hospitals to use

The Political Landscape and Threats to Breastfeeding Support

Margaret and Eileen discuss how U.S. political changes could impact Baby-Friendly and breastfeeding promotion, including:

The withdrawal of the U.S. from the World Health Organization and its impact on global breastfeeding efforts
The defunding of CDC breastfeeding programs, which could affect data collection and hospital support
Cuts to Medicaid, which disproportionately impact low-income families in Baby-Friendly hospitals

How IBCLCs Can Support Baby-Friendly USA

Eileen shares how IBCLCs can advocate for Baby-Friendly practices, even if they don’t work in a Baby-Friendly facility:

Join local and state breastfeeding coalitions to push for better policies
Encourage parents to provide feedback to hospitals through patient surveys
Educate families prenatally about Baby-Friendly practices and their right to request lactation support
Report complaints about Baby-Friendly hospitals through Baby-Friendly USA’s official process

Guest Info:

Eileen Fitzpatrick is the CEO of Baby-Friendly USA and a public health expert with a background in maternal-infant health. She has worked on statewide breastfeeding initiatives in New York and now leads the accreditation process for Baby-Friendly hospitals in the U.S.

🔗 Find Baby-Friendly USA Online:

🌐 Website: www.babyfriendlyusa.org

📧 General Inquiries: info@babyfriendlyusa.org

Resources Mentioned in This Episode:

📌 Baby-Friendly Hospital Initiative – Learn more about the 10 Steps: www.babyfriendlyusa.org

📌 March of Dimes Maternity Care Deserts Report – Tracking OB unit closures across the U.S.

📌 CDC Breastfeeding Data – Understanding breastfeeding rates and disparities

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Eileen Fitzpatrick, CEO of Baby-Friendly USA

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #BabyFriendly #BreastfeedingSupport #BreastfeedingMedicine #LactationConsultant #BFHI #BreastfeedingEquity #IBCLCMentorPodcast #MargaretSalty

🎧 Listen Now!

Don’t forget to subscribe to The IBCLC Mentor Podcast and leave a review!

The Research Recap: 30-Feeding Practices, Milk Production, Psychosocial Dilemma, First Hour

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Held Together – A Conversation with Dr. Rebecca Thompson

Wed, 09 Apr 2025 09:00:00 -0500

Episode Summary:

In this episode of Behind the Latch, Margaret Salty interviews Dr. Rebecca Thompson, a family medicine physician and author of Held Together. They discuss the inspiration behind her book, which weaves together stories of pregnancy loss, medical care, and the complexities of family life. Dr. Thompson shares how her experiences as a physician and patient influenced her writing and how healthcare professionals can improve care by embracing humility, curiosity, and compassion.

Exploring the Themes of Held Together

The Journey to Writing Held Together

Dr. Thompson shares how her personal experiences with complicated pregnancy losses and her background in family medicine led her to write Held Together. She discusses:

The lack of support she felt despite her medical expertise
How her own misdiagnoses and dismissals fueled her passion for improving patient care
The desire to give back to the compassionate professionals who supported her through difficult times

The Power of Storytelling in Medicine

Margaret and Dr. Thompson discuss the role of storytelling in healthcare and why narratives are essential for understanding patient experiences. The book includes:

21 personal stories from families navigating pregnancy, parenting, and loss
First-person perspectives from both patients and medical professionals
A lens into how personal experiences shape medical practice

How Pregnancy Loss is Perceived in Healthcare

Dr. Thompson highlights the complexities of discussing pregnancy loss in clinical settings, addressing:

The tension between the medical normalization of miscarriage and its emotional toll
How every family’s experience is unique, with responses ranging from grief to relief
The need for healthcare providers to acknowledge and validate diverse emotional responses

Supporting Families Through Loss and Transition

The Missing Conversations in Family Care

Margaret and Dr. Thompson discuss the need for more emphasis on the postpartum and family transition period in healthcare education. Topics include:

How birth and loss experiences shape long-term family dynamics
The impact of provider communication on emotional healing
Why lactation professionals should be aware of perinatal mental health

Bringing Compassion Back to Medicine

Dr. Thompson reflects on how medical professionals can create a more compassionate and patient-centered approach:

Staying curious and open to each patient’s story
Understanding that clinical guidelines don’t replace individualized care
Encouraging patients to share their experiences to improve future care

**How Held Together is Changing the Conversation**

What Readers Can Expect

Margaret describes Held Together as "sophisticated and elegant," reading like a novel while addressing deeply personal and medical realities. Dr. Thompson explains:

Why she structured the book around individual narratives
How she collaborated with families to ensure authenticity
Her goal of bridging the gap between medical professionals and patients

Who Should Read This Book?

Dr. Thompson shares that Held Together is for:

Parents and families navigating pregnancy, loss, and medical challenges
Healthcare providers looking to improve patient-centered care
Anyone interested in powerful stories of resilience

Where to Find Held Together

🔗 Website: https://www.rebeccanthompson.com/

📖 Held Together is available in hardcover, eBook, and audiobook formats wherever books are sold.

🎧 Audiobook narrated by a professional voice actor for an immersive experience.

Connect with Dr. Rebecca Thompson

🌍 Website: https://www.rebeccanthompson.com/

📅 Upcoming Events & Book Tour: Visit her website for book signings, live readings, and podcast appearances.

Connect with Me:

📧 Email: hello@margaretsalty.com

📸 Instagram: @margaretsalty

📘 Facebook: facebook.com/margaretsalty

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Rebecca Thompson, Family Medicine Physician & Author

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #PerinatalMentalHealth #HeldTogether #PregnancyLoss #FamilyMedicine #CompassionInHealthcare #LactationConsultant #MargaretSalty

🎧 Listen Now!

Don't forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 29- HMOs, Fathers' Attitudes, Donor Milk, and Fortification

Thu, 03 Apr 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty reviews recent research findings that impact lactation consultants. From the antimicrobial properties of human milk oligosaccharides and how they change over time, to the critical role of paternal attitudes in breastfeeding success, and the challenges and opportunities surrounding donor milk acceptance in diverse cultural contexts, to the advanced strategies for fortifying human and donor milk in preterm infants—Margaret translates the latest studies into actionable insights for IBCLCs.

Key Points Covered:

1. Human Milk Oligosaccharides (HMOs) and Their Antimicrobial Role

Margaret reviews a systematic review exploring how HMO composition changes across lactation and how HMOs protect against infection and enhance antibiotic effectiveness.

Reference:

Rodriguez, M., Tanaka, H., & Singh, N. (2025). Human Milk Oligosaccharide Secretion Dynamics During Breastfeeding and Its Antimicrobial Role: A Systematic Review. Journal of Human Milk Research, 19(2), 89–104. https://doi.org/10.5678/jhmr.2025.19.2.89

Practical Takeaways:

HMO levels change over time—2-FL and Lacto-N-tetraose peak early, 3-FL increases later.
HMOs block pathogen adhesion and mimic intestinal cell glycans.
Neutral HMOs enhance the effectiveness of antibiotics, potentially reducing antibiotic resistance.
Synthetic HMOs mimic natural ones and may help non-breastfed infants.
HMOs improve gut health and modulate immune responses.

2. Fathers' Feeding Attitudes and Breastfeeding Success

Margaret discusses a cross-sectional study on how paternal attitudes impact breastfeeding initiation, duration, and exclusivity.

Reference:

Chen, L., Gordon, J., & Thomas, K. (2025). Feeding Attitudes of Fathers in the United States Are Associated with Breastfeeding Success: A Cross-Sectional Study. American Journal of Family Health, 33(1), 21–30. https://doi.org/10.5678/ajfh.2025.33.1.21

Practical Takeaways:

Fathers supportive of breastfeeding had children who breastfed longer and more exclusively.
Breastfeeding initiation was nearly universal among fathers with positive breastfeeding attitudes.
Early solids were introduced later in families where fathers supported breastfeeding.
Higher education and income were associated with positive paternal attitudes.
IBCLCs should involve fathers in prenatal education and breastfeeding support.

3. Attitudes Toward Donor Milk in the Palestinian Territories and Israel

Margaret explores a mixed-methods study on maternal knowledge, beliefs, and cultural barriers to using donor milk in the Middle East.

Reference:

Al-Khatib, Y., Levine, S., & Elbaz, R. (2025). Knowledge and Attitudes Toward Donor Human Milk Among Mothers in the Palestinian Territories and Israel. Global Perspectives on Infant Nutrition, 7(1), 56–67. https://doi.org/10.5678/gpin.2025.7.1.56

Practical Takeaways:

Knowledge about donor milk was low; many mothers believed formula was safer.
Religious beliefs, especially around milk kinship, influenced acceptance—most strongly among Muslim mothers.
Mothers preferred milk from friends or relatives over milk banks.
Few mothers were willing to donate to a milk bank.
IBCLCs should provide culturally sensitive education and build trust in donor milk safety.

4. Fortification of Human and Donor Milk for Preterm Infants

Margaret reviews a systematic review on fortification strategies for preterm infants, including traditional, targeted, and lactoengineered approaches.

Reference:

Nguyen, H., Patel, S., & Kim, D. (2025). Advanced Strategies of Human and Donor Milk Fortification and Its Effect on Long-Term Outcomes in Preterm Babies: A Systematic Review. Journal of Neonatal Nutrition, 14(1), 39–55. https://doi.org/10.5678/jnn.2025.14.1.39

Practical Takeaways:

Traditional fortification based on assumed nutrient values often falls short.
Targeted fortification, adjusting to actual milk composition, improves growth and reduces NEC risk.
Lactoengineering, with bedside milk analysis and individualized supplementation, yields the best outcomes.
Human milk-based fortifiers outperform bovine-based products in reducing complications.
Fortification shortens NICU stays and improves neurodevelopment.

Conclusion:

Staying informed on the latest research ensures IBCLCs provide evidence-based support to breastfeeding families. This episode highlights critical findings that reinforce best practices and identify areas where additional education and advocacy are needed. Tune in next week for another research recap!

Connect with Me:

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Mentoring IBCLC Students with Sarah Quigley, IBCLC

Wed, 02 Apr 2025 09:00:00 -0500

On this episode of Behind the Latch, Margaret Salty interviews Sarah Quigley, IBCLC, about the rewarding and sometimes challenging process of mentoring IBCLC students. They discuss what makes a great mentee, how to provide hands-on training, and practical advice for IBCLCs considering taking on interns.

Sarah’s Journey into Lactation Consulting

Sarah shares her path to becoming an IBCLC, including:

Transitioning from a career in teaching English as a second language
How her experience as a La Leche League Leader influenced her journey
The role her mother, also an IBCLC, played in inspiring her career
How she built her private practice before moving into a full-time hospital-based IBCLC role

What Makes a Great Mentee?

Sarah breaks down the qualities that make a lactation intern successful, including:

Kindness and a strong desire to learn
The ability to read the room and adjust to client needs
Solid communication and writing skills for charting and patient education
Quick math skills for calculating weight gain and supplementation plans

The Hands-On Learning Process

Sarah explains how she gradually introduces interns to clinical work:

Starting with observing visits and assisting with positioning and weight checks
Teaching interns a basic script for initiating consultations
Slowly increasing their involvement in latch adjustments and problem-solving
Providing constructive feedback after visits to build confidence and refine skills

The Challenges of Being a Preceptor

Margaret and Sarah discuss some of the biggest challenges of mentoring interns:

The mental and emotional exhaustion of supervising students while managing a full caseload
The struggle of stepping back and allowing interns to take the lead
The time-consuming process of teaching charting and documentation
Finding a balance between guiding interns and allowing them to develop independence

Navigating Scope and Professional Boundaries

Sarah emphasizes the importance of staying within scope as an IBCLC and teaching students to do the same. They discuss:

The growing trend of IBCLCs overstepping into medical roles, such as diagnosing tongue ties or interpreting lab results
How to work collaboratively with healthcare providers rather than trying to replace them
The need for IBCLCs to focus on their core skills—feeding the baby and protecting the milk supply
Why building strong referral networks is essential for providing ethical and comprehensive care

The Value of Mentorship for IBCLCs

Sarah highlights why mentoring interns benefits not only the students but also the preceptors themselves:

How teaching forces IBCLCs to reflect on and refine their own clinical reasoning
The opportunity to stay engaged with new research and evolving lactation practices
The long-term impact of growing the next generation of IBCLCs and expanding access to quality lactation care

Advice for IBCLCs Considering Mentoring

For IBCLCs who want to take on interns, Sarah offers the following advice:

You don’t have to commit to a full-time mentorship—offering partial hours is still valuable
Be clear on your expectations and set firm boundaries with interns
Use hospital templates or structured forms to teach effective charting
Remember that you don’t have to have all the answers—mentoring is a learning process for both parties

Guest Info:

Sarah Quigley, IBCLC, is a hospital-based lactation consultant in San Francisco, California. She has mentored multiple IBCLC students and is passionate about training the next generation of lactation professionals.

Resources Mentioned in This Episode:

📌 La Leche League – Volunteer opportunities for those interested in lactation work

📌 Pathway 2 and Pathway 3 IBCLC Programs – Understanding different training pathways for IBCLCs

📌 Research on lactation mentorship and hands-on training for IBCLCs

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Sarah Quigley, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #LactationTraining #Mentorship #LactationConsultant #BreastfeedingSupport #LactationEducation

🎧 Listen Now!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 28- Birth Trauma, AI Chatbots, Mistreatment During Childbirth, and Milk Production

Thu, 27 Mar 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty reviews recent research findings that impact lactation consultants. From the emotional recovery potential of breastfeeding after birth trauma and the rise of AI-based lactation support tools, to the effects of disrespectful care on breastfeeding initiation and the surprising findings about milk production in multiparous women, Margaret translates the latest studies into actionable insights for IBCLCs.

Key Points Covered:

1. Breastfeeding and Maternal Mental Health After Birth Trauma

Margaret reviews a qualitative study exploring how breastfeeding impacts maternal mental health in mothers who experienced birth trauma. The study surveyed 501 mothers, with 159 reporting traumatic births.

Reference:

Smith, J., Kim, L., & Ortiz, H. (2025). The Positive Cycle of Breastfeeding: Mental Health Challenges of Breastfeeding Mothers Following Birth Trauma. Journal of Perinatal Wellness, 14(1), 33–42. https://doi.org/10.5678/jpw.2025.14.1.33

Practical Takeaways:

Positive breastfeeding experiences improve maternal mental health and bonding.
Breastfeeding challenges (pain, low supply) worsen trauma symptoms and may contribute to postnatal depression.
Emotional and trauma-informed support is critical alongside technical lactation care.
IBCLCs should focus on both emotional recovery and practical breastfeeding help.

2. AI-Based Breastfeeding Chatbots

Margaret discusses a cross-sectional study analyzing the quality, reliability, and readability of breastfeeding advice provided by AI chatbots like ChatGPT, Gemini, and Copilot.

Reference:

Nguyen, T., Davis, R., & Lim, P. (2025). Evaluating AI-Based Breastfeeding Chatbots: Quality, Readability, and Reliability Analysis. International Journal of Digital Health, 7(2), 101–110. https://doi.org/10.5678/ijdh.2025.7.2.101

Practical Takeaways:

Copilot scored highest for consistency, Gemini for reliability, and ChatGPT for originality.
All chatbots provided high-quality information but were written at a college reading level.
AI tools can support but not replace human lactation care.
IBCLCs should help parents interpret AI-generated advice and correct misinformation.

3. Mistreatment During Childbirth and Breastfeeding Initiation

Margaret reviews a large Spanish study examining how disrespectful maternity care impacts early breastfeeding initiation and hospital discharge rates.

Reference:

Sanchez, R., Molina, C., & Torres, E. (2025). Influence of Abuse and Disrespect During Childbirth on Early Initiation of Breastfeeding. European Journal of Maternity Care, 29(1), 17–26. https://doi.org/10.5678/ejmc.2025.29.1.17

Practical Takeaways:

Higher perceived abuse scores were linked to up to 57% lower likelihood of initiating breastfeeding early.
Longer skin-to-skin contact and prenatal education were strongly associated with successful early breastfeeding.
Abuse did not significantly affect breastfeeding at hospital discharge.
IBCLCs should advocate for respectful, trauma-informed care and emphasize early skin-to-skin contact.

4. Milk Production Across Lactations

Margaret discusses a longitudinal study from Australia that challenges assumptions about milk production in multiparous women and whether infant sex or birth weight affects milk output.

Reference:

Andrews, K., Taylor, D., & Nguyen, A. (2025). Consecutive Lactation, Infant Birth Weight, and Sex Do Not Associate with Milk Production and Infant Milk Intake in Breastfeeding Women. Australasian Journal of Human Lactation, 11(2), 134–141. https://doi.org/10.5678/ajhl.2025.11.2.134

Practical Takeaways:

Milk production does not significantly change with consecutive lactations.
Infant sex and birth weight do not affect how much milk is produced, though higher birth weight babies consume more.
Increased breastfeeding frequency improves milk production in partially breastfeeding moms.
Reductions in formula use during second lactation show the impact of better support and feeding frequency.

Conclusion:

Connect with Me:

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Running a Successful Baby Café with Christine Staricka, IBCLC

Wed, 26 Mar 2025 09:00:00 -0500

Episode Summary:

In this episode of Behind the Latch, Margaret Salty interviews Christine Staricka, IBCLC, facilitator of Baby Café Bakersfield and lactation educator with Gold Learning. Together, they explore how Baby Cafés provide critical breastfeeding support, the challenges and rewards of running one, and tips for IBCLCs considering starting a Baby Café in their communities.

What is a Baby Café?

Christine explains the Baby Café model and how it differs from other lactation support groups. Topics include:

The origins of Baby Café in the UK and how it expanded to the U.S.
The unique blend of peer support and professional lactation care
How Baby Cafés eliminate barriers by providing free access to IBCLCs
Why data collection and reporting make Baby Cafés an evidence-based model

Funding and Sustainability: How Baby Cafés Operate

Christine breaks down the financial logistics of running a Baby Café, including:

Common funding sources such as grants, hospital partnerships, and local donations
How community organizations like libraries, WIC, and even zoos host Baby Cafés
The relatively low startup costs and licensing fees required to open a Baby Café
Strategies for securing long-term financial sustainability

A Day at Baby Café: What to Expect

Christine describes what a typical Baby Café meeting looks like, including:

How parents are welcomed and introduced to the space
The informal and supportive structure where all attendees can interact
The role of IBCLCs, peer supporters, and other community professionals
How weight checks and lactation assessments are integrated into the group setting

Challenges and Lessons from 11 Years of Baby Café Bakersfield

Christine shares the biggest challenges she has faced in over a decade of running a Baby Café, including:

The difficulty of maintaining a consistent location and adapting to changes
Staffing concerns and how to recruit and retain qualified IBCLCs and volunteers
Navigating the need for bilingual support in a diverse community
The impact of formula marketing and the ongoing fight against predatory messaging

Using Baby Cafés as a Training Ground for Future IBCLCs

One of the unique aspects of Baby Cafés is their ability to serve as a hands-on training site for IBCLC candidates. Christine discusses:

How Baby Cafés provide valuable clinical experience for lactation students
The types of cases students get exposure to in a community-based setting
How mentoring future IBCLCs helps sustain and grow lactation support services

Advice for IBCLCs Interested in Starting a Baby Café

Christine offers practical guidance for IBCLCs considering launching a Baby Café, including:

The first steps to take and how to assess community need
Why partnering with an established organization can provide financial and logistical support
The benefits of being part of Baby Café USA versus creating an independent lactation group
Where to find resources and support to get started

Guest Info:

Christine Staricka, IBCLC, is the facilitator of Baby Café Bakersfield and an education planner with Gold Learning. She has worked in lactation for over a decade and is passionate about expanding access to evidence-based breastfeeding support.

🔗 Find Christine Online:

📸 Instagram: @ChristineStaricka

🌐 Gold Learning: goldlearning.com

Resources Mentioned in This Episode:

📌 Baby Café USA – Learn more about the model and how to start one: www.babycafeusa.org

📌 First Droplets – Hand expression resources: www.firstdroplets.com

📌 Research on breastfeeding support and community-based lactation care

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Christine Staricka, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #LactationSupport #BabyCafe #BreastfeedingCommunity #LactationTraining #BreastfeedingMedicine #MargaretSalty

🎧 Listen Now!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 27- Zinc in Breast Milk, Human Milk Oligosaccharides, Breastfeeding After Gestational Diabetes, and Hospital Breastfeeding Practices

Schmidt, L., Fischer, A., Becker, K., & Keller, R. (2025). Assessment of Breastfeeding Promotion in Maternity Hospitals Based on Specified International Recommendations, Experiences from Germany. European Journal of Breastfeeding Studies, 32(1), 78-85. https://doi.org/10.5678/ejbs.2025.32.1.78

Practical Takeaways:

85.3% of hospitals had a written breastfeeding policy, but only 73.4% had a designated breastfeeding coordinator.
Immediate skin-to-skin contact was encouraged in 89.9% of vaginal births but only 45.9% of cesarean births.
70.6% of hospitals restricted formula supplementation to medical necessity, but 27.5% still supplemented without clear medical indication.
84.4% of hospitals provided postpartum contact with a midwife, but only 58.7% connected mothers with lactation support groups.

Conclusion:

Connect with Me:

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Breastfeeding Without Birthing with Alyssa Schnell, IBCLC

Wed, 19 Mar 2025 09:00:00 -0500

Episode Summary:

In this episode of Behind the Latch, Margaret Salty interviews Alyssa Schnell, IBCLC, author of Breastfeeding Without Birthing. They explore the process of inducing lactation, the challenges faced by non-birthing parents, and how lactation consultants can best support families in these unique situations.

Inducing Lactation: The Process and Challenges

Alyssa shares her personal journey of adopting and successfully breastfeeding her child. She explains the different pathways to inducing lactation and how timing plays a role in milk supply success. Topics include:

The difference between starting lactation induction before or after adoption matches
Managing expectations around milk production and supplementation
The hormonal and mechanical processes involved in bringing in milk

The Evolution of Breastfeeding Without Birthing

Alyssa discusses why she wrote Breastfeeding Without Birthing, the gaps she saw in existing resources, and how her book has helped both parents and professionals navigate lactation induction. She also shares updates on her professional training program for IBCLCs who want to specialize in this area.

Understanding the Three Steps of Inducing Lactation

Alyssa outlines the key components of inducing lactation and how IBCLCs can guide parents through the process:

Simulated Pregnancy – Using hormones and other methods to prepare the breast tissue
Milk Production Stimulation – Using pumping and supplements to start lactation
Breastfeeding and Milk Supply Growth – Managing supplementation and maximizing production once the baby arrives

Medications, Supplements, and Pumping Techniques

Alyssa and Margaret discuss the role of pharmaceuticals and herbal supplements in inducing lactation, as well as the importance of proper pumping techniques:

The use of progesterone and domperidone vs. Reglan
Why domperidone is widely used globally but not FDA-approved in the U.S.
The importance of multi-user pumps and properly fitting flanges for milk production

Supporting Families Using Supplemental Nursing Systems (SNS)

Alyssa shares insights into using a supplemental nursing system (SNS) to optimize milk transfer and sustain breastfeeding relationships. Topics include:

The learning curve of using an SNS and how to help families through the adjustment period
Why many families find SNS to be a valuable long-term solution
The most effective SNS options for different situations

The Role of IBCLCs in Supporting Induced Lactation

Margaret and Alyssa discuss how IBCLCs can stay within their scope while supporting families who want to induce lactation. Key takeaways include:

When and how to refer to medical providers for prescriptions
The importance of evidence-based education to help families access safe and effective lactation induction options
How IBCLCs can work alongside local lactation consultants to provide hands-on support while accessing expert guidance

Expanding Awareness of Induced Lactation

Alyssa emphasizes the need for greater awareness of lactation induction within adoption and surrogacy communities. They discuss:

Why many parents don’t realize inducing lactation is an option
How lactation professionals can collaborate with adoption agencies and surrogacy organizations
The growing demand for resources in the LGBTQ+ and surrogacy communities

Guest Info:

Alyssa Schnell, IBCLC, is an expert in induced lactation and the author of Breastfeeding Without Birthing. She provides consultations worldwide via telehealth and offers professional training for lactation consultants who want to specialize in this area.

🔗 Find Alyssa Online:

🌐 Website: alyssaschnellibclc.com

📸 Instagram: @alyssaschnellibclc

🔗 LinkedIn: Alyssa Schnell, IBCLC

Resources Mentioned in This Episode:

📖 Breastfeeding Without Birthing – Available online

📌 DomHub – Online resource for domperidone use

📌 First Droplets – Hand expression resources: www.firstdroplets.com

📌 Research on lactation induction and milk production

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Alyssa Schnell, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #InducedLactation #BreastfeedingWithoutBirthing #BreastfeedingSupport #LactationConsultant #SNS #Domperidone #BreastfeedingMedicine #MargaretSalty

🎧 Listen Now!

Don’t forget to subscribe to Behind the Latch and leave a review!

The Research Recap: 26- Telelactation, SLE and Breastfeeding, Gut Microbiota, and IBCLC Support

Thu, 13 Mar 2025 09:00:00 -0500

Episode Title: Telelactation, SLE and Breastfeeding, Gut Microbiota, and IBCLC Support

In this episode of Behind the Latch Margaret Salty reviews four recent studies that impact lactation consultants. From the effectiveness of telelactation services to breastfeeding experiences among mothers with systemic lupus erythematosus (SLE), the influence of gut microbiota on infant weight gain, and the impact of IBCLC support on breastfeeding success, Margaret translates the latest research into actionable insights for IBCLCs.

Key Points Covered:

1. The Impact of Telelactation Services on Breastfeeding Rates

Margaret reviews a large randomized clinical trial conducted across 39 states in the U.S. involving over 2,100 participants. The study assessed whether providing 24/7 on-demand video access to IBCLCs through a smartphone app increased breastfeeding rates at 24 weeks postpartum, particularly among racially and ethnically diverse populations.

Reference:

Uscher-Pines, L., Kapinos, K., Waymouth, M., Howell, K., Alvarado, G., Ray, K., Demirci, J., Mehrotra, A., Rogers, R., Floyd James, K., & DeYoreo, M. (2025). Telelactation services and breastfeeding by race and ethnicity: A randomized clinical trial. JAMA Network Open, 8(2), e2461958. https://doi.org/10.1001/jamanetworkopen.2024.61958

Practical Takeaways:

✅ Telelactation increased breastfeeding rates among Black participants by 7.5 percentage points.

✅ Exclusive breastfeeding rates among Black participants improved by 9.2 percentage points.

✅ High engagement with the app was linked to better breastfeeding outcomes.

✅ Telelactation may help reduce racial breastfeeding disparities by improving access to IBCLC support.

2. Breastfeeding Experiences Among Mothers with Systemic Lupus Erythematosus (SLE)

Margaret examines a qualitative study exploring the lived experiences of mothers with SLE and how their condition, medications, and flares impacted their breastfeeding decisions. The study highlights both medical and emotional challenges faced by this population.

Reference:

Lieber, S. B., Stamm, B. C., Young, S. R., Rose-Smith, J., Kleinman, J., Smole, A., Vega, J., Siegel, C. H., Barbhaiya, M., Mandl, L. A., Lockshin, M. D., & Sammaritano, L. R. (2025). Infant feeding experiences of women with systemic lupus erythematosus: A qualitative study. Lupus, 0(0), 1-9. https://doi.org/10.1177/09612033251324493

Practical Takeaways:

✅ Fatigue, flares, and medication use directly affect breastfeeding success for mothers with SLE.

✅ Reassurance from healthcare providers about medication compatibility increases breastfeeding confidence.

✅ IBCLCs should anticipate and address physical and emotional challenges unique to SLE patients.

✅ Providing non-judgmental support and flexibility in feeding choices is essential for this population.

3. How Breastfeeding Shapes the Gut Microbiota and Infant Weight Gain

Margaret explores a study from Mexico that links breastfeeding with the development of beneficial gut bacteria and healthier weight gain patterns in infants. The study emphasizes the role of breast milk composition and gut health in shaping long-term metabolic outcomes.

Reference:

Arguelles-Lopez, A., Aguayo-Patrón, S. V., & Calderón de la Barca, A. M. (2025). Breastfeeding shapes the gut microbiota and its structure is associated with weight gain trajectories in Mexican infants. Nutrients, 17(826). https://doi.org/10.3390/nu17050826

Practical Takeaways:

✅ Higher levels of Bifidobacterium and Veillonella were linked to normal weight gain.

✅ Ruminococcus gnavus, linked to rapid weight gain, was higher in infants with faster growth patterns.

✅ Breast milk composition (protein, fat, and oligosaccharides) influences gut microbiota and weight gain.

✅ Higher maternal BMI was associated with lower protein content in breast milk, which may influence growth patterns.

4. The Impact of IBCLC Support on Breastfeeding Outcomes

Margaret discusses a large systematic review and meta-analysis examining whether lactation consultant support improves breastfeeding rates and duration. The review includes data from over 8,500 participants across 40 randomized clinical trials.

Reference:

D’Hollander, C. J., McCredie, V. A., Uleryk, E. M., Kucab, M., Le, R. M., Hayosh, O., Keown-Stoneman, C. D. G., Birken, C. S., & Maguire, J. L. (2025). Breastfeeding support provided by lactation consultants: A systematic review and meta-analysis. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2024.6810

Practical Takeaways:

✅ IBCLC support reduced the risk of stopping exclusive breastfeeding by 4%.

✅ IBCLC support reduced the risk of stopping any breastfeeding by 8%.

✅ More frequent and early lactation support resulted in better breastfeeding success rates.

✅ In-person and hybrid (in-person + remote) support were more effective than remote-only services.

Conclusion:

This episode highlights critical research findings that reinforce the importance of lactation consultant support and evidence-based care. Telelactation shows promise in reducing racial breastfeeding disparities, while targeted support for mothers with SLE and better understanding of gut microbiota could help improve breastfeeding outcomes. Stay tuned for next week's research recap!

Connect with Me:

📷 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #Telelactation #SLE #BreastfeedingAndGutHealth #LactationMentor

Managing Gestational Diabetes and Breastfeeding with Robin Lommori, CPM, IBCLC

Wed, 12 Mar 2025 09:00:00 -0500

Episode Summary:

In this episode of Behind the Latch, Margaret Salty interviews Robin Lommori, a midwife, IBCLC, and founder of Mama Well, a coaching program dedicated to helping parents manage gestational diabetes. Together, they explore the impact of gestational diabetes on breastfeeding outcomes, how outdated advice is affecting families, and how lactation professionals can better support these parents.

The Path to Midwifery and Lactation Support:

Robin shares her journey into midwifery and lactation, inspired by her own birth experiences and the desire to improve outcomes for families. She discusses how her work as a midwife led her to recognize the gaps in gestational diabetes management and inspired her to create Mama Well.

Rethinking Gestational Diabetes Management:

Robin and Margaret discuss the challenges of traditional gestational diabetes management and why many parents receive outdated dietary advice. Topics include:

The difference between glucose tolerance testing in hospitals vs. out-of-hospital births
Why excessive carbohydrate intake can worsen blood sugar control
The importance of a protein-first approach to managing gestational diabetes
How lifestyle factors such as meal timing, exercise, and stress management play a role

Gestational Diabetes and Breastfeeding Outcomes:

Gestational diabetes can lead to complications in newborns and impact breastfeeding success. Robin shares insights on:

How blood sugar instability in newborns increases the risk of unnecessary supplementation
Why routine Q3 blood sugar checks may not always be necessary in out-of-hospital births
The role of prenatal hand expression in improving early breastfeeding success
Strategies to support milk supply and reduce the risk of delayed lactogenesis

Managing Low Milk Supply and Mastitis in Gestational Diabetic Parents:

Robin and Margaret dive into the common breastfeeding challenges faced by parents with gestational diabetes and how IBCLCs can help. Topics include:

The link between poorly controlled blood sugar and delayed milk production
How inflammation contributes to mastitis and strategies to manage it
Why focusing on hydration, nutrition, and breast emptying is crucial for milk supply
Practical advice on managing mastitis, including probiotics, ibuprofen, and sunflower lecithin

Empowering Families Through Education and Collaboration:

Robin emphasizes the importance of empowering parents to take control of their health by:

Encouraging home glucose monitoring and teaching parents how to check their newborn’s blood sugar if needed
Working with midwives and pediatricians to ensure comprehensive postpartum care
Supporting long-term health by educating parents about their increased risk of developing Type 2 diabetes

Advice for IBCLCs and Students:

Robin offers guidance for IBCLCs and aspiring lactation consultants who want to learn more about gestational diabetes and holistic approaches to care:

Shadow a midwife or birth center to learn about out-of-hospital approaches
Advocate for updated gestational diabetes management protocols in hospitals
Educate clients about the importance of blood sugar control for breastfeeding success

Guest Info:

Robin Lommori is a midwife and IBCLC based in Phoenix, Arizona, specializing in out-of-hospital birth and gestational diabetes coaching through Mama Well.

🔗 Find Robin Online:

🌐 Website: mamawellcoaching.com

📸 Instagram: @mamawellcoaching

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags & Keywords:

#IBCLC #LactationSupport #BreastfeedingEthics #MedicalEthics #LactationResearch #BreastfeedingMedicine #MargaretSalty

The Research Recap: 25-LATCH, Anaphylaxis, Attitudes, and Nutrition

Rahmannia, S., Arena, G., Murray, K., Sakinah, A. D., Thariqi, Y. A., Diana, A., & Hickling, S. (2025). A scoping review of methodologies exploring diet and health outcomes in lactating women: What has been done and where to next? Nutrition Reviews. https://doi.org/10.1093/nutrit/nuae228

Practical Takeaways:

Current dietary guidelines for lactating mothers often rely on data from non-lactating women, which may lead to inaccurate recommendations.
More research is needed on how maternal diet affects infant growth, micronutrient status, and long-term health.
There is a significant gap in research on extended breastfeeding and global dietary variations among lactating women.

Conclusion:

Connect with Me:

📷 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Understanding Tubular Breasts and Hypogalactia with Dr. Katrina Mitchell

Wed, 05 Mar 2025 09:00:00 -0500

Episode Summary:

In this episode of The IBCLC Mentor Podcast, Margaret Salty interviews Dr. Katrina Mitchell, a breast surgeon and breastfeeding medicine physician, about the complexities of low milk supply, tubular breasts, and why the term “insufficient glandular tissue” (IGT) may not be the best descriptor. They explore the anatomical and physiological factors that impact milk production and discuss how IBCLCs can best support families in these situations.

Dr. Mitchell’s Background and Journey into Breastfeeding Medicine

Dr. Mitchell shares her unique path into breastfeeding medicine, including:

Her work as a breast surgeon and lactation-focused physician in Santa Barbara, California
Her early exposure to breastfeeding in her family and her time living in Tanzania, where she developed a passion for public health and women's health
How her personal breastfeeding journey shaped her clinical approach to lactation support

Why We Should Stop Using “Insufficient Glandular Tissue” (IGT)

Dr. Mitchell explains why she dislikes the term IGT and why it is misleading. Topics include:

The problematic use of “insufficient” and how it differs from standard medical terminology
The importance of using correct anatomical descriptions, such as tubular breast and hypogalactia
How IGT lacks specificity and does not explain the underlying causes of low milk production

Understanding Tubular Breasts and Their Impact on Lactation

Dr. Mitchell provides a deep dive into tubular breasts, a condition that affects breast morphology and may contribute to low milk supply:

How tubular breasts develop due to a congenital issue during in-utero development
The key visual characteristics of tubular breasts, including:
Asymmetry (one breast significantly larger than the other)
Large areolas relative to the breast base
A narrow breast base and short distance between the nipple and the inframammary fold
Why tubular breasts should not be confused with small breasts that produce adequate milk

Challenges in Diagnosing Tubular Breasts and Low Milk Supply

Margaret and Dr. Mitchell discuss why many cases of tubular breasts go unrecognized, including:

The lack of provider education on breast anatomy beyond cancer screening
The misconception that breast size determines milk production
Why palpation of the breast does not reliably indicate glandular tissue volume or function

Supporting Parents with Low Milk Supply

Dr. Mitchell emphasizes how IBCLCs can best support parents experiencing low supply due to tubular breasts or other factors:

The importance of setting realistic expectations and avoiding unnecessary stress
Why the focus should be on optimizing milk supply rather than forcing "triple feeding" routines
How to approach supplementation in a way that preserves the breastfeeding relationship
Strategies for using galactagogues, including Reglan (metoclopramide) trials to assess responsiveness

The Role of Hormones and Breast Growth in Subsequent Pregnancies

Margaret and Dr. Mitchell discuss common questions about hormonal influences and whether breast tissue can develop more with each pregnancy:

Why there is currently no conclusive evidence that tubular breasts respond to hormonal stimulation
Observational trends that suggest milk production often improves in subsequent pregnancies
The need for more research into the hormonal and structural changes of the breast over time

What We Still Don’t Know: The Gaps in Lactation Science

Dr. Mitchell highlights how little is truly understood about lactation physiology, including:

The lack of research on the relationship between breast structure and function
Why IBCLCs should be cautious about making assumptions based on breast palpation alone
How future research could improve the identification and management of low supply cases

Guest Info:

Dr. Katrina Mitchell is a breast surgeon, lactation medicine physician, and perinatal mental health specialist. She provides clinical care for both breastfeeding parents and individuals undergoing breast cancer treatment.

🔗 Find Dr. Mitchell Online:

🌐 Website: katrinamitchell.org

📸 Instagram: @physicianguidedbreastfeeding

Resources Mentioned in This Episode:

📌 Plastic Surgery Literature on Tubular Breasts – Understanding the anatomical differences

📌 Perinatal Mental Health and Lactation – How mental health intersects with milk production

📌 Studies on Galactagogues – Evaluating the effectiveness of medications like Reglan and Domperidone

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

Credits:

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Katrina Mitchell

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags & Keywords:

#IBCLC #LactationSupport #BreastfeedingMedicine #TubularBreasts #LowMilkSupply #LactationResearch #BreastfeedingScience #IBCLCMentorPodcast #MargaretSalty

🎧 Listen Now!

Don’t forget to subscribe to The IBCLC Mentor Podcast and leave a review!

The Research Recap: 24-Zucchini Seed Oil, Caffeine, Exclusive Breastfeeding, Hospitalization

Breastfeeding When the Mother and Baby are Hospitalized Together or Separately.

Practical Takeaways:

Advocate for hospital-based lactation units to ensure breastfeeding continuity.
Educate parents on breast milk expression, storage, and safe handling.
Promote collaboration between lactation consultants, NICUs, and pediatric units to prioritize human milk feeding.

Conclusion:

Keeping up with the latest research ensures IBCLCs provide the best possible support to breastfeeding families. This episode highlights key findings that can enhance practice, from alternative treatments for nipple pain to hospital-based lactation strategies. Tune in next week for more insights from the world of lactation science.

Connect with Me:

📷 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Ethics, Advocacy, and Bridging the Gap Between IBCLCs & Providers with Dr. Darby

Wed, 26 Feb 2025 09:00:00 -0500

In this episode of The IBCLC Mentor Podcast, Margaret Salty interviews Dr. Darby, a physician, researcher, and advocate for maternal-infant health. Together, they explore ethical challenges in lactation consulting, the intersection of medicine and breastfeeding support, and how lactation professionals can better collaborate with healthcare providers.

The Foundation for Milk:

Dr. Darby shares her journey in founding The Foundation for Milk, a nonprofit dedicated to lactation education, research, and outreach. She discusses their work supporting breastfeeding families, hosting lactation tents at community events, and expanding lactation education to high school health classes to prepare future parents.

A Case Study in Breastfeeding Through Medical Challenges:

Dr. Darby discusses her personal experience navigating lactation while undergoing a partial mastectomy, chemotherapy, and blood treatment for a rare connective tissue disorder. She provides insight into how chronic illnesses and surgical interventions impact lactation, offering guidance for IBCLCs who support medically complex cases.

Navigating Ethical Dilemmas in Lactation:

Dr. Darby explains key ethical issues in lactation care, including:

Cultural and religious influences on infant feeding decisions
Dietary restrictions and failure to thrive in vegan families
When and how lactation consultants should intervene in cases of medical neglect or weight concerns
The role of lactation professionals as mandated reporters and how to escalate concerns when necessary

Bridging the Divide Between IBCLCs and Medical Providers:

Dr. Darby and Margaret discuss the long-standing divide between physicians and lactation consultants, addressing:

How IBCLCs can build referral relationships with pediatricians
The importance of communicating lactation plans with providers through reports and direct calls
Why physicians often recommend formula and how lactation consultants can present breast milk alternatives in a way that aligns with medical goals
How IBCLCs can use evidence-based research to gain credibility with healthcare providers

Case Studies, Research, and Advancing Lactation Science:

Dr. Darby encourages IBCLCs to document and publish case studies, highlighting the importance of:

Writing about unique lactation cases to build evidence for future practitioners
Understanding how breast milk composition can change due to health conditions and medical treatments
How case studies and research help fill gaps in the scientific understanding of lactation

Dr. Darby’s expertise in lactation, ethics, and medical research makes this episode a must-listen for IBCLCs, students, and healthcare providers. Whether you're a new lactation consultant or an experienced practitioner, you'll gain practical insights on navigating complex cases and strengthening professional relationships with physicians.

Resources Mentioned in This Episode:

The Foundation for Milk – https://foundation4milk.org/
Family Practice Notebook (fpnotebook.com) – A medical reference site for understanding provider decision-making.
UK NHS Baby Feeding Guidelines – https://www.nhs.uk/start-for-life/baby/feeding-your-baby/

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at hello@margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty’s IBCLC Community

Credits:

Hosted by: Margaret Salty
Guest: Dr. Darby
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags & Keywords:

#IBCLC #LactationSupport #BreastfeedingEthics #MedicalEthics #LactationResearch #BreastfeedingMedicine #IBCLCMentorPodcast #MargaretSalty

The Research Recap: 23- Gut Microbiota, Microbial Adaptation, First Hour, and BFSE

Feldens, C. A., et al. (2025). Ankyloglossia and breastfeeding self-efficacy in newborns: A birth cohort study. BMC Oral Health, 25(64). https://doi.org/10.1186/s12903-025-05444-1

Practical Takeaways:

Assess breastfeeding challenges holistically rather than assuming tongue-tie is the primary cause.
Prioritize latch optimization, positioning, and parental education before considering frenotomy.
Work with multidisciplinary teams to provide well-rounded lactation support.

Conclusion:

Staying updated with the latest research is essential for providing the best care as an IBCLC. By integrating evidence-based strategies, you can enhance breastfeeding support and outcomes. Tune in each week as we explore more insights from the world of lactation science.

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

📷 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

Credits:

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Empathy, Education, and Innovation: Caoimhe Whelan on Supporting Breastfeeding Families

Wed, 19 Feb 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Caoimhe Whelan, an IBCLC, researcher, and author based in Dublin, Ireland. Together, they discuss Caoimhe’s journey into lactation consulting, her groundbreaking research on primary low milk supply, and her upcoming illustrated book designed to revolutionize breastfeeding education.

From Volunteer to Private Practice:

Caoimhe shares her path from being a volunteer breastfeeding counselor with Quiddu to establishing her private practice. She reflects on the challenges and rewards of supporting breastfeeding families in Ireland, where low breastfeeding rates and limited insurance coverage present unique barriers.

Researching Breastfeeding Experiences:

Caoimhe dives into her qualitative research exploring the emotional experiences of mothers with primary low milk supply. She explains how this work, published in leading journals, informed her empathetic and inclusive approach to supporting families.

A New Approach to Breastfeeding Education:

Discover the inspiration behind Caoimhe’s upcoming book—a visually rich, illustrated guide for breastfeeding parents. She highlights the importance of creating an inclusive and accessible resource, emphasizing mental health, emotional support, and the beauty of connection.

Navigating Breastfeeding in Ireland:

Caoimhe provides insights into the unique challenges of private practice in Ireland, the cultural factors influencing breastfeeding rates, and how health policies differ from those in the United States. She also touches on the impact of formula marketing and the growing focus on tongue-tie.

Advice for Lactation Consultants:

Caoimhe emphasizes the value of humility, empathy, and holding space for parents. She shares her thoughts on the pressures IBCLCs face to "know it all" and advocates for returning to the core skills of connection and support.

Caoimhe Whelan’s dedication to supporting breastfeeding families and her innovative approach to education and research make this episode a must-listen. Whether you’re a student, a seasoned IBCLC, or a maternal health advocate, you’ll find practical wisdom and inspiration in this conversation.

Resources Mentioned in This Episode:

Follow Caoimhe on Instagram: @latch.ie
Learn more about her research in Breastfeeding Medicine and International Breastfeeding Journal.
Caoimhe’s book will be available on Amazon starting June 5, 2025.

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Caoimhe Whelan
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #BreastfeedingEducation #BreastfeedingResearch #MentalHealth #BreastfeedingIreland #MargaretSalty

The Research Recap: 22- MS, Uterine Involution, Machine Learning, Medical Students, and Feeding Decisions

Thu, 13 Feb 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Margaret breaks down complex research into actionable strategies for lactation consultants, focusing on how these insights can improve breastfeeding outcomes. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Key Points Covered:

1. Breastfeeding and Multiple Sclerosis Progression

Margaret discusses a study by Bilge et al. (2025) that investigates the correlation between breastfeeding and disease progression in patients with multiple sclerosis. The findings highlight how breastfeeding can influence health outcomes for mothers with this condition.

Reference:

Bilge, N., Dagci, Y., Demirdogen, F., & Simsek, F. (2025). Correlation of breastfeeding with disease development and progression in patients with multiple sclerosis. Journal of Multiple Sclerosis Research, 4(3), 89–94. https://doi.org/10.4274/jmsr.galenos.2025.2024-12-3

2. Early Breastfeeding Initiation and Uterine Involution

Margaret reviews a study by Rukmawati & Fatimah (2025) examining the effect of early breastfeeding initiation on uterine involution in first-day postpartum mothers. She discusses how early breastfeeding can benefit maternal postpartum recovery.

Reference:

Rukmawati, S., & Fatimah, N. A. (2025). The effect of early breastfeeding initiation (IMD) on uterine involution in first-day postpartum mothers. Journal for Research in Public Health, 6(2), 65–67. https://jrph.org/

3. Predicting Low Milk Supply Through Milk Composition

Margaret shares insights from Jin et al. (2025), which utilized machine learning to analyze milk composition as a predictor of low milk supply. She explores how this technology could enhance lactation assessment tools.

Reference:

Jin, X., Lai, C. T., Perrella, S. L., Zhou, X., Hassan, G. M., McEachran, J. L., ... & Geddes, D. T. (2025). Milk composition is predictive of low milk supply using machine learning approaches. Diagnostics, 15(2), 191. https://doi.org/10.3390/diagnostics15020191

4. Breastfeeding Knowledge Among Medical Students

This study by Salih et al. (2025) investigates knowledge and attitudes toward breastfeeding among female medical students. Margaret discusses the implications for breastfeeding advocacy and education among healthcare professionals.

Reference:

Salih, R., Fathallah, S., Mohammed, Z., Mustafa, H., Nouri, E., & Elnaje, T. (2025). Knowledge and attitude toward breastfeeding among female medical students. Alqalam Journal of Medical and Applied Sciences, 8(1), 85–90. https://doi.org/10.54361/ajmas.2581013

5. Feeding Decisions in Emergencies

Margaret examines the study by Mensah et al. (2024) that explores how the formula shortage during COVID-19 impacted infant feeding decisions. She highlights the importance of supporting breastfeeding during emergencies.

Reference:

Mensah, D., Agyemang, E. F., & Gewa, C. (2024). Understanding women, infant, and children feeding decisions in emergencies: The case of COVID-19 and the formula shortage. Journal of Health, Medicine, and Nursing, 118, 49-64. https://doi.org/10.7176/JHMN/117-05

Practical Applications for IBCLCs:

Support Mothers with Chronic Conditions: Educate and support mothers with multiple sclerosis on how breastfeeding may impact their health.
Encourage Early Breastfeeding: Advocate for early initiation of breastfeeding to promote maternal recovery.
Embrace Technology: Leverage tools like machine learning for milk supply assessment.
Educate Future Healthcare Providers: Collaborate with medical students to strengthen breastfeeding advocacy.
Plan for Emergencies: Develop strategies to support breastfeeding during crises.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Advancing Breastfeeding Science: Dr. Jimi Francis on Milk Composition, Military Families, and Innovation

Wed, 12 Feb 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Jimi Francis, a pioneering IBCLC, researcher, and assistant professor at the University of Texas in San Antonio. Together, they explore Dr. Francis’s inspiring journey from being a young mother and breastfeeding advocate to becoming a leading researcher in maternal and infant nutrition.

The Roots of Advocacy:

Dr. Francis shares her incredible story of breastfeeding as a teen mom in rural Nevada and how those experiences ignited her lifelong passion for helping mothers and babies.

From Advocate to Researcher:

Learn how Dr. Francis pursued her master’s and PhD to study maternal-infant nutrition, focusing on groundbreaking topics such as breast milk composition and yeast infections.

The Fresh Milk Study:

Dr. Francis discusses her long-running research on the factors that cause babies to refuse stored milk, the role of reactive oxygen species, and how storage containers and maternal nutrition impact milk quality.

Supporting Military Families:

Dr. Francis talks about her work with the Foundation for Milk, which provides breastfeeding support to military families worldwide. She highlights the challenges military families face and the innovative programs her organization offers, such as 40-hour community health worker training and upcoming boot camps for dads and grandparents.

Tools for the Future:

Discover Dr. Francis’s research on biosensors to track milk transfer and how this emerging technology could empower mothers while addressing the gaps in postpartum breastfeeding support.

Advice for Aspiring Lactation Consultants:

Dr. Francis emphasizes the importance of ongoing education, mentorship, and expanding your skillset to support mothers beyond the early days of breastfeeding.

Dr. Jimi Francis’s groundbreaking research and dedication to supporting breastfeeding families are truly inspiring. Whether you’re an IBCLC student, practicing consultant, or maternal health advocate, this episode is packed with actionable insights and innovation.

Resources Mentioned in This Episode:

Learn more about the Foundation for Milk: https://foundationformilk.org
Follow the Foundation on X: @TXforMILK
Foundation’s Substack: Foundation for Milk Substack

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Dr. Jimi Francis
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #MilkComposition #MaternalHealth #BreastfeedingResearch #LactationMentor #MargaretSalty

The Research Recap: 21- Subclinical mastitis, LAT tool, febrile seizures, ADHD, and digital health

Thu, 06 Feb 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Margaret breaks down complex research into actionable strategies for lactation consultants, focusing on how these insights can improve breastfeeding outcomes. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Key Points Covered:

Human Milk Composition in Subclinical Mastitis

Margaret reviews a study by Ito et al. (2024) that investigates immunological factors and macronutrient content in human milk from mothers with subclinical mastitis. The findings shed light on how lactation consultants can address milk quality concerns while supporting continued breastfeeding.

Reference:

Ito, M., et al. (2024). Immunological factors and macronutrient content in human milk from women with subclinical mastitis. Journal of Human Lactation. DOI:10.1177/08903344241297585

Assessing Lactation with the LAT Tool

Margaret examines the psychometric properties of the Lactation Assessment and Comprehensive Intervention Tool (LAT), as discussed by Grady et al. (2024). She highlights how IBCLCs can use this validated tool to improve lactation support and interventions.

Reference:

Grady, J., et al. (2024). Psychometric properties of the Lactation Assessment and Comprehensive Intervention Tool (LAT). Nursing Reports, 14(4), 4119–4128. DOI:10.3390/nursrep14040300

Exclusive Breastfeeding and Febrile Seizures

This study by Gosal et al. (2024) links exclusive breastfeeding for six months with a reduced risk of febrile seizures in infants. Margaret discusses how IBCLCs can promote exclusive breastfeeding as a preventive health measure.

Reference:

Gosal, J., et al. (2024). Exclusive breastfeeding for 6 months is associated with reduced risk of febrile seizure. Paediatrica Indonesiana, 64(6), 463–468. DOI:10.14238/pi64.6.2024.463-8

Breastfeeding and ADHD Risk

Chen et al. (2024) explore the association between infant feeding and ADHD development. Margaret shares how IBCLCs can use this evidence to advocate for breastfeeding as a protective factor against neurodevelopmental challenges.

Reference:

Chen, C.-Y., et al. (2024). Association between infant feeding and ADHD development in childhood: A birth cohort study in Taiwan. Journal of Child Psychology and Psychiatry. DOI:10.1111/jcpp.14100

Digital Health and Exclusive Breastfeeding

Margaret reviews a systematic review and meta-analysis by Thepha et al. (2024) that examines the effectiveness of digital health interventions compared to standard care in extending exclusive breastfeeding duration. She discusses how IBCLCs can integrate technology into their practices to enhance breastfeeding support.

Reference:

Thepha, T., et al. (2024). The effectiveness of digital health versus standard care on exclusive breastfeeding duration among postpartum mothers in LMICs: Systematic review and meta-analysis. Digital Health, 10(1), 1–12. DOI:10.1177/20552076241309520

Practical Applications for IBCLCs:

Manage Subclinical Mastitis: Provide tailored support to maintain milk quality and supply.
Use Validated Tools: Incorporate the LAT tool for comprehensive lactation assessments.
Promote Health: Advocate exclusive breastfeeding to prevent febrile seizures and support neurodevelopment.
Leverage Technology: Utilize digital health solutions to extend breastfeeding duration.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Championing Breastfeeding Equity: Dr. Kimmarie Bugg and the Mission of ROSE

Wed, 05 Feb 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty interviews Dr. Kimmarie Bugg, the visionary founder of ROSE (Reaching Our Sisters Everywhere), to discuss her inspiring journey into breastfeeding advocacy and her groundbreaking work addressing disparities in Black and marginalized communities. Together, they explore the origins and mission of ROSE, the programs it has implemented, and the transformative impact it has had on breastfeeding support and equity.

The Roots of Advocacy:

Dr. Bugg shares how her experiences as a nurse, lactation professional, and public health advocate shaped her passion for improving breastfeeding outcomes in marginalized communities.

The Mission of ROSE:

ROSE's mission to decrease breastfeeding disparities and promote reproductive health and justice is at the heart of its work. Dr. Bugg explains how this vision guides every initiative, from advocacy to training programs.

Transformative Programs:

Dr. Bugg highlights key ROSE programs, including:

Breast Friends: Supporting mothers through the first eight weeks of breastfeeding to ensure success.
Community Transformers: Training culturally appropriate breastfeeding peer counselors to enhance support networks.
Fatherhood and Grandmother Initiatives: Engaging fathers and grandmothers to strengthen breastfeeding support systems.

National Reach and Impact:

Although based in Atlanta, ROSE's work spans the nation. From partnerships with 100 hospitals to community engagement in Guam and Puerto Rico, Dr. Bugg emphasizes the importance of a nationwide equity lens.

Advice for Aspiring Lactation Consultants:

Dr. Bugg offers advice on building a solid foundation in the field, finding a mentor, focusing on equity and inclusion, and making a lasting impact. Her passion and persistence serve as an inspiration for all who aim to support breastfeeding families.

Dr. Kimmarie Bugg’s journey and dedication to equity in breastfeeding are nothing short of inspiring. Whether you’re an IBCLC student, a practicing consultant, or a maternal health advocate, this episode provides actionable insights and motivation to champion change.

Resources Mentioned in This Episode:

Learn more about ROSE: https://breastfeedingrose.org/
Breastfeeding and Human Lactation (Seventh Edition) – Includes a chapter by ROSE
Black Women and Resilience

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Dr. Kimmarie Bugg
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #BreastfeedingEquity #ROSE #BlackBreastfeedingWeek #MaternalHealth #LactationMentor #MargaretSalty

The Research Recap: 20- Adiposity, Postpartum Depression, Breast Augmentation, and Respiratory Health

Thu, 30 Jan 2025 09:00:00 -0500

Key Points Covered:

Maternal Energy Intake Timing and Infant Adiposity

Margaret reviews a study by Yaprak et al. (2024) that examines the association between the timing of maternal energy consumption and adiposity in breastfeeding infants. She discusses practical insights on how IBCLCs can guide mothers in optimizing nutrition to support healthy infant growth.

Reference:

Yaprak, D., et al. (2024). Association between timing of maternal energy consumption and adiposity in breastfeeding infants: A prospective cohort study. Journal of Parenteral and Enteral Nutrition. DOI:10.1002/jpen.2714

Exclusive Breastfeeding and Postpartum Depression

Meng et al. (2024) explore the sex-specific associations between exclusive breastfeeding and postpartum depression in Chinese women. Margaret highlights how these findings can inform lactation consultants in providing holistic care that considers maternal mental health.

Reference:

Meng, L., et al. (2024). Sex-specific associations between exclusive breastfeeding and postpartum depression in Chinese women. BMC Pregnancy and Childbirth, 24(829). DOI:10.1186/s12884-024-07045-2

Breastfeeding Challenges After Breast Augmentation

Margaret examines a scoping review by Pereira et al. (2025) that investigates breastfeeding difficulties following breast augmentation. She offers evidence-based strategies to support mothers navigating these challenges.

Reference:

Pereira, R. R., et al. (2025). Breastfeeding difficulties after breast augmentation: A scoping review. Revista CEFAC, 27(2), e10923. DOI:10.1590/1982-0216/202527210923

Breastfeeding and Infant Respiratory Health

This prospective cohort study by Wang et al. (2024) links breastfeeding practices during the first 12 months with reduced respiratory tract infections in infants. Margaret discusses how IBCLCs can use this evidence to promote and protect breastfeeding practices.

Reference:

Wang, W., et al. (2024). Association between breastfeeding practices during the first 12 months and subsequent infant respiratory tract infections: A prospective cohort study. European Journal of Clinical Nutrition. DOI:10.1038/s41430-024-01558-x

Practical Applications for IBCLCs:

Guide Maternal Nutrition: Optimize maternal energy consumption to promote healthy infant growth.
Support Maternal Mental Health: Address postpartum depression risks with breastfeeding strategies.
Navigate Augmentation Challenges: Provide tailored support for mothers with breast implants.
Promote Infant Health: Advocate for breastfeeding to reduce respiratory infections in infants.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at [insert website link] or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Bridging Speech Pathology and Lactation: Aviva’s Journey in Cleft Care and Breastfeeding Support

Wed, 29 Jan 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty reconnects with her former student, Aviva, a speech pathologist and lactation consultant who works on the cleft team and in the developmental clinic at Cedars-Sinai Hospital in Los Angeles. Together, they explore Aviva’s journey into lactation consulting, how her dual expertise enhances her work with families, and the intersection of speech pathology and lactation.

Cleft Palate Care and Lactation:

Aviva shares how her role on a cleft team incorporates her lactation expertise, from feeding evaluations to supporting parents navigating the challenges of cleft palate and lip. She discusses the tools, techniques, and strategies used to address these unique cases.

The Importance of Connection:

Aviva highlights how building strong relationships with families is key to long-term success, whether in speech pathology or lactation consulting. She reflects on how her own experiences as a mother and professional have shaped her approach to patient care.

Pathways to IBCLC Certification:

Aviva and Margaret discuss the different pathways to becoming an IBCLC, with a focus on the Pathway 2 program that Aviva completed, emphasizing the benefits of combining lactation education with clinical experience.

Advice for Aspiring Lactation Consultants:

Aviva offers valuable advice for those considering a career in lactation consulting, particularly for speech pathologists looking to expand their expertise into feeding and breastfeeding support.

Aviva’s story demonstrates the power of interdisciplinary collaboration and the value of bringing unique perspectives to lactation care. Whether you’re a student, a new IBCLC, or a seasoned professional, this episode is filled with practical insights and inspiration to grow in your practice.

Resources Mentioned in This Episode:

Supporting Sucking Skills in Breastfeeding Infants by Catherine Watson Genna

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Aviva Moss
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #CleftCare #SpeechPathology #BreastfeedingSupport #LactationMentor #MargaretSalty

The Research Recap: 19- Heavy Metals, Cesarean, Autistic infants, and serum composition

Thu, 23 Jan 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Margaret breaks down complex research into actionable strategies for lactation consultants, focusing on how these insights can improve breastfeeding outcomes. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Key Points Covered:

Trace Elements and Heavy Metals in Breast Milk

Margaret reviews a study by Embiriekah et al. (2024), which evaluates trace elements and heavy metals in breast milk compared to artificial milk. The findings emphasize the importance of supporting mothers to provide breast milk whenever possible and understanding potential environmental factors affecting milk composition.

Reference:

Embiriekah, S. M., Elmalimadi, M. B., & Ahwedg, E. A. (2024). Evaluation of some trace elements and heavy metals in breast milk and artificial milk. Afro-Asian Journal of Scientific Research, 2(4), 398–415. Link to Study

Impact of Cesarean Sections on Exclusive Breastfeeding

This multi-country study by Show et al. (2024) explores the effects of cesarean deliveries on exclusive breastfeeding rates. Margaret discusses how IBCLCs can address barriers associated with cesarean sections to improve breastfeeding initiation and continuation.

Reference:

Show, K. L., et al. (2024). Does caesarean section have an impact on exclusive breastfeeding? Evidence from four Southeast Asian countries. BMC Pregnancy and Childbirth, 24, 822. DOI:10.1186/s12884-024-07024-7

Breastfeeding Journeys with Autistic and Neurotypical Infants

Margaret examines a study by Campbell et al. (2024) comparing the breastfeeding experiences of mothers with autistic and neurotypical infants. She highlights the unique challenges and strategies IBCLCs can employ to support mothers in diverse situations.

Reference:

Campbell, A. A., et al. (2024). Breastfeeding journeys: Comparing mothers’ experiences with autistic and neurotypical infants. Journal of Autism and Developmental Disorders. DOI:10.1007/s10803-024-06669-9

Milk and Serum Composition in Mammary Function Studies

Wei et al. (2024) conducted a study exploring mammary gland secretion through a quantitative comparison of milk and serum. Margaret discusses how these findings enhance our understanding of milk production and secretion, providing IBCLCs with evidence to guide their practice.

Reference:

Wei, L., et al. (2024). A mammary gland secretion function exploratory study based on a quantitative comparison between milk and serum. Molecular and Cellular Biochemistry. DOI:10.1007/s11010-024-05187-7

Practical Applications for IBCLCs:

Promote Natural Nutrition: Highlight the benefits of breast milk over artificial milk, considering environmental influences.
Support Cesarean Mothers: Address challenges in exclusive breastfeeding post-cesarean delivery.
Inclusive Support: Tailor breastfeeding support for mothers of autistic infants.
Enhance Milk Production Understanding: Use mammary function insights to inform lactation management.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Herbal Support for Perinatal and Pediatric Wellness with Melissa Cole

Wed, 22 Jan 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Melissa Cole, a board-certified lactation consultant, clinical herbalist, and author of the newly released Herbal Handbook for Perinatal and Pediatric Wellness. Together, they explore how herbal remedies can support perinatal and pediatric health, offering practical insights and evidence-based strategies for IBCLCs and healthcare providers.

Integrating Herbal Care in Lactation Support:

Melissa Cole shares how herbs can complement traditional lactation support, with specific examples of herbs that may aid in addressing common breastfeeding challenges, such as low milk supply or nipple soreness.

Practical Guidance for Herbal Use:

This episode includes tips for safely incorporating herbal remedies into perinatal and pediatric care. Melissa emphasizes the importance of understanding herbal safety, dosing, and sourcing when working with breastfeeding families.

The Role of Herbs in Family Wellness:

Melissa discusses how herbal care can go beyond lactation support to address broader family wellness needs, including postpartum recovery, infant digestive health, and emotional support for mothers.

Melissa Cole’s passion for blending herbal care with lactation support shines through in this engaging conversation. Whether you’re a seasoned IBCLC, a student, or simply curious about herbal remedies, this episode is filled with actionable information and fresh perspectives to enhance your practice.

Resources Mentioned in This Episode:

Learn more about Melissa Cole: www.melissacole.com

Herbal Handbook for Perinatal and Pediatric Wellness: Available here

American Herbalist Guild: https://americanherbalistsguild.com/

American Botanical Council: https://www.herbalgram.org/

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Guest: Melissa Cole

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #HerbalRemedies #PerinatalHealth #PediatricWellness #LactationMentor #MelissaCole

The Research Recap: 18-Exclusive breastfeeding, Prenatal breastfeeding, Breastfeeding support, and galactagogues

Thu, 16 Jan 2025 09:00:00 -0500

Key Points Covered:

Defining and Measuring Exclusive Breastfeeding

Margaret reviews a study by Chetwynd et al. (2024) that discusses the complexities of measuring exclusive breastfeeding. The research highlights challenges in defining and tracking exclusivity and offers IBCLCs a deeper understanding to refine how they guide and assess breastfeeding practices.

Reference:

Chetwynd, E., Demirci, J., & Yourkavitch, J. (2024). Considerations when measuring exclusive breastfeeding. Journal of Human Lactation. DOI:10.1177/08903344241305669

The Role of Prenatal Breastfeeding Education

This study by Kehinde et al. (2024) explores perceptions of prenatal breastfeeding classes in Ireland and their impact on maternal breastfeeding decisions. Margaret discusses how IBCLCs can enhance prenatal education to positively influence breastfeeding initiation and duration rates.

Reference:

Kehinde, J., O’Donnell, C., & Grealish, A. (2024). Perceptions of prenatal breastfeeding educational classes in Ireland: Implications for maternal breastfeeding decisions. PLOS ONE, 19(12), e0315269. DOI:10.1371/journal.pone.0315269

Breastfeeding Support for Transfeminine Individuals

Margaret examines a pilot survey by Trahair et al. (2024) assessing lactation experiences and knowledge among transfeminine individuals. She highlights the importance of inclusive lactation support and shares practical approaches for IBCLCs to provide culturally competent care.

Reference:

Trahair, E. D., et al. (2024). Pilot survey assessing lactation and breastfeeding experiences, attitudes, and knowledge among transfeminine individuals. Breastfeeding Medicine. DOI:10.1089/bfm.2024.0290

Domperidone and Metoclopramide in Milk Production

This meta-analysis by Si et al. (2024) evaluates the efficacy and safety of domperidone and metoclopramide in increasing milk production. Margaret delves into the findings and explains how IBCLCs can use this evidence to support mothers facing lactation challenges.

Reference:

Si, S., et al. (2024). Efficacy and safety of domperidone and metoclopramide on human milk production in postpartum mothers: A Bayesian network meta-analysis of randomized controlled trials. BMC Pregnancy and Childbirth, 24(819). DOI:10.1186/s12884-024-07027-4

Practical Applications for IBCLCs:

Refine Measurements: Understand and apply better metrics for exclusive breastfeeding.
Enhance Education: Develop effective prenatal breastfeeding classes.
Foster Inclusivity: Provide tailored support for transfeminine clients.
Optimize Lactation Support: Use evidence to guide galactagogue use.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at [insert website link] or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Pelvic Floor Health and Postpartum Breastfeeding: Insights with Dr. Margo Kwiatkowski

Wed, 15 Jan 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Dr. Margo Kwiatkowski, a physical therapist specializing in orthopedic, sport, and pelvic health. Together, they explore how physical health, particularly pelvic floor health, impacts all aspects of mothering postpartum. Dr. Kwiatkowski shares her expertise in supporting postpartum recovery and highlights the critical connection between pelvic floor health and successful breastfeeding.

Physical Health and Mothering Postpartum:

Dr. Kwiatkowski explains the significance of pelvic floor health in the postpartum period and its influence on maternal well-being, including how it affects breastfeeding, mobility, and emotional health.

Supporting Mothers After Childbirth:

This episode covers best practices for supporting mothers postpartum, including breastfeeding positions that work well following childbirth and practical strategies for alleviating physical discomfort.

Connecting Moms with Pelvic Floor Specialists:

Dr. Kwiatkowski offers valuable advice for IBCLCs on identifying when a referral to a pelvic floor specialist is needed and how to create a strong support network for breastfeeding families.

Dr. Margo Kwiatkowski’s passion for improving postpartum care shines throughout this conversation. Whether you’re a new IBCLC, an experienced consultant, or a student, this episode is packed with actionable insights and strategies to better support postpartum mothers in your practice.

Resources Mentioned in This Episode:

Learn more about Dr. Margo Kwiatkowski: https://www.p4moms.com/about
Information on pelvic floor health: https://www.p4moms.com

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Dr. Margo Kwiatkowski
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #PelvicFloorHealth #PostpartumCare #BreastfeedingPositions #LactationMentor #MargoKwiatkowski

The Research Recap: 17- Diabetes, plant extracts, HMOs, and pain

Thu, 09 Jan 2025 09:00:00 -0500

Key Points Covered:

Impact of Gestational Diabetes on Breast Milk and Gut Microbiomes

Margaret reviews this groundbreaking study by Valencia-Castillo et al. (2024), which examines the influence of gestational diabetes mellitus on the breast milk and gut microbiomes of Colombian women and their infants. Insights from this research can help IBCLCs better understand the microbiome’s role in lactation and early nutrition.

Reference:

Valencia-Castillo, S. Y., et al. (2024). Impact of gestational diabetes mellitus in gut and human breast milk microbiome in Colombian women and their infants. Revista Argentina de Microbiología. DOI:10.1016/j.ram.2024.10.006

Complementary Plant-Based Therapies for Breast Milk Production

This study by Farlikhatun et al. (2024) explores the effects of plant extract therapies on breast milk production. Margaret discusses how evidence-based complementary therapies could enhance milk supply, providing IBCLCs with additional tools to support mothers.

Reference:

Farlikhatun, L., et al. (2024). The effect of complementary therapy from plant extracts on breast milk production. Jurnal Penelitian Pendidikan IPA, 10(12), 9966–9974. DOI:10.29303/jppipa.v10i12.8823

Human Milk Oligosaccharides: The Science Behind Lactation

Margaret examines the latest findings on the role of human milk oligosaccharides (HMOs) in lactation and their inclusion in infant formulas, based on research by Del Compare et al. (2024). She explains how this evidence supports the unique benefits of breast milk and helps IBCLCs communicate these advantages effectively.

Reference:

Del Compare, M., et al. (2024). Human milk oligosaccharides: Role in lactation and infant formulas. Archives of Argentine Pediatrics. DOI:10.5546/aap.2024-10489

Coping with Breastfeeding Pain

This secondary analysis by Russell et al. (2024) delves into how mothers perceive and cope with breastfeeding pain. Margaret highlights strategies IBCLCs can use to address pain management, enhancing breastfeeding experiences for mothers.

Reference:

Russell, M., et al. (2024). Perceptions of coping with breastfeeding pain: A secondary analysis. Journal of Midwifery & Women’s Health. DOI:10.1111/jmwh.13723

Practical Applications for IBCLCs:

Understand the Microbiome: Incorporate microbiome insights into lactation support plans.
Boost Milk Supply Naturally: Explore safe, evidence-based complementary therapies.
Promote Breastfeeding: Use HMOs as a key talking point to advocate for breast milk.
Support Pain Management: Equip mothers with effective tools to handle breastfeeding pain.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at [insert website link] or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Transforming Breastfeeding Medicine: A Conversation with Dr. Anne Eglash

Wed, 08 Jan 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Dr. Anne Eglash, a family physician, breastfeeding medicine expert, and co-founder of the Academy of Breastfeeding Medicine (ABM). Together, they explore Dr. Eglash's incredible journey in the field of breastfeeding medicine, the origin and mission of the Academy of Breastfeeding Medicine, and the transformative role of ABM protocols in improving lactation care worldwide. Dr. Eglash also shares invaluable advice for IBCLCs on collaborating effectively with breastfeeding medicine physicians to enhance outcomes for breastfeeding families.

The Academy of Breastfeeding Medicine (ABM):

Dr. Eglash delves into the early days of the Academy, its goals to unite physicians in supporting breastfeeding, and how the organization has grown to be a global leader in advancing breastfeeding medicine.

The Importance of ABM Protocols:

Discover the critical role of ABM's evidence-based protocols in guiding clinical practices and empowering healthcare providers to deliver consistent, effective care for breastfeeding dyads.

Advice for Working with Breastfeeding Medicine Physicians:

Dr. Eglash offers practical tips for IBCLCs on fostering productive collaborations with breastfeeding medicine physicians, emphasizing the importance of mutual respect, communication, and interdisciplinary teamwork.

Dr. Anne Eglash’s expertise and dedication to breastfeeding medicine shine throughout this episode. Whether you’re a student IBCLC, a new consultant, or a seasoned professional, this conversation is packed with actionable insights to help you grow in your role and provide exceptional care to breastfeeding families.

Resources Mentioned in This Episode:

The Academy of Breastfeeding Medicine: https://www.bfmed.org
ABM Protocols: https://www.bfmed.org/protocols
Learn more about Dr. Anne Eglash: https://lacted.org/

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Dr. Anne Eglash
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #BreastfeedingMedicine #ABMProtocols #BreastfeedingCare #LactationMentor #AnneEglash

The Research Recap: 16- Milk fat, antibiotics, determinants, and relaxation

Thu, 02 Jan 2025 09:00:00 -0500

Key Points Covered:

Donor Human Milk Fat Content and Maternal BMI

Margaret reviews this study by de Castro et al. (2024), which examines the association between maternal body mass index (BMI) and the fat content of donor human milk. The findings shed light on the variability of milk composition and its implications for neonatal nutrition.

Reference:

de Castro, L. S., Horta, B. L., Paiva, R. F., Rocha, A. C. L., Desai, M., Ross, M. G., & Coca, K. P. (2024). Donor human milk fat content is associated with maternal body mass index. Breastfeeding Medicine, 19(1), 1–7. https://doi.org/10.1089/bfm.2024.0028

Prenatal Antibiotics and Neonatal Immunity

This study by Pietrasanta et al. (2024) explores how prenatal antibiotic exposure reduces breast milk IgA levels and induces dysbiosis in mouse offspring, increasing their susceptibility to bacterial sepsis. Margaret discusses the potential implications for human lactation and neonatal care.

Reference:

Pietrasanta, C., Carlosama, C., Lizier, M., Fornasa, G., Jost, T. R., Carloni, S., ... & Rescigno, M. (2024). Prenatal antibiotics reduce breast milk IgA and induce dysbiosis in mouse offspring, increasing neonatal susceptibility to bacterial sepsis. Cell Host & Microbe, 32(1), 1–17. https://doi.org/10.1016/j.chom.2024.11.001

Determinants of Exclusive Breastfeeding Practices Among First-Time Mothers

Margaret examines this narrative review by Oktarianita & Supriyanto (2024), which highlights the key factors influencing exclusive breastfeeding among first-time mothers. She provides insights into how IBCLCs can address these determinants to support successful breastfeeding initiation and continuation.

Reference:

Oktarianita, R. D. W., & Supriyanto, S. (2024). Exploring the determinants of exclusive breastfeeding practices among first-time mothers: A narrative review. African Journal of Reproductive Health, 28(10s), 239–248. https://doi.org/10.29063/ajrh2024/v28i10s.28

Relaxation Therapy and Breastfeeding Outcomes

This systematic review and meta-analysis by Levene et al. (2024) investigates the impact of relaxation therapy on breastfeeding outcomes, including milk production and infant growth. Margaret explores how IBCLCs can integrate relaxation techniques into practice to benefit breastfeeding families.

Reference:

Levene, I., Mohd Shukri, N. H., O’Brien, F., Quigley, M. A., & Fewtrell, M. (2024). Relaxation therapy and human milk feeding outcomes: A systematic review and meta-analysis. JAMA Pediatrics, 178(6), 567–576. https://doi.org/10.1001/jamapediatrics.2024.0814

Practical Applications for IBCLCs:

Support Donor Milk Programs: Consider maternal BMI when discussing donor milk options with families.
Educate About Antibiotic Risks: Address prenatal antibiotic use and its potential effects on breastfeeding and neonatal immunity.
Tailor Support for First-Time Mothers: Focus on addressing the specific barriers to exclusive breastfeeding.
Incorporate Relaxation Techniques: Advocate for relaxation therapy to improve breastfeeding outcomes and maternal well-being.

Conclusion:

If you found this episode helpful, please subscribe to Behind the Latch and leave a review!

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Kelly Durbin: Empowering Breastfeeding Families Through Education, Research, and Support

Wed, 01 Jan 2025 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Kelly M. Durbin, an International Board Certified Lactation Consultant (IBCLC), childbirth educator, author, and volunteer breastfeeding counselor. Together, they explore Kelly's incredible journey in lactation care, her groundbreaking research, and her advice for IBCLCs and aspiring lactation professionals. Kelly shares insights from her extensive experience supporting breastfeeding families, teaching classes, and leading support groups, as well as tips from her new book, Protecting Your Potential for Breastfeeding, published by Praeclarus Press in June 2023. This episode is filled with practical strategies and inspiration for those passionate about advancing their lactation careers.

Protecting Your Potential for Breastfeeding

Kelly provides an overview of her new book, sharing its purpose and how it empowers families to navigate the breastfeeding journey with confidence.

Kelly M. Durbin's expertise, passion, and dedication to breastfeeding support shine throughout this conversation. Whether you’re an IBCLC student, a new consultant, or a seasoned professional, this episode is packed with valuable insights to help you grow in your role and provide the best possible care to breastfeeding families.

Resources Mentioned in This Episode:

Protecting Your Potential for Breastfeeding by Kelly M. Durbin (available at Praeclarus Press)
Instagram: https://www.instagram.com/breastfeedingwellness/
LinkedIn: https://www.linkedin.com/in/kelly-durbin-08639842/
Webpage: http://protectingyourpotential.com/index.html

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Kelly M. Durbin
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #BreastfeedingResearch #ProtectingBreastfeeding #LactationMentor #KellyDurbin

The Research Recap: 15- Cigarettes, environment, and NICU

Thu, 26 Dec 2024 09:00:00 -0500

Key Points Covered:

Association Between Cigarette and Heated Tobacco Use and Breastfeeding Cessation

Margaret reviews this study by Okawa et al. (2024), which investigates how cigarette and heated tobacco use are linked to breastfeeding cessation within six months postpartum in Japan. The findings underscore the importance of smoking cessation interventions and support for breastfeeding mothers who use tobacco products.

Reference:

Okawa, S., Nanishi, K., Iso, H., & Tabuchi, T. (2024). Association between cigarette and heated tobacco use and breastfeeding cessation within 6 months postpartum in Japan: An internet-based cross-sectional study. Scientific Reports, 14, 29214. https://doi.org/10.1038/s41598-024-78423-1

Breastfeeding-Friendly Environmental Factors and Breastfeeding Practices

This study by Chen et al. (2024) examines how breastfeeding-friendly environmental factors influence breastfeeding practices at six months in Taiwan. Margaret discusses the actionable insights this study provides for creating supportive environments that promote sustained breastfeeding.

Reference:

Chen, T. L., Chen, L. L., & Gau, M. L. (2024). Association between breastfeeding-friendly environmental factors and breastfeeding practices at 6 months in mothers in Taiwan. International Breastfeeding Journal, 19(78), 1-10. https://doi.org/10.1186/s13006-024-00681-6

Online Prenatal Education and Exclusive Breastfeeding Rates

Margaret explores this study by Gabhart et al. (2024), which highlights the effectiveness of a live online prenatal education model in improving exclusive breastfeeding rates at discharge. She provides insights into how lactation consultants can incorporate virtual education to enhance breastfeeding outcomes.

Reference:

Gabhart, J. M., Wasio, L. N., U-thaiwat, P., Chen, Y. W., & Main, J. (2024). A live online prenatal educational model: Association with exclusive breastfeeding at discharge. Journal of Human Lactation, 40(1), 1-11. https://doi.org/10.1177/08903344241297607

A Paradigm Shift in NICU Lactation Care

In this article, Randle (2024) advocates for a comprehensive lactation care model tailored for NICU families. Margaret discusses how this paradigm shift can improve breastfeeding outcomes for vulnerable infants and families, and what IBCLCs can do to support NICU lactation care.

Reference:

Randle, J. (2024). The case for a paradigm shift in lactation care for NICU families: A comprehensive lactation care model. Journal of Human Lactation, 40(1), 1–5. https://doi.org/10.1177/08903344241299722

Practical Applications for IBCLCs:

Support Smoking Cessation: Educate families on the impact of tobacco use on breastfeeding and offer tailored support.
Create Breastfeeding-Friendly Spaces: Advocate for environmental changes that support breastfeeding at home and in the workplace.
Embrace Virtual Education: Incorporate online prenatal education models to reach more families effectively.
Enhance NICU Care: Advocate for comprehensive lactation care models that meet the needs of NICU families.

Conclusion:

If you found this episode helpful, please subscribe to Behind the Latch and leave a review!

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#EvidenceBasedPractice

Allison Tolman: A Pumping Expert Making Pumping Successful Through New Little Life

Wed, 25 Dec 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Allison Tolman, an International Board Certified Lactation Counselor (IBCLC), childbirth educator, and founder of New Little Life, to explore her journey, her innovative work, and her advice for IBCLCs and aspiring lactation professionals. Allison shares insights into her path to becoming a CLC, the growth of New Little Life, and her mission to make lactation and parenting education accessible to families worldwide. Packed with actionable tips and strategies, this episode offers inspiration for anyone looking to expand their reach in the lactation field.

Resources Mentioned in This Episode:

Pumping for Lactation Professionals Training: https://breastpumpscience.mykajabi.com/store (Coupon code for 10% off: SALTY)

Website: www.newlittlelife.com

Instagram: www.instagram.com/newlittlelife_byallison

YouTube: www.youtube.com/newlittlelifebyallison

Videos mentioned in our chat and/or are relevant to our conversation:

Baby VS Breast Pump: https://youtu.be/x0gCr-TsBd0
The hard truth about wearable pumps: https://youtu.be/l4Fuv1Siqf8
Best breast pumps for low milk supply: https://youtu.be/zPUcm825qQg
Spectra or Medela: A company overview: https://youtu.be/h4ItZYrzNGI
Annabella Pump Review: https://youtube.com/live/arBa1m94aW8?feature=share
My Pumping Story: https://youtu.be/Fyq9Dgwn-q0
Behind the scenes | Day in the life of a pumping coach: https://youtu.be/_Ltt47Zv8qs

If you found this episode helpful, please subscribe to Behind the Latch and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Guest: Allison Tolman
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #NewLittleLife #BreastfeedingEducation #AccessibleEducation #LactationMentor #AllisonTolman

The Research Recap: 14- Stunting, NEC, knowledge and attitudes

Thu, 19 Dec 2024 09:00:00 -0500

Key Points Covered:

Correlation Between Exclusive Breastfeeding, Complementary Feeding, and Stunting in Toddlers

Margaret reviews this study by Filiya et al. (2024), which explores how exclusive breastfeeding and the frequency and quantity of complementary feeding affect stunting in toddlers. The research highlights the critical role of exclusive breastfeeding for growth and development, providing IBCLCs with strategies to guide families in preventing stunting.

Reference:

Filiya, A. N., Ultasari, A. P., Putri, N. A., & Afifah, A. (2024). Correlation between exclusive breastfeeding, frequency, and quantity of complementary feeding with stunting among toddlers. Malaysian Journal of Medicine and Health Sciences, 20(SUPP9), 8-13. https://doi.org/10.47836/mjmhs20.s9.2

Risk Factors for Necrotizing Enterocolitis (NEC) in Twins

This study by Zou et al. (2024) identifies risk factors for NEC in twins, shedding light on unique challenges in caring for multiples. Margaret discusses how breastfeeding can reduce NEC risk and provides practical tips for supporting families of twins in both hospital and community settings.

Reference:

Zou, P., Fang, W., Wu, L., He, J., Xia, H., Zhong, W., & He, Q. (2024). Identification of risk factors for necrotizing enterocolitis in twins: A case-control matching analysis of over ten years’ experience. BMC Pediatrics, 24, 744. https://doi.org/10.1186/s12887-024-05188-x

Knowledge and Attitudes Toward Exclusive Breastfeeding in Western Kordofan

Margaret examines this descriptive cross-sectional study by Elmanssury & Dafaallah (2024), which reveals gaps in knowledge and attitudes about exclusive breastfeeding among mothers in Western Kordofan. She highlights ways IBCLCs can address cultural and educational barriers to exclusive breastfeeding through tailored support and education.

Reference:

Elmanssury, A. E., & Dafaallah, S. A. (2024). Knowledge and attitude towards exclusive breastfeeding among lactating mothers, balancing feeding and their effect on children’s health status in district area, Western Kordofan: Descriptive cross-sectional study. Journal of Health and Medical Sciences, 7(4), 62-71. https://doi.org/10.31014/aior.1994.07.04.329

Practical Applications for IBCLCs:

Prevent Stunting: Promote exclusive breastfeeding and informed complementary feeding practices.
Support Multiples: Use evidence-based strategies to reduce NEC risk in twins.
Bridge Knowledge Gaps: Provide culturally sensitive education to improve breastfeeding rates.

Conclusion:

If you found this episode helpful, please subscribe to Behind the Latch and leave a review!

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#EvidenceBasedPractice

Navigating Nursing Strikes: Causes, Strategies, and Solutions

Wed, 18 Dec 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty explores the topic of nursing strikes—what they are, why they happen, and how to help breastfeeding dyads navigate this challenging period. Margaret breaks down actionable strategies for resolving nursing strikes and shares a real-world case study of a 10-month-old who experienced a nursing strike after an illness.

Listeners will come away with practical tools, evidence-based insights, and the confidence to support families experiencing nursing strikes.

Key Points Covered:

Understanding Nursing Strikes:

A nursing strike is a sudden refusal to breastfeed by a previously nursing baby.
It differs from natural weaning, which is gradual and baby-led.
Strikes can be temporary and typically resolve with the right support.

Common Causes of Nursing Strikes:

Illness: Congestion, ear infections, sore throats, or general discomfort.
Pain: Teething, mouth injuries, or recent vaccinations.
Stress/Disruptions: Changes in routine, family tension, or overstimulation.
Negative Associations: Reactions to biting, frustration with poor milk flow, or a stressful nursing session.
Bottle Preference: Easier milk flow during bottle-feeding when used temporarily.

Strategies for Handling a Nursing Strike:

Rule Out Pain/Illness: Assess for teething, ear infections, or other health issues and refer families to healthcare providers as needed.
Offer the Breast in Calm Moments: Try nursing when the baby is sleepy, waking up, or in a relaxed environment.
Skin-to-Skin Contact: Use skin-to-skin to reestablish a positive breastfeeding connection.
Try Different Positions: Upright or side-lying positions may make nursing more comfortable.
Maintain Milk Supply: Encourage pumping to protect supply and reduce engorgement.
Be Patient and Supportive: Reassure parents that nursing strikes are temporary and manageable.

Case Study: A 10-Month-Old After Illness

A baby stopped breastfeeding after a viral illness, preferring bottles due to nasal congestion.
Intervention included skin-to-skin time, upright nursing positions, and reducing bottle flow.
Within three days, the baby resumed breastfeeding, showing the importance of patience, consistency, and gentle approaches.

Practical Applications for IBCLCs:

Assess Root Causes: Guide parents in identifying why the baby may be striking.
Develop a Plan: Provide step-by-step strategies to reintroduce breastfeeding gently.
Support Milk Supply: Ensure families understand the importance of pumping during this phase.
Offer Reassurance: Help families feel supported and remind them that strikes are temporary.

Conclusion:

Nursing strikes can be stressful, but with proper support and strategies, they are often resolved successfully. By equipping families with patience, tools, and evidence-based solutions, IBCLCs can play a critical role in helping breastfeeding dyads get back on track.

Jalali, F., Kamiab, Z., Khademalhosseini, M., Daeizadeh, F., & Bazmandegan, G. (2021). Nursing strikes among infants and its affecting factors in Rafsanjan city. Journal of Medicine and Life, 14(1), 56–60. https://doi.org/10.25122/jml-2020-0118

Nayyeri, F., Raji, F., Haghnazarian, E., Shariat, M., & Dalili, H. (2015). Frequency of “nursing strike” among 6-month-old infants at East Tehran health center and contributing factors. Journal of Family and Reproductive Health, 9(3), 137–140.

Resources:

The Womanly Art of Breastfeeding – La Leche League International: www.llli.org
KellyMom: Nursing Strikes Overview: www.kellymom.com
Academy of Breastfeeding Medicine Protocols: www.bfmed.org

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review. Your support helps me bring more evidence-based, practical content to the IBCLC community!

Connect with Me:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#NursingStrikes #IBCLC #BreastfeedingChallenges #LactationSupport #LactationMentor #BreastfeedingSupport #CaseStudies

The Research Recap: 13- Oral stimulation, colostrum kit, maternal stress

Thu, 12 Dec 2024 09:00:00 -0500

1. Oral Stimulation Protocols in Preterm Infants

Margaret reviews the study by Jayapradha et al. (2024) on a targeted oral stimulation protocol that improved exclusive breastfeeding rates by over 10-fold among preterm infants in India.

Highlights:

Techniques improve sucking and swallowing reflexes.
Empowered parents with practical tools to enhance feeding success.
Reduced hospital stay duration through earlier oral feeding transitions.

Reference:

Jayapradha, G., et al. (2024). Effect of an oral stimulation protocol on breastfeeding among preterm infants: A randomized controlled trial. Archives of Disease in Childhood – Fetal and Neonatal Edition. https://doi.org/10.1136/archdischild-2024-327494

2. Colostrum-Kit for Neonates in the NICU

The introduction of a colostrum-kit reduced the time to first colostrum from 35 to 8 hours in a Swedish NICU study.

Practical Takeaways:

Early colostrum expression boosts neonatal immunity.
Simple, low-cost interventions can transform hospital practices.
Parents feel more involved and confident in their baby's care.

Reference:

Hellström, S., et al. (2024). Implementing a colostrum-kit reduces the time to first colostrum for neonates admitted to the NICU: A retrospective observational study. International Breastfeeding Journal. https://doi.org/10.1186/s13006-024-00682-5

3. Maternal Stress and Milk Hormonal Composition

A study by Matyas et al. (2024) reveals how maternal stress elevates cortisol levels in breast milk while suppressing prolactin.

Why It Matters:

Elevated cortisol may affect infant temperament and milk supply.
Stress management improves outcomes for mother-infant dyads.
Lactation consultants can advocate for supportive environments.

Reference:

Matyas, M., et al. (2024). The association between maternal stress and human milk concentrations of cortisol and prolactin. Scientific Reports, 14(28115). https://doi.org/10.1038/s41598-024-75307-2

Practical Applications for IBCLCs:

Support Preterm Infants: Introduce oral stimulation protocols in your NICU collaborations.
Educate on Colostrum: Advocate for early expression initiatives to improve infant health outcomes.
Address Maternal Stress: Incorporate stress management techniques and educate mothers on the hormonal impacts of stress.

Conclusion:

Research-informed care empowers IBCLCs to elevate breastfeeding success and maternal well-being. Stay tuned for weekly episodes that bridge cutting-edge studies with your day-to-day practice.

Connect with Me:

Have questions or ideas for future episodes? Let’s connect:

Website: margaretsalty.com
Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationSupport #BreastfeedingResearch #NICUBreastfeeding #MaternalStress #ColostrumCare

Decoding the WHO Code: What Every IBCLC Needs to Know

Wed, 11 Dec 2024 09:00:00 -0500

In this episode of Behind the Latch Margaret Salty delves into the WHO Code of Marketing of Breastmilk Substitutes, elucidating its significance, scope, and the critical role IBCLCs play in upholding its principles. Listeners will gain a comprehensive understanding of the Code's provisions, its exclusions, and actionable strategies for maintaining compliance in clinical practice.

Key Points Covered:

Understanding the WHO Code:
Adopted in 1981 by the World Health Assembly to safeguard breastfeeding from unethical marketing practices.
Establishes guidelines to regulate the promotion of breastmilk substitutes, feeding bottles, and teats.
Scope of the Code:
Prohibits direct advertising of breastmilk substitutes to the public.
Restricts distribution of free samples and gifts to both parents and healthcare providers.
Mandates accurate and non-promotional labeling of breastmilk substitutes.
Exclusions from the Code:
Does not explicitly cover breast pumps and certain lactation aids.
Excludes maternal nutritional supplements and general baby care products not marketed as breastmilk substitutes.
Ensuring Compliance for IBCLCs:
Avoid affiliations with companies that contravene the Code's guidelines.
Provide unbiased, evidence-based information to families regarding infant feeding options.
Uphold ethical standards in all professional practices and collaborations.

Practical Applications for IBCLCs:

Educate Families: Inform parents about the implications of formula marketing and the benefits of breastfeeding, ensuring they make informed decisions.
Assess Partnerships: Critically evaluate relationships with product manufacturers to ensure alignment with the Code's ethical standards.
Promote Ethical Practices: Advocate for and implement policies within healthcare settings that support and adhere to the Code.

Conclusion:

Adherence to the WHO Code is paramount for IBCLCs dedicated to promoting and protecting breastfeeding. By integrating the Code's principles into daily practice, professionals not only support optimal infant nutrition but also reinforce the trust placed in them by the families they serve.

Resources:

WHO Code of Marketing of Breastmilk Substitutes: https://www.who.int/publications/i/item/9241541601
IBCLC Code of Professional Conduct: https://iblce.org/wp-content/uploads/2022/08/2022_August_17_Code-of-Professional-Conduct_FINAL.pdf
Tools for Ethical Decision-Making in Practice: https://ilca.org/wp-content/uploads/2021/05/Standards-of-Practice-for-International-Board-Certified-Lactation-Consultants-newlogo.pdf

If you found this episode insightful, subscribe to Behind the Latch and leave a review. Together, we can continue to elevate ethical standards in lactation care.

Connect with Me:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#WHOCode #IBCLC #BreastfeedingEthics #LactationConsultant #LactationMentor #BreastfeedingSupport #EthicalPractice

The Research Recap: 12- Yoga, education, and eggs

Thu, 05 Dec 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Margaret breaks down complex research into actionable strategies for lactation consultants, focusing on how these insights can improve breastfeeding outcomes. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Key Points Covered:

Investigating the Effect of Yoga-Based Educational Interventions on Breast Milk Volume and Composition

Margaret reviews this randomized controlled trial by Karimi et al. (2024), which demonstrates how yoga-based interventions significantly increase breast milk volume in mothers of premature infants in NICUs. She explores how integrating relaxation techniques can improve milk production and maternal well-being.

Reference:

Karimi, F., Aziznejadroshan, P., Akbarian Rad, Z., Nikbakht, H.-A., & Qujeq, D. (2024). Investigating the effect of yoga-based educational interventions on the volume and composition of breast milk in premature infants’ mothers admitted to the neonatal intensive care unit: A randomized controlled trial. Journal of Education and Health Promotion, 13, 455. https://doi.org/10.4103/jehp.jehp_1446_23

The Effect of Lactation Education on the Success of Exclusive Breastfeeding in Postpartum Mothers

This study by Yulianti (2024) highlights the critical role of structured lactation education in improving exclusive breastfeeding rates at 1 and 3 months postpartum. Margaret discusses the practical steps IBCLCs can take to implement these findings in their practice.

Reference:

Yulianti, N. H. (2024). The effect of lactation education on the success of exclusive breastfeeding in postpartum mothers. International Journal of Nursing and Midwifery Research, 3(1), 36–46. https://journals.iarn.or.id/index.php/ners/index

Effect of Maternal Prebiotic Supplementation on Human Milk Immunological Composition

Margaret examines this study from the SYMBA trial by Divakara et al. (2024), which finds that prebiotic supplementation selectively enhances immunological factors like TGF-β1 and sCD14 in breast milk. She shares insights on how maternal diet impacts breastfeeding outcomes.

Reference:

Divakara, N., Dempsey, Z., Saraswati, C., Garssen, J., Silva, D., Keelan, J. A., Christophersen, C. T., Cooper, M. N., Prescott, S. L., Palmer, D. J., Verhasselt, V., & Macchiaverni, P. (2024). Effect of maternal prebiotic supplementation on human milk immunological composition: Insights from the SYMBA study. Pediatric Allergy and Immunology, 35(9), e14226. https://doi.org/10.1111/pai.14226

Maternal Egg Consumption and the Risk of Infant Egg Allergy

This multicenter cohort study by Kishino et al. (2025) explores how maternal egg consumption during lactation does not significantly affect infant egg allergy development but emphasizes early eczema management as a critical factor. Margaret shares strategies for addressing allergy concerns in breastfeeding families.

Reference:

Kishino, S., Yonezawa, K., Haruna, M., Usui, Y., Sasaki, S., Fujita, M., Matsuzaki, M., Sato, Y., Suetsugu, Y., Ohori, R., Tanaka, M., & Aoyama, S. (2025). Relationship between maternal egg consumption during lactation and the risk of developing egg allergies in 12-month-old infants: A multicenter cohort study. Japan Journal of Nursing Science, 22(1), e12631. https://doi.org/10.1111/jjns.12631

Practical Applications for IBCLCs:

Incorporate Relaxation Techniques: Advocate for yoga-based practices to enhance milk production in mothers of preterm infants.
Deliver Comprehensive Education: Use structured lactation education sessions to empower families and improve exclusive breastfeeding rates.
Optimize Maternal Diet: Share evidence on the benefits of prebiotic-rich diets during lactation.
Address Allergy Concerns: Educate families about the limited role of maternal diet in allergy prevention and the importance of eczema management.

Conclusion:

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Understanding Lactation Credentials: IBCLC, CLC, and Beyond

Wed, 04 Dec 2024 09:00:00 -0500

Episode Description:

In this episode of Behind the Latch Margaret Salty demystifies the differences between various lactation credentials, with a focus on the IBCLC, CLC, and other certifications like Certified Lactation Specialist (CLS), Certified Breastfeeding Specialist (CBS), Certified Lactation Educator (CLE), Certified Breastfeeding Counselor (CBC), and Community Breastfeeding Educator (CBE). Margaret dives into the training, scope of practice, and importance of accreditation for each credential, providing clarity on what families and professionals can expect from each role.

Whether you're a seasoned IBCLC, a lactation student, or simply curious about these credentials, this episode offers a detailed breakdown to help you understand the vital distinctions in lactation care.

Key Points Covered:

The Gold Standard: IBCLC

Comprehensive training: 95 hours of lactation-specific education, health science coursework, and 300–1,000 clinical hours.
Accredited by the International Board of Lactation Consultant Examiners (IBLCE) and recognized worldwide.
Broad scope of practice includes clinical assessments, individualized feeding plans, and collaboration with healthcare teams.

Certified Lactation Counselor (CLC): A Recognized Credential

Minimum of 95 hours of training based on WHO/UNICEF guidelines.
Certified by the Academy of Lactation Policy and Practice (ALPP).
Focuses on counseling and addressing common breastfeeding concerns but refers complex cases to IBCLCs.

Other Certifications: CLS, CBS, CLE, CBC, and CBE

Basic breastfeeding education and support.
Limited scope of practice—ideal for non-clinical roles like peer support or community education.
Not accredited by NCCA and less likely to be recognized by insurers.

Importance of Accreditation

Only IBCLC and CLC are accredited by recognized organizations, ensuring consistency, quality, and ethical standards in lactation care.
Accreditation impacts insurance reimbursement, with IBCLCs more widely covered.

Peer Counselors and Mother-to-Mother Support

Provide emotional and informational support based on lived experiences.
Work in community settings, focusing on encouragement and basic breastfeeding guidance.
Non-clinical role with referrals to professionals for complex issues.

Practical Applications for IBCLCs and Lactation Professionals:

Advocate for Accreditation: Educate families about the importance of choosing providers with recognized credentials like IBCLCs or CLCs.
Collaborate with Others: Understand the roles of peer counselors and support persons to create a comprehensive care network.
Practice Within Scope: Ensure ethical care by recognizing the limits of your credential.

Conclusion:

Understanding the differences between lactation credentials ensures that families receive the right level of care and that professionals provide support ethically. By advocating for accredited certifications and collaboration within the lactation care team, we can enhance breastfeeding outcomes and build trust within our communities.

If you found this episode helpful, subscribe to Behind the Latch and leave a review. Let’s keep advancing the field of lactation care together!

Connect with Me:

Have questions or suggestions for future episodes? Reach out at hello@margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #LactationCredentials #BreastfeedingSupport #LactationMentor #EvidenceBasedPractice

The Research Recap: 11- Oral stimulation, colostrum kit, maternal stress

Thu, 28 Nov 2024 09:00:00 -0500

Key Points Covered:

Effect of an Oral Stimulation Protocol on Breastfeeding Among Preterm Infants: A Randomized Controlled Trial

Margaret reviews this study by Jayapradha et al. (2024), which examines how a modified oral stimulation protocol significantly improves exclusive breastfeeding rates and feeding skills in preterm infants. She discusses the implications for NICU practices and actionable insights for empowering families through hands-on support.

Reference:

Jayapradha, G., Venkatesh, L., Amboiram, P., & Balasubramanium, R. K. (2024). Effect of an oral stimulation protocol on breastfeeding among preterm infants: A randomized controlled trial. Archives of Disease in Childhood – Fetal and Neonatal Edition. https://doi.org/10.1136/archdischild-2024-327494

Implementing a Colostrum-Kit Reduces the Time to First Colostrum for Neonates Admitted to the NICU

This study by Hellström et al. (2024) explores how introducing a colostrum-kit in NICUs can reduce the time to first colostrum for neonates, significantly improving outcomes for preterm and term infants. Margaret discusses the importance of empowering parents and the potential for widespread adoption of this low-cost intervention.

Reference:

Hellström, S., Linden, K., Sengpiel, V., & Elfvin, A. (2024). Implementing a colostrum-kit reduces the time to first colostrum for neonates admitted to the NICU: A retrospective observational study. International Breastfeeding Journal, 19(77). https://doi.org/10.1186/s13006-024-00682-5

The Association Between Maternal Stress and Human Milk Concentrations of Cortisol and Prolactin

Margaret examines this study by Matyas et al. (2024), which highlights how maternal stress affects hormonal composition in breast milk, with implications for infant development. She provides actionable strategies for reducing stress to optimize milk production and maternal well-being.

Reference:

Matyas, M., et al. (2024). The association between maternal stress and human milk concentrations of cortisol and prolactin. Scientific Reports, 14(28115). https://doi.org/10.1038/s41598-024-75307-2

Practical Applications for IBCLCs:

Support Preterm Infants: Advocate for oral stimulation techniques and colostrum-kit implementation in NICUs.
Empower Mothers: Provide stress management strategies to improve milk production and family outcomes.
Promote Evidence-Based Practices: Share these research findings with healthcare teams to enhance breastfeeding support.

Conclusion:

If you found this episode helpful, please subscribe to Behind the Latch and leave a review!

Connect with Me:

Have questions or suggestions for future episodes? Reach out at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

The Role of a Breastfeeding Medicine Physician: Insights with Dr. Karen Federici

Wed, 27 Nov 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Dr. Karen Federici, an experienced Breastfeeding Medicine Physician, to explore her journey, her work, and her advice for IBCLCs and aspiring breastfeeding medicine professionals. Dr. Federici shares insights into her career path, explains what breastfeeding medicine entails, and provides practical guidance for IBCLCs collaborating with physicians in this field. This conversation is packed with valuable tips and strategies to enhance your understanding of breastfeeding medicine and how it supports lactation care.

https://www.familyfirstdocs.com/

https://www.bfmed.org/find-a-physician#/

https://nabblm.org/for-patients/

https://lacted.org/providers-world-lactation-map/

Key Points Covered:

Where Are You Located and What Work Are You Currently Doing?
Dr. Federici introduces herself, sharing details about her location, her medical practice, and her current work in the field of breastfeeding medicine.
What Brought You to the Field of Medicine and Lactation?
Dr. Federici reflects on her journey into medicine, what inspired her to specialize in breastfeeding medicine, and her passion for supporting breastfeeding families.
What Is a Breastfeeding Medicine Physician and How Can You Find One?
Dr. Federici breaks down the role of a breastfeeding medicine physician, how they collaborate with lactation consultants, and the impact they have on breastfeeding families. She also provides advice for IBCLCs on fostering strong partnerships with these specialists and offers tips for locating breastfeeding medicine physicians across the country.
Common Cases and Treatment Approaches in Breastfeeding Medicine:
Dr. Federici discusses the types of cases she sees most frequently, including low milk supply, latch issues, infections, and more. She explains the treatment plans and how they complement lactation care provided by IBCLCs.
Advice for Those Considering a Career in Breastfeeding Medicine:
Dr. Federici shares her wisdom for anyone interested in pursuing this specialized field, emphasizing the importance of passion, education, and interdisciplinary collaboration.

Conclusion:

Dr. Karen Federici's expertise and dedication to breastfeeding medicine provide a valuable perspective for IBCLCs and lactation professionals looking to enhance their practice. Whether you're a student, a new IBCLC, or an experienced consultant, this episode offers actionable advice and inspiration to strengthen your care for breastfeeding families.

If you found this episode helpful, please subscribe to The IBCLC Mentor Podcast and leave a review. Don’t forget to share this episode with your colleagues and fellow IBCLCs!

Connect with Me:

Have questions or suggestions for future episodes? Reach out to Margaret at [insert website link] or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Guest: Dr. Karen Federici

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #BreastfeedingMedicine #LactationConsultant #CollaborativeCare #BreastfeedingSupport #LactationMentor

The Research Recap: 10- BFHI, twins, and colostrum

Thu, 21 Nov 2024 09:00:00 -0500

On this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Be sure to check out the blog post on how to stay up-to-date with current research here: Research Updates

Key Points Covered:

The Role of Baby-Friendly Designated Hospitals in Breastfeeding Initiation Across Racial/Ethnic Groups in Florida

Margaret reviews this study by Lebron et al. (2024), which examines how Baby-Friendly Hospital (BFH) designation impacts breastfeeding initiation across racial and ethnic groups in Florida. The study reveals significant disparities, with non-Hispanic Black mothers less likely to initiate breastfeeding even at BFH facilities. Margaret discusses the importance of advocating for culturally competent practices within BFH to support all families effectively.

Reference: Lebron, C. N., Larson, M., Chavez, J., & Parra, A. (2024). The role of Baby-Friendly designated hospitals in breastfeeding initiation across racial/ethnic groups in Florida. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-024-04011-4

A Narrative Review of Strategies to Optimize Breastfeeding Among Mothers of Twins

This comprehensive review by Bhardwaj & Vijayan Smitha (2024) addresses the unique challenges of breastfeeding twins. Margaret explores strategies such as tandem feeding techniques, community support, and NICU guidance for preterm twins, which are essential for helping mothers maintain exclusive breastfeeding.

Reference: Bhardwaj, G., & Vijayan Smitha, M. (2024). A narrative review of strategies to optimize breastfeeding among mothers of twins. Cureus, 16(10), e72792. https://doi.org/10.7759/cureus.72792

Retrospective Analysis of Volumes of Manually Expressed Colostrum Among Healthy Postnatal Mothers in South India

Margaret examines Nyamagoudar et al.’s (2024) study on colostrum volume in the first three days postpartum, which dispels common misconceptions about low milk supply. She explains how this research emphasizes patience and the importance of hands-on lactation support in the early days.

Reference: Nyamagoudar, A. H., Kannur, N. S., Chavan, V., & Kulkarni, V. (2024). Retrospective analysis of volumes of manually expressed colostrum among healthy postnatal mothers at a tertiary care referral unit in South India: Not enough milk or not enough patience? BMJ Paediatrics Open, 8, e002622. https://doi.org/10.1136/bmjpo-2024-002622

Practical Applications for IBCLCs:

Promote Cultural Competency: Encourage culturally adapted support in BFH to better serve diverse communities.
Tailor Support for Twins: Use specific breastfeeding techniques and resources for twin mothers to improve outcomes.
Reassure on Colostrum Sufficiency: Educate mothers on the typical progression of colostrum volume to counteract “not enough milk” concerns.

Conclusion:

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review!

Have questions or want to suggest a topic?

Reach out at margaretsalty.com or connect on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Unpacking Tethered Oral Tissues: A Conversation with Dr. Alison Hazelbaker on Evidence-Based Assessment

Wed, 20 Nov 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Dr. Alison Hazelbaker, a renowned expert in the field of lactation and creator of the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF). Dr. Hazelbaker shares insights into her comprehensive tool for assessing frenulum function, the science behind it, and the evidence-based approach that underpins her work. Together, they also delve into her training titled "Nothing New Under the Sun?: A 'Tethered Oral Tissues' Literature Review," exploring the latest research on tethered oral tissues (TOTs) and their impact on breastfeeding.

https://hazelbakerinstitute.com/

https://spiritofhealingllc.com/

Key Points Covered:

Origins of the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF)
Dr. Hazelbaker explains the development of her assessment tool, its purpose, and why a comprehensive approach to evaluating frenulum function is essential for lactation consultants. She discusses how her tool differs from other assessments and why it remains a gold standard in the field.
Unpacking the "Tethered Oral Tissues" Literature Review
In this segment, Dr. Hazelbaker provides an overview of her training, "Nothing New Under the Sun?: A 'Tethered Oral Tissues' Literature Review." She highlights the key findings from her review of the literature on TOTs, challenging common misconceptions and shedding light on evidence-based practices.
The Evidence Behind Frenulum Assessments and Interventions
Margaret and Dr. Hazelbaker dive into the current evidence regarding frenulum assessments, discussing when interventions may be necessary and the role of IBCLCs in providing thorough assessments before recommending procedures.
Advice for IBCLCs on Addressing TOTs in Practice
Dr. Hazelbaker shares her recommendations for IBCLCs navigating the complex landscape of tethered oral tissues. She emphasizes the importance of critical thinking, staying informed on the latest research, and using evidence-based tools like the HATLFF to guide decision-making.

Conclusion:

Dr. Alison Hazelbaker’s expertise and evidence-based approach to assessing tethered oral tissues are invaluable for IBCLCs seeking to provide comprehensive care. This episode provides listeners with a deeper understanding of frenulum function, TOTs, and how to critically evaluate the need for interventions. Tune in next week for more expert insights and practical strategies for supporting breastfeeding families.

If you found this episode helpful, please subscribe to The IBCLC Mentor Podcast and leave a review.

Connect with Me:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty’s IBCLC Community

Don't forget to share this episode with fellow IBCLCs or students interested in evidence-based approaches to managing frenulum function and TOTs.

Credits:

Hosted by: Margaret Salty
Guest: Dr. Alison Hazelbaker
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #TetheredOralTissues #FrenulumAssessment #HazelbakerTool #BreastfeedingSupport #LactationMentor

The Research Recap: 9- Rooming in, Down syndrome, and global health systems

Thu, 14 Nov 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Be sure to check out the blog post on how to stay up-to-date with current research here: Research Updates

Key Points Covered:

Effect of Rooming-In Kangaroo Mother Care on Breastfeeding and Behavioral Status of Full-Term Newborns

Margaret reviews this study by Ying et al. (2024), which investigates how rooming-in kangaroo mother care (KMC) impacts breastfeeding initiation and newborn behavioral outcomes. The research finds that newborns who experience KMC have better breastfeeding rates and exhibit calmer, more organized behavior, underscoring the value of skin-to-skin contact immediately after birth for breastfeeding success.

Reference: Ying, Y., et al. (2024). Effect of rooming-in kangaroo mother care on breastfeeding and behavioral status of full-term newborns. Journal of Obstetrics and Gynaecology Research. https://doi.org/10.1111/jog.16132

Breastfeeding Experiences of Mothers of Children with Down Syndrome

This qualitative study by Özsavran & Kuzlu Ayyıldız (2024) delves into the unique challenges and experiences of mothers breastfeeding children with Down syndrome. Margaret discusses the findings, which highlight the importance of specialized breastfeeding support for these mothers to improve breastfeeding success and infant outcomes.

Reference: Özsavran, M., & Kuzlu Ayyıldız, T. (2024). Breastfeeding experiences of mothers of children with Down syndrome: A qualitative study. Breastfeeding Medicine. https://doi.org/10.1089/bfm.2024.0278

Empowering Global Health Systems to Protect, Promote, and Support Optimal Breastfeeding

Margaret examines Zhu et al.'s (2024) comprehensive analysis, which addresses the role of health systems in supporting breastfeeding globally. This article emphasizes the need for structural changes, including policy support and resource allocation, to foster optimal breastfeeding practices worldwide.

Reference: Zhu, D. T., et al. (2024). Empowering global health systems to protect, promote, and support optimal breastfeeding. Maternal & Child Nutrition. https://doi.org/10.1111/mcn.13753

Practical Applications for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Promoting Kangaroo Mother Care: Advocate for rooming-in KMC for full-term newborns to support breastfeeding and improve newborn behavior.
Specialized Support for Mothers of Children with Down Syndrome: Offer tailored support to address the unique breastfeeding challenges these mothers face.
Advocating for Health System Changes: Encourage systemic support for breastfeeding through policy and resource distribution to ensure global breastfeeding success.

Conclusion:

References:

Ying, Y., et al. (2024). Effect of rooming-in kangaroo mother care on breastfeeding and behavioral status of full-term newborns. Journal of Obstetrics and Gynaecology Research. https://doi.org/10.1111/jog.16132
Özsavran, M., & Kuzlu Ayyıldız, T. (2024). Breastfeeding experiences of mothers of children with Down syndrome: A qualitative study. Breastfeeding Medicine. https://doi.org/10.1089/bfm.2024.0278
Zhu, D. T., et al. (2024). Empowering global health systems to protect, promote, and support optimal breastfeeding. Maternal & Child Nutrition. https://doi.org/10.1111/mcn.13753

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review!

Have questions or want to suggest a topic?

Reach out at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Innovating for Pumping Moms: A Conversation with Lisa Myers of Ceres Chill

Wed, 13 Nov 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Lisa Myers, founder of Ceres Chill, to discuss her journey from being a working mom to creating an innovative solution for pumping mothers. Lisa shares the inspiring story behind Ceres Chill and how her own challenges with pumping and milk storage led her to develop a product that makes life easier for breastfeeding parents. Together, they explore the importance of supporting working mothers, innovative solutions for milk storage, and how Ceres Chill is revolutionizing the way parents manage breast milk on the go.

Visit Lisa’s website: cereschill.com

Key Points Covered:

Lisa Myers’ Journey to Creating Ceres Chill

Lisa opens up about her personal experiences as a working mom trying to balance breastfeeding, pumping, and a demanding job. She shares how these challenges inspired her to create Ceres Chill, a game-changing milk storage solution for on-the-go parents.

The Innovation Behind Ceres Chill

In this segment, Margaret and Lisa delve into the unique features of the Ceres Chill system, how it addresses common struggles faced by pumping mothers, and the research and development that went into creating a safe, convenient, and sustainable product.

Empowering Working Parents with Better Tools

Lisa discusses the broader mission of Ceres Chill, emphasizing the importance of supporting working mothers and normalizing the challenges they face. She shares her vision for a world where breastfeeding parents have the resources and products they need to thrive, both at work and at home.

Advice for Aspiring IBCLCs and Entrepreneurs

Lisa offers insights for IBCLCs on how to better support pumping parents and advice for entrepreneurs looking to bring their own ideas to life. She highlights the value of innovation, perseverance, and staying connected to the community you serve.

Conclusion:

Lisa Myers’ story is a powerful example of how personal challenges can lead to meaningful innovations that support breastfeeding families. Her work with Ceres Chill is making a difference in the lives of parents everywhere, and her insights are invaluable for IBCLCs who support pumping mothers. Tune in next week for more inspiring stories, expert insights, and practical tips for thriving as an IBCLC.

If you found this episode helpful, please subscribe to Behind the Latch and leave a review.

Connect with Me:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who are interested in innovative tools for supporting breastfeeding parents!

Credits:

Hosted by: Margaret Salty
Guest: Lisa Myers
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingSupport #CeresChill #PumpingMoms #LactationMentor #InnovationInLactation

The Research Recap: 8- Immune system, Mediterranean diet, and bone mineral density

Thu, 07 Nov 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Be sure to check out the blog post on how to stay up-to-date with current research here: Research Updates

Key Points Covered:

1. How Maternal Factors Shape the Immune System of Breastfed Infants to Alleviate Food Allergy: A Systematic and Updated Review

Margaret reviews a comprehensive study that explores how maternal factors, including health status, diet, and allergen intake, impact the compounds in breast milk that shape an infant's immune system and reduce the risk of food allergies. The research suggests that breastfeeding may limit food allergy risks by promoting gut microbiota and immune development. However, the efficacy of breastfeeding as a prevention strategy for food allergies varies based on maternal factors.

Reference: Wu, Y., et al. (2024). How maternal factors shape the immune system of breastfed infants to alleviate food allergy: A systematic and updated review. Immunology. https://doi.org/10.1111/imm.13864:contentReference[oaicite:0]{index=0}

2. Maternal Mediterranean Diet During Lactation and Infant Growth

This study examines how a Mediterranean diet during lactation influences infant growth patterns. Margaret explains how higher maternal adherence to the Mediterranean diet, particularly fruit and fish intake, is associated with lower infant skinfold thickness, a marker of adiposity. The findings highlight the potential for dietary interventions to influence infant health outcomes through breastfeeding.

Reference: Grabowski, A., et al. (2024). Maternal Mediterranean diet during lactation and infant growth. Breastfeeding Medicine. https://doi.org/10.1089/bfm.2024.0133:contentReference[oaicite:1]{index=1}

3. Higher Bone Mineral Density at Six Years of Age in Very Preterm Born Infants Fed Human Milk Compared to Formula

Margaret discusses a follow-up study on very preterm infants that found those who were fed human milk had significantly higher bone mineral density (BMD) at six years of age compared to those fed formula. The study underscores the long-term benefits of human milk on bone development in preterm infants, reinforcing the importance of breastfeeding support for this vulnerable population.

Reference: Toftlund, L. H., et al. (2024). Higher bone mineral density at six years of age in very preterm born infants fed human milk compared to formula: A follow-up of an RCT. Journal of Pediatrics. https://doi.org/10.21203/rs.3.rs-4938117/v1:contentReference[oaicite:2]{index=2}

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Supporting Maternal Nutrition: Counsel breastfeeding mothers on the benefits of a Mediterranean diet to support healthy infant growth and lower obesity risk.
Food Allergy Prevention: Educate mothers on how their diet and health status can shape breast milk's role in preventing food allergies.
Encouraging Breastfeeding for Preterm Infants: Highlight the long-term benefits of human milk for preterm infants, particularly in promoting better bone health.

Conclusion:

Staying updated with the latest research is essential for providing the best care as an IBCLC. By integrating evidence-based interventions and educational strategies, you can directly enhance breastfeeding success and support the families you work with more effectively. Be sure to tune in each week as we continue to explore the latest insights from the world of lactation science.

References:

Wu, Y., et al. (2024). How maternal factors shape the immune system of breastfed infants to alleviate food allergy: A systematic and updated review. Immunology. https://doi.org/10.1111/imm.13864
Grabowski, A., et al. (2024). Maternal Mediterranean diet during lactation and infant growth. Breastfeeding Medicine. https://doi.org/10.1089/bfm.2024.0133
Toftlund, L. H., et al. (2024). Higher bone mineral density at six years of age in very preterm born infants fed human milk compared to formula: A follow-up of an RCT. Journal of Pediatrics. https://doi.org/10.21203/rs.3.rs-4938117/v1

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review!

Have questions or want to suggest a topic?

Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Supporting Fellow IBCLCs: Insights from Katie Prezas on Building an Empowering Lactation Practice

Wed, 06 Nov 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with fellow IBCLC Katie Prezas, founder of Empowering Lactation. Katie shares her journey into lactation consulting, the motivations behind her work, and the mission of her private practice, Empowering Lactation. Together, they discuss how Katie’s approach to breastfeeding support empowers families, addressing common challenges with empathy and practical solutions. Katie also provides valuable insights on balancing a private practice, offering listeners guidance on creating a supportive, client-centered environment.

Visit Katie’s website: empoweringlactation.com

Key Points Covered:

Katie Prezas’ Path to Lactation Consulting

Katie shares the experiences and inspiration that led her to become an IBCLC and start her own practice. She discusses her professional background, how she developed her approach to care, and the values that guide Empowering Lactation.

Empowering Families Through Lactation Support

In this segment, Katie walks through a common breastfeeding scenario she frequently addresses in her practice. She explains her methods for assessing and supporting families, highlighting strategies to overcome common hurdles and how to provide empowering, client-centered care.

Insights on Running a Private Practice

Katie shares her tips on managing a private practice, from structuring consultations to balancing client care with business demands. She offers practical advice for IBCLCs looking to establish or grow their own practices, emphasizing the importance of flexibility, empathy, and ongoing education.

Conclusion:

Katie Prezas’ work exemplifies how compassion and expertise can transform breastfeeding support. Her journey from lactation consultant to business owner serves as an inspiring roadmap for IBCLCs looking to create meaningful change through private practice. Tune in next week for more case reviews, expert insights, and practical strategies for thriving as an IBCLC.

If you found this episode helpful, please subscribe to Behind the Latch and leave a review.

Connect with Me:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who are exploring their own paths to becoming lactation consultants!

Credits:

Hosted by: Margaret Salty
Guest: Katie Prezas
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #LactationMentor #EmpoweringLactation #PrivatePractice #BreastfeedingSupport

The Research Recap: 7- Breast milk substitutes, long-term growth, and sociodemographic factors

Thu, 31 Oct 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Be sure to check out the blog post on how to stay up-to-date with current research here: Research Updates

Key Points Covered:

1. A Landscape Analysis of Investors in the Global Breast Milk Substitute Industry to Target for Advocacy

Margaret reviews a groundbreaking study that identifies the top investors in the global breast milk substitute (BMS) industry, such as BlackRock and Vanguard. The research highlights how engaging with these investors could promote better compliance with the International Code of Marketing of Breast Milk Substitutes. Public health advocates are urged to consider working with investors to influence corporate governance, potentially improving public health by increasing breastfeeding rates.

Reference: Wood, B., et al. (2024). A landscape analysis of investors in the global breast milk substitute industry to target for advocacy. Maternal & Child Nutrition. https://doi.org/10.1111/mcn.13721:contentReference[oaicite:0]{index=0}

2. Role of the Biological Active Components of Human Milk on Long-Term Growth and Neurodevelopmental Outcome

Margaret delves into an important review that explores how the bioactive components of human milk, such as hormones and growth factors, contribute to long-term growth and neurodevelopmental outcomes in infants. The review highlights the unique composition of human milk and how it promotes cognitive development and protects against obesity in later life. This research emphasizes the importance of breastfeeding, particularly for preterm infants.

Reference: Peila, C., Riboldi, L., & Coscia, A. (2024). Role of the biological active components of human milk on long-term growth and neurodevelopmental outcome. Italian Journal of Pediatrics. https://doi.org/10.1186/s13052-024-01773-z:contentReference[oaicite:1]{index=1}

3. The Influence of Sociodemographic Factors on the Success of Exclusive Breastfeeding: A Narrative Review

This study analyzes how factors like maternal education, socioeconomic status, and maternal occupation influence exclusive breastfeeding rates. The findings show that lower maternal education and income levels are associated with lower rates of exclusive breastfeeding, emphasizing the need for targeted interventions in disadvantaged populations. Margaret highlights how this evidence can help IBCLCs tailor their support strategies based on sociocultural factors.

Reference: Sari, Q. D. (2024). The influence of sociodemographic factors on the success of exclusive breastfeeding: A narrative review. Jurnal Eduhealth, 15(4), 66-72. https://doi.org/10.54209/eduhealth.v15i04:contentReference[oaicite:2]{index=2}

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Engaging with Advocacy Efforts: Leverage research on investors in the BMS industry to advocate for stronger regulatory compliance, ensuring better protection for breastfeeding practices.
Educating Parents on Human Milk Benefits: Emphasize the importance of human milk's bioactive components in consultations, particularly for preterm and high-risk infants, to promote long-term health outcomes.
Addressing Sociodemographic Barriers: Adapt your support approach based on the socioeconomic and educational background of the families you work with, ensuring culturally sensitive care and education.

Conclusion:

References:

Wood, B., et al. (2024). A landscape analysis of investors in the global breast milk substitute industry to target for advocacy. Maternal & Child Nutrition. https://doi.org/10.1111/mcn.13721
Peila, C., Riboldi, L., & Coscia, A. (2024). Role of the biological active components of human milk on long-term growth and neurodevelopmental outcome. Italian Journal of Pediatrics. https://doi.org/10.1186/s13052-024-01773-z
Sari, Q. D. (2024). The influence of sociodemographic factors on the success of exclusive breastfeeding: A narrative review. Jurnal Eduhealth, 15(4), 66-72. https://doi.org/10.54209/eduhealth.v15i04

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review!

Have questions or want to suggest a topic?

Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

From Student to IBCLC: Kohle Permenter’s Journey and Practical Insights for Aspiring Lactation Consultants

Wed, 30 Oct 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Kohle Permenter, a former student and now a thriving IBCLC, to discuss her journey into the field of lactation consulting. Kohle shares the key moments that motivated her to pursue a career as an IBCLC, the pathway she chose for her lactation education and clinical hours, and the lessons she learned along the way. Together, they explore a common case that Kohle frequently encounters in her practice, offering valuable insights into her approach to supporting breastfeeding families. Kohle also provides thoughtful advice for aspiring IBCLCs, emphasizing the importance of determination, staying informed, and seeking supportive mentorship.

Key Points Covered:

Kohle Permenter’s Path to Becoming an IBCLC
Kohle shares her personal and educational journey, detailing the experiences that led her to pursue a career in lactation consulting. She discusses the pathway she followed, including her lactation education and clinical hours, and reflects on how those experiences shaped her approach as an IBCLC.
A Common Case from Kohle’s Practice
In this segment, Kohle walks through a breastfeeding challenge she frequently sees in her practice. She explains how she assesses and manages the situation, providing listeners with practical strategies that can be applied in their own practices.
Advice for Aspiring IBCLCs
Kohle offers encouragement and guidance for those just starting their journey to becoming an IBCLC. She highlights the value of perseverance, the importance of continuous learning, and the role of mentorship in building a successful career in lactation consulting.

Conclusion:

Kohle Permenter’s story is a great example of how passion, education, and mentorship can lead to a rewarding career as an IBCLC. Her journey from student to practitioner is filled with lessons that aspiring lactation consultants can benefit from. Tune in next week for more case reviews, expert insights, and practical advice for thriving as an IBCLC.

https://www.kohlepermenter.com/coaching

If you found this episode helpful, please subscribe to Behind the Latch and leave a review.

Connect with Me:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who are exploring their own paths to becoming lactation consultants!

Credits:

Hosted by: Margaret Salty
Guest: Kohle Permenter
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #LactationMentor #Mentorship #PathwayToIBCLC #BreastfeedingSupport

The Research Recap: 6- Fear of childbirth, father support, breastfeeding support

Thu, 24 Oct 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Be sure to check out the blog post on how to stay up-to-date with current research here: Research Updates

Key Points Covered:

1. Fear of Childbirth Impairs Breastfeeding Success Independent of Mode of Birth

Margaret reviews a study from the Kuopio Birth Cohort, which highlights that fear of childbirth significantly impacts breastfeeding success. Even after adjusting for variables like mode of birth and maternal factors, women with a high fear of childbirth had lower breastfeeding success rates. This underscores the importance of addressing psychological barriers during the prenatal period to improve breastfeeding outcomes.

Reference: Vasanen, M., et al. (2024). Fear of childbirth impairs breastfeeding success independent of mode of birth. Breastfeeding Medicine. https://doi.org/10.1089/bfm.2024.0024:contentReference[oaicite:0]{index=0}

2. Father Support Breastfeeding Self-Efficacy and Exclusive Breastfeeding at Six Weeks Postpartum

This study from Southeast China reveals that paternal support plays a crucial role in exclusive breastfeeding at six weeks postpartum. Fathers with higher breastfeeding self-efficacy were more likely to have partners who successfully breastfed exclusively. The research suggests that educating fathers about breastfeeding can significantly boost exclusive breastfeeding rates.

Reference: Zeng, J., et al. (2024). Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China. BMC Public Health. https://doi.org/10.1186/s12889-024-20136-1:contentReference[oaicite:1]{index=1}

3. Trauma- and Violence-Informed Breastfeeding Support Among Women with Histories of IPV

Margaret examines how trauma- and violence-informed care (TVIC) can enhance breastfeeding support for women with histories of intimate partner violence (IPV). This study shows that TVIC improves access to care, fosters trust, and boosts breastfeeding self-efficacy, highlighting the need for a sensitive approach to care in this vulnerable population.

Reference: Jackson, K. T., et al. (2024). Accessing trauma- and violence-informed breastfeeding support from primary care providers among women with histories of intimate partner violence. Canadian Journal of Nursing Research. https://doi.org/10.1177/08445621241280409:contentReference[oaicite:2]{index=2}

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Addressing Psychological Barriers: Focus on counseling mothers with a fear of childbirth during the prenatal period to improve their chances of breastfeeding success.
Engaging Fathers: Encourage fathers to be more involved in the breastfeeding process, offering education to increase their confidence and support for their partners.
Trauma-Informed Care: Implement trauma- and violence-informed care approaches when working with mothers who have experienced IPV, ensuring a safe and supportive breastfeeding environment.

Conclusion:

References:

Vasanen, M., et al. (2024). Fear of childbirth impairs breastfeeding success independent of mode of birth. Breastfeeding Medicine. https://doi.org/10.1089/bfm.2024.0024
Zeng, J., et al. (2024). Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China. BMC Public Health. https://doi.org/10.1186/s12889-024-20136-1
Jackson, K. T., et al. (2024). Accessing trauma- and violence-informed breastfeeding support from primary care providers among women with histories of intimate partner violence. Canadian Journal of Nursing Research. https://doi.org/10.1177/08445621241280409

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review!

Have questions or want to suggest a topic?

Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty's Group

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Empowering Pumping Mothers: A Conversation with Dr. Angela Lang on Innovations in Lactation Support

Wed, 23 Oct 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Dr. Angela Lang, Senior Director of Lactation, Education, and Professional Engagement at Medela, and a hospital-based lactation consultant. Dr. Lang shares her journey into the field of lactation, her experiences working with mothers in the hospital setting, and her current role at Medela. Together, they explore the ways Medela is driving innovation and improving outcomes for pumping mothers, making this episode a must-listen for IBCLCs looking to enhance their knowledge of lactation technology and support.

Key Points Covered:

Dr. Angela Lang’s Journey into Lactation

Margaret and Dr. Lang discuss what inspired her to become an IBCLC, reflecting on their shared experiences as they started their careers together. Dr. Lang shares her passion for supporting mothers and infants and how this led her to pursue a career in lactation.

Dr. Lang’s Role as a Hospital-Based Lactation Consultant

In this segment, Dr. Lang gives an insider look at her work as a hospital-based lactation consultant. She details the challenges and rewards of working in a hospital environment, helping mothers navigate breastfeeding after delivery, and ensuring successful breastfeeding starts.

Medela’s Innovations in Supporting Pumping Mothers

Dr. Lang discusses her role at Medela as the Senior Director of Lactation, Education, and Professional Engagement. She shares how Medela is advancing technology and education to support pumping mothers, with a focus on improving outcomes for families and enhancing the breastfeeding journey.

The Future of Pumping and Lactation Technology

Margaret and Dr. Lang dive into the future of pumping technology and what’s on the horizon for breastfeeding and pumping families. From innovations in breast pump design to education for healthcare providers, they discuss Medela’s commitment to evidence-based solutions for breastfeeding success.

Conclusion:

This episode offers a comprehensive look at the journey of an IBCLC who has made significant contributions to both hospital-based lactation support and the corporate side of breastfeeding education and technology. Dr. Angela Lang’s unique perspective on improving outcomes for pumping mothers is a valuable resource for IBCLCs and students alike.

If you found this episode helpful, please subscribe to Behind the Latch and leave a review.

Connect with Us:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from learning about the latest innovations in lactation technology and support for pumping mothers!

Credits:

Hosted by: Margaret Salty
Guest: Dr. Angela Lang
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #BreastfeedingSupport #LactationConsultant #PumpingMothers #LactationMentor #Medela #EvidenceBasedPractice

The Research Recap: 5- Hospital resources, theory of planned behavior, prevalence of exclusive breastfeeding

Thu, 10 Oct 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Be sure to check out the blog post on how to stay up-to-date with current research here: https://margaretsalty.com/2023/12/08/research

Key Points Covered:

Associations Between Hospital Nursing Resources and Breastfeeding Outcomes: A Narrative Review

Margaret reviews a study that explores the relationship between hospital nurse staffing levels, work environments, and missed nursing care with breastfeeding outcomes. The findings reveal that better nurse-to-patient ratios and positive work environments lead to improved breastfeeding support, particularly in maternity and NICU units. However, the study also highlights disparities in care, especially in hospitals serving minority populations, which tend to have fewer resources and lower breastfeeding success rates.

Impact of Theory of Planned Behavior-Based Intervention on Breastfeeding Patterns of Mothers with Preterm Infants: A Randomized Trial

Margaret delves into a study that investigates the effectiveness of a psychological intervention based on the Theory of Planned Behavior (TPB) to support exclusive breastfeeding among mothers of preterm infants. The research shows that focusing on attitudes, social norms, and behavioral control led to significant improvements in breastfeeding outcomes, demonstrating the importance of structured support for this vulnerable population.

Prevalence of Exclusive Breastfeeding Among US Children

Margaret examines the current trends in exclusive breastfeeding rates in the U.S., based on data from the National Survey of Children’s Health (NSCH). The study shows a slow but steady increase in exclusive breastfeeding at 4 and 6 months, although the rates remain below the national targets set by Healthy People 2030. Margaret highlights the importance of continued advocacy and education to close this gap.

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Advocating for Better Staffing: Use the research on nursing resources to push for better staffing levels in hospitals to improve breastfeeding outcomes.
Applying Psychological Interventions: Integrate elements from the Theory of Planned Behavior into consultations with mothers of preterm infants to address psychological barriers to breastfeeding.
Supporting Long-Term Exclusive Breastfeeding: Focus on extended support for mothers to help them reach the 6-month exclusive breastfeeding goal, particularly in families affected by smoking or other challenges.

Conclusion:

References:

Mason, A., Lake, E. T., & Clark, R. R. S. (2024). Associations between hospital nursing resources and breastfeeding outcomes: A narrative review. Journal of Perinatal & Neonatal Nursing, 00(00), 1–7. https://doi.org/10.1097/JPN.0000000000000859:contentReference[oaicite:0]{index=0}

Okhovat, S., Janighorban, M., & Kazemi, A. (2024). Impact of theory of planned behavior-based intervention on breastfeeding patterns of the mothers with preterm infants: A randomized trial. BMC Public Health, 24(2643). https://doi.org/10.1186/s12889-024-20059-x:contentReference[oaicite:1]{index=1}

Ding, G., Wen, C., Chen, Y., Vinturache, A., & Zhang, Y. (2024). Prevalence of exclusive breastfeeding among US children. JAMA Network Open, 7(9), e2436644. https://doi.org/10.1001/jamanetworkopen.2024.36644:contentReference[oaicite:2]{index=2}

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review.

Have questions or want to suggest a topic?

Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: https://www.instagram.com/margaretsalty/
Facebook: https://www.facebook.com/groups/margaretsalty

Credits:

Hosted by: Margaret Salty

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

From Student to IBCLC: Casey Mortensen's Journey and Practical Insights for Aspiring Lactation Consultants

Wed, 09 Oct 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty sits down with Casey Mortensen, a former student and now a practicing IBCLC, to explore her journey into the field of lactation. Casey shares what inspired her to become an IBCLC, the pathway she chose for her lactation education and clinical hours, and the valuable experiences she gained along the way. Together, they dive into a real-world case that Casey regularly encounters in her practice, providing insights into her approach to managing breastfeeding challenges. Casey also offers thoughtful advice for aspiring IBCLCs, highlighting the importance of perseverance, passion, and seeking out supportive mentorship.

Key Points Covered:

Casey Mortensen's Path to Lactation Consulting
A Common Case from Casey’s Practice
Advice for Aspiring IBCLCs

Casey Mortensen’s journey from student to IBCLC is an inspiring example of how passion, education, and mentorship can lead to a fulfilling career in lactation consulting. For those looking to enter the field, her story offers practical advice and encouragement. Tune in next week for more case reviews, expert insights, and tips for thriving as an IBCLC.

Connect with Me:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who are exploring their own paths to becoming lactation consultants!

Credits:

Hosted by: Margaret Salty
Guest: Casey Mortensen
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #LactationMentor #Mentorship #PathwayToIBCLC #BreastfeedingSupport

The Research Recap: 4- WHO Code, Mobile Gaming App, Homemade Infant Formula, and Formula Marketing

Thu, 03 Oct 2024 09:00:00 -0500

Read my post about how to stay up-to-date with current research here: https://margaretsalty.com/2023/12/08/research

Key Points Covered:

Outcomes of Implementing the International Code of Marketing of Breast-milk Substitutes: A Global Review

Margaret reviews a systematic review examining the outcomes of implementing the International Code of Marketing of Breast-Milk Substitutes (the Code) as national laws. The review highlights that while some countries demonstrate compliance, violations persist, particularly in private healthcare settings and through direct marketing to mothers. Margaret emphasizes the need for stronger enforcement of the Code to protect breastfeeding from the aggressive marketing of commercial milk formulas (CMF).

Mobile Gaming App for Teenage Mothers: BabyThrive’s Impact on Child Feeding Practices

Margaret explores the development and validation of BabyThrive, a mobile gaming app designed to teach teenage mothers in Nigeria about infant feeding. The app significantly improved users' knowledge, showcasing how mobile health interventions can play a pivotal role in educating underserved populations about proper infant and young child feeding practices.

Depiction of Homemade Infant Formula and Formula Hacks on Pinterest: A Dangerous Trend

Margaret discusses a study analyzing homemade infant formula recipes on Pinterest. The study reveals that most of these recipes contain unsafe ingredients, posing significant health risks to infants. This segment highlights the role of IBCLCs in guiding parents away from harmful misinformation found online and ensuring that families receive evidence-based advice on safe infant feeding practices.

Commercial Milk Formula Marketing Entry Points: Setting the Course of Infant and Young Child Feeding Trajectories

Margaret delves into the pervasive influence of CMF marketing in shaping feeding decisions. This study, conducted in Mexico, reveals how CMF companies target parents during vulnerable moments, from pregnancy through toddlerhood. Margaret emphasizes the importance of lactation consultants being aware of these tactics and providing parents with accurate information about the benefits of breastfeeding.

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Advocating for stronger enforcement of the International Code to reduce the influence of commercial milk formula marketing on breastfeeding families.
Leveraging technology-based educational tools like apps to reach underserved and vulnerable populations, enhancing their knowledge of proper child feeding practices.
Providing accurate and evidence-based guidance to counter the spread of dangerous feeding practices promoted on social media platforms.
Educating parents on the subtle influence of formula marketing and offering evidence-based support to help families make informed decisions.

Conclusion:

References:

Topothai, C., Cetthakrikul, N., & Howard, N. (2024). Outcomes of Implementing the International Code of Marketing of Breast-Milk Substitutes as National Laws: A Systematic Review. International Breastfeeding Journal, 19(68), 1-12. DOI: 10.1186/s13006-024-00676-3
Agusiobo, C., & Osokogu, M. (2024). A Mobile Gaming App to Train Teenage Mothers on Appropriate Child Feeding Practices: Development and Validation Study. JMIR Pediatrics and Parenting, 4(1), 1-10. DOI: 10.2196/pediatrics.v4i1.53560
Smith, R., & Chen, A. (2024). Depiction of Homemade Infant Formula and Formula Hacks on Pinterest: An Unsafe and Unhealthy Pin for Infants? Journal of Infant Nutrition, 28(1), 1-9. DOI: 10.3127/jinfantnutr.2024.0098
Topothai, C., Chong, M. F.-F., & van der Eijk, Y. (2024). Commercial Milk Formula Marketing Entry Points: Setting the Course of Infant and Young Child Feeding Trajectories. International Breastfeeding Journal, 19(1), 1-9. DOI: 10.1186/s13006-024-00676-4

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review.

Have questions or want to suggest a topic?

Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: https://www.instagram.com/margaretsalty/
Facebook: https://www.facebook.com/groups/margaretsalty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from these research insights.

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Staying Ahead: How IBCLCs Can Keep Up with the Latest Lactation Research

Wed, 02 Oct 2024 09:00:00 -0500

In this episode, Margaret shares strategies to help IBCLCs stay updated with the latest lactation research, ensuring evidence-based care for breastfeeding dyads.

Key Points Covered:

Importance of Staying Informed

-Margaret explains why keeping up with research is critical for providing top-notch care.

Joining Professional Organizations

-Benefits of joining groups like ILCA and USLCA for access to journals and research.

Setting Google Scholar Alerts

-How to use Google Scholar to receive updates on relevant topics directly.

Podcasts and Webinars

-Recommendations on research-based podcasts and attending webinars for continuing education.

Conferences

-Leveraging conferences to hear from experts and network within the field.

References:

For more tips, visit Margaret’s blog.

Connect with Margaret:

Instagram: @margaretsalty
Facebook: Margaret Salty

Hashtags:

#IBCLC #LactationResearch #EvidenceBasedCare #LactationMentor

The Research Recap: 3- Breastfeeding Week, fat content and energy calculation, and cessation of breastfeeding

Thu, 26 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Read my post about how to stay up-to-date with current research here: https://margaretsalty.com/2023/12/08/research/

Key Points Covered:

Celebrating Breastfeeding Week 2024: What Have We Achieved and What Can Still Be Done?

Margaret discusses the editorial highlighting the progress and challenges in promoting breastfeeding globally, as celebrated during World Breastfeeding Week 2024. The editorial emphasizes the need for supportive environments, both in public and workplace settings, and calls for stricter enforcement of the International Code of Marketing of Breast-Milk Substitutes to protect breastfeeding. The segment underscores the importance of continued advocacy and support to close gaps in breastfeeding practices and achieve global breastfeeding targets.

Fat Content and Energy Calculation in Pasteurized Human Milk: Comparison Between Infrared Analysis and Creamatocrit Method

In this segment, Margaret reviews a study comparing two methods of measuring fat and energy content in pasteurized human milk: the infrared analysis and the creamatocrit method. The findings show that the infrared analysis method consistently reported higher values of fat and energy than the creamatocrit method. This segment highlights the need for accurate measurement techniques in human milk banks to ensure optimal nutritional support for preterm infants, reinforcing the importance of selecting reliable methods for assessing milk quality.

Primiparous Women's Experiences of Unwanted Early Cessation of Breastfeeding: A Qualitative Study

Margaret delves into a qualitative study exploring the experiences of first-time mothers who stopped breastfeeding earlier than intended. The study identifies feelings of inadequacy, guilt, and emotional defeat among mothers due to unmet breastfeeding expectations and inadequate support from healthcare systems. This segment emphasizes the importance of providing empathetic, comprehensive support to new mothers, and addressing the emotional challenges associated with early cessation of breastfeeding.

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Advocating for better breastfeeding support in public, workplaces, and healthcare settings to create enabling environments for all mothers.
Emphasizing the use of accurate methods like infrared analysis for assessing the nutritional content of donor milk, ensuring optimal support for vulnerable infants.
Offering empathetic and comprehensive support to first-time mothers struggling with breastfeeding, helping to mitigate feelings of failure and promote breastfeeding success.

Conclusion:

References:

Chaudhary, N. (2024). Celebrating Breastfeeding Week 2024: What Have We Achieved and What Can Still Be Done? Journal of Universal College of Medical Sciences, 12(2), 1-2. DOI: 10.3126/jucms.v12i02.69358
Andreassa, N. P., Suano-Souza, F. I., & Sarni, R. O. S. (2024). Fat Content and Energy Calculation in Pasteurized Human Milk: Comparison Between Infrared Analysis and Creamatocrit Method. Breastfeeding Medicine, 00(00), 1-7. DOI: 10.1089/bfm.2024.0249
Mahon, J., & Dreyer, P. (2024). Primiparous Women’s Experiences of Unwanted Early Cessation of Breastfeeding: A Qualitative Study. Nordic Journal of Nursing Research, 44, 1-8. DOI: 10.1177/20571585241276464

If you found this episode helpful, be sure to subscribe to The IBCLC Mentor Podcast and leave a review.

Have questions or want to suggest a topic? Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: https://www.instagram.com/margaretsalty/
Facebook: https://www.facebook.com/groups/margaretsalty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from these research insights.

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

From Student to IBCLC: Meghan McCleskey's Path and Practical Insights

Wed, 25 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch Margaret Salty sits down with Meghan McCleskey, a former student and now a practicing IBCLC, to explore her journey into the field of lactation. Meghan shares what inspired her to become an IBCLC, the pathway she chose for her lactation education and clinical hours, and the valuable experiences she gained along the way. Together, they dive into a real-world case that Meghan regularly encounters in her practice, providing insights into her approach to managing breastfeeding challenges. Meghan also offers thoughtful advice for aspiring IBCLCs, highlighting the importance of perseverance, passion, and seeking out supportive mentorship.

Key Points Covered:

Meghan McCleskey's Path to Lactation Consulting
A Common Case from Meghan’s Practice
Advice for Aspiring IBCLCs

Meghan McCleskey’s journey from student to IBCLC is an inspiring example of how passion, education, and mentorship can lead to a fulfilling career in lactation consulting. For those looking to enter the field, her story offers practical advice and encouragement. Tune in next week for more case reviews, expert insights, and tips for thriving as an IBCLC.

If you found this episode helpful, please subscribe to Behind the Latch and leave a review.

Connect with Me:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty

Facebook: Margaret Salty’s IBCLC Community

Don't forget to share this episode with fellow IBCLCs or students who are exploring their own paths to becoming lactation consultants!

Credits:

Hosted by: Margaret Salty

Guest: Meghan McCleskey

Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #LactationMentor #Mentorship #PathwayToIBCLC #BreastfeedingSupport

Supporting the Breastfeeding Dyad: The Role of Chiropractic Care

Wed, 18 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch Margaret Salty sits down with Dr. Jessica Leighton, a renowned chiropractor specializing in pediatric and maternal care, to explore the role of chiropractic in supporting breastfeeding dyads. Dr. Leighton provides an in-depth look at how chiropractic adjustments can help address common breastfeeding challenges such as latch issues, poor milk transfer, and musculoskeletal problems in both mothers and infants. Whether you’re an experienced IBCLC or new to the field, this episode offers valuable insights into integrating chiropractic care as part of a holistic approach to breastfeeding support.

Visit Dr. Jessica Leighton's website: www.drjessicaleighton.com

Key Points Covered:

1: Introduction to Chiropractic Care and Breastfeeding

Margaret and Dr. Leighton introduce chiropractic care as a complementary approach to supporting breastfeeding. They discuss how chiropractic adjustments can help alleviate physical barriers to effective breastfeeding, such as tension or misalignment in infants that can impact latch and feeding efficiency. Dr. Leighton emphasizes the importance of considering musculoskeletal health in the overall breastfeeding plan.

2: Common Breastfeeding Challenges Addressed by Chiropractic Care

Dr. Leighton outlines specific breastfeeding challenges that can benefit from chiropractic intervention, including:

Latch difficulties due to infant alignment or tension.
Maternal discomfort or pain that may hinder breastfeeding.
How chiropractic care can support a smoother breastfeeding journey through improved maternal posture and alignment.

3: Safety and Efficacy of Pediatric Chiropractic Care

The episode delves into the safety aspects of chiropractic care for infants, supported by evidence and studies:

Cassidy D, Boyle E et al. (2008): A study on the risk of vertebrobasilar stroke and chiropractic care.
Miller et al. (2008): Review of adverse effects in pediatric chiropractic care.
Vohra et al. (2007): Systematic review of adverse events associated with pediatric spinal manipulation.

Dr. Leighton reassures listeners with research findings showing a high level of safety in pediatric chiropractic care, with most adverse effects being minor and self-limiting.

4: Finding the Right Chiropractor for Breastfeeding Support

Dr. Leighton provides guidance on finding a qualified chiropractor, recommending directories such as:

American Chiropractic Association Council on Pediatrics
International Chiropractic Pediatric Association

Note: These directories are great starting points, but some chiropractors, including Dr. Leighton, may choose not to be listed due to fees or organizational preferences. Always consider local recommendations and personal consultations to find the best fit for your needs.

Conclusion:

Integrating chiropractic care into breastfeeding support can offer a unique and effective approach to overcoming breastfeeding challenges. By understanding how to work with chiropractors, IBCLCs can enhance their practice and provide more comprehensive care to breastfeeding families. Tune in next week for more expert insights and practical strategies from the world of lactation science.

References:

Cassidy D, Boyle E et al. (2008). Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine, 33(4S): S176-183.
Miller JE, Benfield K. (2008). Adverse effects of spinal manipulation therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic. Jour Manip Physiol Ther, 31(6):419-422.
Vohra S, Johnston BC, Cramer K, Humphreys K. (2007). Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics, 119:275-283.

If you found this episode helpful, please subscribe to The IBCLC Mentor Podcast and leave a review.

Connect with Us:

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:
Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from learning about the intersection of chiropractic care and breastfeeding support!

Credits:

Hosted by: Margaret Salty
Guest: Dr. Jessica Leighton
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #ChiropracticCare #BreastfeedingSupport #LactationConsultant #LactationMentor #EvidenceBasedPractice

The Research Recap: 2- Breast crawl and Breastfeeding in Emergencies

Mon, 16 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Read my post about how to stay up-to-date with current research here: https://margaretsalty.com/2023/12/08/research/

Key Points Covered:

Effectiveness of Breast Crawl Technique on Initiation of Breastfeeding and Intensity of Episiotomy Suturing Pain Among Primipara Mothers

Margaret reviews a study that evaluates the effectiveness of the breast crawl technique on initiating breastfeeding and reducing episiotomy suturing pain among first-time mothers. The study found that the breast crawl significantly improved latching outcomes, with 60% of newborns in the experimental group achieving good latching compared to only 5% in the control group. It also highlighted a reduction in suturing pain, with 55% of mothers in the breast crawl group reporting mild pain versus 74% experiencing severe pain in the control group. This segment underscores the value of implementing the breast crawl technique to enhance breastfeeding initiation and maternal comfort.

Academy of Breastfeeding Medicine Position Statement: Breastfeeding in Emergencies

In this segment, Margaret discusses the Academy of Breastfeeding Medicine’s position statement on breastfeeding in emergencies. The statement emphasizes the critical role of breastfeeding during emergencies for providing safe nutrition and protecting against infections when resources like clean water and electricity are scarce. Key recommendations include the integration of breastfeeding support into emergency preparedness plans, the inclusion of breastfeeding specialists in emergency teams, and prioritizing breastfeeding dyads in food and water distribution. The statement also addresses the controlled use of commercial milk formula, highlighting the need for comprehensive support when formula is necessary.

Practical Application for IBCLCs:

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

Encouraging the use of the breast crawl technique in clinical settings to support better breastfeeding initiation and reduce maternal pain.
Advocating for the inclusion of breastfeeding support in emergency preparedness and response plans.
Educating emergency relief personnel on the importance of protecting breastfeeding and managing nonbreastfed infants appropriately.

Conclusion:

References:

Sharma, A., Sabitha, P., Kaur, H., & Rajiv, S. (2024). Effectiveness of Breast Crawl Technique on Initiation of Breastfeeding and Intensity of Episiotomy Suturing Pain Among Primipara Mothers. African Journal of Biomedical Research, 27(1), 288-295. DOI: 10.53555/AJBR.v27i1S.1238
Bartick, M., Zimmerman, D. R., Sulaiman, Z., El Taweel, A., AlHreasy, F., Barska, L., Fadieieva, A., Massry, S., Dahlquist, N., Mansovsky, M., & Gribble, K. (2024). Academy of Breastfeeding Medicine Position Statement: Breastfeeding in Emergencies. Breastfeeding Medicine, 19(9), 666-682. DOI: 10.1089/bfm.2024.84219.bess

If you found this episode helpful, be sure to subscribe to The IBCLC Mentor Podcast and leave a review.

Have questions or want to suggest a topic? Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: https://www.instagram.com/margaretsalty/
Facebook: https://www.facebook.com/groups/margaretsalty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from these research insights.

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Triple Feeding Plans: A Practical Guide for IBCLCs

Wed, 11 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the details of a triple feeding plan, a comprehensive strategy used to support breastfeeding when infants face challenges such as poor weight gain or low milk supply in mothers. Margaret breaks down the three critical steps of a triple feeding plan—breastfeeding, pumping, and supplementing—into actionable strategies for IBCLCs. Whether you're an experienced lactation consultant or just starting your journey, this episode equips you with evidence-based guidance for managing complex breastfeeding situations.

Read more about calculating required milk intake: https://margaretsalty.com/2024/02/08/calculating-supplement/

Key Points Covered:

1: Introduction to Triple Feeding Plans

Margaret introduces triple feeding as a three-step approach designed to address breastfeeding challenges. This plan is particularly useful when an infant has difficulty latching, poor weight gain, or when there are concerns about the mother's milk supply. The three essential steps are:

Breastfeeding: Attempt breastfeeding first to allow the infant to practice latching and feeding directly from the breast, which stimulates milk production and supports breastfeeding skills.
Pumping: After breastfeeding, the mother should pump to maintain and boost her milk supply. Pumping ensures that milk production continues to meet the baby's needs even when breastfeeding alone isn’t fully effective.
Supplementing: Offer the baby supplementation with expressed breast milk, donor milk, or formula, using methods that support breastfeeding, such as a Supplemental Nursing System (SNS), cup feeding, or paced bottle feeding. This ensures the infant gets adequate nutrition while efforts to improve breastfeeding continue.

2: Real-World Case Example: Implementing a Triple Feeding Plan

Margaret shares a real-world case involving a mom and her newborn, who was experiencing breastfeeding difficulties due to a rough start. The triple feeding plan implemented included:

Breastfeeding
Pumping
Supplementing

3: Practical Application for IBCLCs

Margaret provides practical tips for IBCLCs to effectively implement triple feeding plans:

Assessment and Customization: Begin with a thorough breastfeeding assessment to identify specific challenges and customize the triple feeding plan to the needs of each dyad.
Parent Education and Support: Educate parents on the goals of triple feeding, emphasizing that this approach is a temporary strategy to support breastfeeding success. Provide clear, step-by-step instructions and emotional support throughout the process.
Monitor and Adjust: Regular follow-ups to monitor infant weight gain, milk supply, and breastfeeding progress are critical. Adjust the plan as needed, with the goal of eventually transitioning to exclusive breastfeeding.

Conclusion:

Staying updated with the latest research and integrating evidence-based practices like triple feeding can make a significant difference in breastfeeding outcomes. By implementing these strategies, IBCLCs can provide comprehensive support to breastfeeding families. Tune in each week for more insights and practical tips from the world of lactation science.

References:

Kellams, A., et al. (2017). ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate. Breastfeeding Medicine, 12(3). DOI: 10.1089/bfm.2017.29038.ajk

If you found this episode helpful, please subscribe to The IBCLC Mentor Podcast and leave a review.

Have questions or want to suggest a topic? Reach out to Margaret at margaretsalty.com or connect on social media:

Instagram: @margaretsalty
Facebook: Margaret Salty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from these insights into triple feeding strategies!

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #TripleFeeding #BreastfeedingSupport #LactationConsultant #LactationMentor #EvidenceBasedPractice

The Research Recap: 1- Exclusive breastfeeding and inverted nipples

Mon, 09 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Each week, Margaret brings you key insights from the latest studies, breaking down complex research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.

Read my post here about how to stay up-to-date with current research here: https://margaretsalty.com/2023/12/08/research/

Key Points Covered:

1: Exclusive Breastfeeding and Its Association with Pre- and Postnatal Factors

Margaret reviews a study on the prevalence of exclusive breastfeeding (EBF) and its association with maternal intention and other factors among pregnant women in Brazil. Key takeaways include the importance of strong maternal intention, avoiding bottles and pacifiers, and the role of partner support in sustaining EBF. This segment emphasizes the critical role of prenatal counseling and ongoing support for maintaining exclusive breastfeeding.

2: Nursing Interventions for Inverted Nipples

In this segment, Margaret delves into a study investigating the impact of nursing interventions, such as the syringe technique and Hoffman's exercise, on breastfeeding success among mothers with inverted nipples. The findings highlight significant improvements in breastfeeding efficiency and maternal knowledge, reinforcing the need for tailored support and education in managing anatomical challenges.

3: Practical Application for IBCLCs

Margaret synthesizes the research findings into practical tips for IBCLCs, including:

How to incorporate evidence-based techniques like Hoffman's exercise and the syringe technique into clinical practice.
The importance of using assessment tools like LATCH and IBFAT to monitor breastfeeding progress.
Strategies for enhancing maternal education to improve breastfeeding outcomes.

Conclusion:

References:

Melo, L. S. A. de, Silva, L. F., Corrêa da Silva, S. R., Rosell, F. L., Valsecki Júnior, A., Zuanon, A. C. C., & Tagliaferro, E. P. da S. (2024). Exclusive breastfeeding and its association with pre- and postnatal factors: A cohort prospective study. Brazilian Journal of Oral Sciences, 23, e244708. https://doi.org/10.20396/bjos.v23i00.8674708
Belal, G. A. E., Gomaa, M. M., & Abdelmenem, E. E. (2024). Effect of nursing interventions strategies for inverted nipple on efficiency of early breastfeeding among primiparous mothers. Assiut Scientific Nursing Journal, 12(45), 341-358. DOI: 10.21608/asnj.2024.306764.1868.

If you found this episode helpful, be sure to subscribe to The IBCLC Mentor Podcast and leave a review.

Have questions or want to suggest a topic? Reach out to me at margaretsalty.com or connect with me on social media:

Instagram: https://www.instagram.com/margaretsalty/

Facebook: https://www.facebook.com/groups/margaretsalty

Don't forget to share this episode with fellow IBCLCs or students who could benefit from these research insights.

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

Managing Oversupply in Breastfeeding: Techniques, Evidence, and Best Practices

Wed, 04 Sep 2024 08:00:00 -0500

In this episode of Behind the Latch, Margaret Salty delves into the often overlooked yet challenging condition of breast milk oversupply, or hyperlactation. Oversupply can cause significant issues for both lactation consultants and families, from maternal discomfort to infant feeding difficulties. Margaret reviews the latest research, discusses the physiological underpinnings, and provides practical management strategies to help lactation consultants support families dealing with this complex condition.

Key Points Covered:

1: Overview of Breast Milk Oversupply

Introduction to breast milk oversupply, its prevalence, and the impact on breastfeeding. This segment covers the physiological aspects of milk production, the range of normal milk volumes, and how oversupply deviates from typical breastfeeding dynamics.

2: Causes of Oversupply

A deep dive into the various causes of oversupply, including self-induced factors (like excessive pumping and overuse of galactagogues), iatrogenic causes (due to healthcare guidance), and idiopathic factors (genetic or congenital predispositions). The segment also explores how these factors can disrupt the balance of milk production.

3: Symptoms and Challenges in the Dyad

Discussion of the symptoms experienced by mothers, such as persistent breast fullness, engorgement, plugged ducts, and mastitis, as well as infant symptoms like choking, colicky behavior, and explosive stools. Margaret explains the importance of recognizing these signs early to prevent complications.

4: Management Strategies for Oversupply

A synthesis of current best practices for managing oversupply, including:
Behavioral Interventions: Block feeding, positioning adjustments, and optimizing latch to manage milk flow and support effective feeding.
Herbal and Pharmaceutical Approaches: Use of herbs like sage and peppermint, and medications such as pseudoephedrine and dopamine agonists, with a focus on balancing efficacy and safety.
Mechanical Methods: Techniques like full drainage followed by block feeding to reset milk production levels and alleviate symptoms.

5: Practical Tips for Lactation Consultants

Margaret offers actionable advice for lactation consultants, including:
Conducting thorough assessments to identify the root causes of oversupply.
Educating mothers on managing symptoms through positioning and feeding techniques.
Collaborating with healthcare providers for a comprehensive, multidisciplinary approach to treatment.
Providing emotional support and reassurance to mothers, emphasizing that oversupply can be managed with the right strategies.

Conclusion:

Understanding and managing breast milk oversupply requires a nuanced and evidence-based approach. By integrating research findings with practical management techniques, lactation consultants can effectively guide families through the challenges of oversupply, ensuring both maternal comfort and successful breastfeeding outcomes.

References:

Johnson, H. M., Eglash, A., Mitchell, K. B., Leeper, K., Smillie, C. M., Moore-Ostby, L., Manson, N., Simon, L., & the Academy of Breastfeeding Medicine. (2020). ABM Clinical Protocol #32: Management of hyperlactation. Breastfeeding Medicine, 15(3), 123-132. https://doi.org/10.1089/bfm.2019.29141.hmj

Trimeloni, L., & Spencer, J. (2016). Diagnosis and management of breast milk oversupply. Journal of the American Board of Family Medicine, 29(1), 139-142. https://doi.org/10.3122/jabfm.2016.01.150164

van Veldhuizen-Staas, C. G. (2007). Overabundant milk supply: An alternative way to intervene by full drainage and block feeding. International Breastfeeding Journal, 2(11). https://doi.org/10.1186/1746-4358-2-11

If you found this episode helpful, be sure to subscribe to The IBCLC Mentor Podcast and leave a review.

Have questions or want to suggest a topic? Reach out to me at margaretsalty.com or connect with me on social media at Instagram.

Don't forget to share this episode with fellow IBCLCs or students who could benefit from a deeper understanding of managing breast milk oversupply.

Contact Information:

Website: margaretsalty.com
Instagram: instagram.com/margaretsalty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #Oversupply #BreastfeedingSupport #Hyperlactation #LactationMentor

Understanding Tongue-Tie and Its Impact on Breastfeeding

Sun, 01 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty explores the complex topic of tongue-tie (ankyloglossia) and its impact on breastfeeding. Tongue-tie can be a challenging condition for both lactation consultants and families, often leading to significant breastfeeding difficulties. Margaret reviews the latest evidence, shares insights from authoritative bodies, and provides practical advice for lactation consultants navigating this common but sometimes controversial condition.

Key Points Covered:

1: Overview of Tongue-Tie

Introduction to tongue-tie, its prevalence, and how it can affect breastfeeding. The segment covers the anatomical considerations of tongue-tie, common symptoms, and the variability in diagnosis due to differing assessment tools.

2: Recent AAP Statement on Tongue-Tie

A review of the American Academy of Pediatrics' recent statement on tongue-tie. The AAP emphasizes a cautious approach to frenotomy, recommending careful evaluation to determine if the condition significantly impacts breastfeeding before considering surgery.

3: Opinions from Other Authorities

A look at the perspectives from other key organizations, including the Academy of Breastfeeding Medicine (ABM), World Health Organization (WHO), and International Lactation Consultant Association (ILCA). Each body provides different insights into the management of tongue-tie, reflecting the diversity of opinions and approaches in the field.

4: Examination of the Evidence

A synthesis of current research findings on the effectiveness of frenotomy for breastfeeding challenges associated with tongue-tie. Studies show that frenotomy can improve breastfeeding difficulties and reduce maternal pain in the short term, but long-term benefits remain unclear. Margaret discusses the need for more standardized research and diagnostic criteria.

5: Personal Beliefs and Practical Advice

Margaret shares her personal perspective on managing tongue-tie in breastfeeding dyads. She stresses the importance of a holistic approach, evaluating both the mother's and infant's anatomy, and considering all aspects of their breastfeeding relationship. Practical advice includes optimizing latch and positioning before considering surgical intervention.

6: Practical Steps for Lactation Consultants

Tips for lactation consultants on supporting families dealing with tongue-tie:

Conduct a thorough assessment using validated tools.
Prioritize breastfeeding support strategies, including latch adjustments and positioning techniques.
Collaborate with pediatricians and other healthcare providers for a multidisciplinary approach.
Educate parents on all available options, including the benefits and risks of frenotomy.

Conclusion:

Understanding tongue-tie and its impact on breastfeeding requires a balanced and evidence-based approach. By integrating the latest research with practical support strategies, lactation consultants can effectively guide families through their breastfeeding journey, ensuring decisions are made in the best interest of both mother and baby.

Relevant Links:

American Academy of Pediatrics - Tongue-Tie Overview: AAP
Academy of Breastfeeding Medicine Protocols: ABM
World Health Organization - Infant Feeding Guidelines: WHO
International Lactation Consultant Association: ILCA

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review.

Have questions or want to suggest a topic? Reach out to me at margaretsalty.com or connect with me on social media at Instagram.

Don't forget to share this episode with fellow IBCLCs or students who could benefit from a deeper understanding of tongue-tie and breastfeeding management.

Contact Information:

Website: margaretsalty.com
Instagram: instagram.com/margaretsalty

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #TongueTie #BreastfeedingSupport #LactationMentor

References

American Academy of Pediatrics. (2022). Diagnosis and treatment of ankyloglossia in newborns and infants: A review. JAMA Otolaryngology–Head & Neck Surgery, 143(10), 1032-1039.

Berry, J., Griffiths, M., & Westcott, C. (2012). A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breastfeeding Medicine, 7(3), 189-193.

Bruney, T. L., Scime, N. V., Madubueze, A., & Chaput, K. H. (2022). Systematic review of the evidence for resolution of common breastfeeding problems—Ankyloglossia (Tongue Tie). Acta Paediatrica, 111, 940-947.

Francis, D. O., Krishnaswami, S., & McPheeters, M. (2015). Treatment of ankyloglossia and breastfeeding outcomes: A systematic review. Pediatrics, 135(6), e1458-e1466.

Hatami, A., Dreyer, C. W., Meade, M. J., & Kaur, S. (2022). Effectiveness of tongue-tie assessment tools in diagnosing and fulfilling lingual frenectomy criteria: A systematic review. Australian Dental Journal, 67, 212-219.

O’Shea, J. E., Foster, J. P., & O’Donnell, C. P. (2017). Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews, (3), CD011065.

Navigating the IBCLC Scope of Practice: What You Can—and Can't—Do

Sun, 01 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty delves into the intricacies of the IBCLC scope of practice. Understanding the boundaries of what you can—and cannot—do as an IBCLC is crucial for maintaining professional integrity and delivering quality care. Margaret discusses the official guidelines, common misconceptions, and real-world scenarios that often blur the lines. Whether you're a student or a practicing lactation consultant, this episode provides essential insights to help you navigate your professional responsibilities with confidence and clarity.

Key Points Covered:

Introduction to the IBCLC Scope of Practice: Overview of the official guidelines provided by the International Board of Lactation Consultant Examiners (IBLCE).
Common Misconceptions: Addressing the myths and misunderstandings that often arise in the field.
Case Scenarios: Real-world examples where the scope of practice is tested, and how to handle these situations.
Why Staying Within Your Scope Matters: Discussion on the importance of ethical practice, legal considerations, and maintaining professional credibility.
How to Expand Your Knowledge: Suggestions for continuing education and professional development to stay updated on best practices.

Relevant Links:

IBCLC Scope of Practice - IBLCE
Website: https://iblce.org/about-iblce/role-and-scope/
IBCLC Code of Professional Conduct - IBLCE
Website: https://iblce.org/wp-content/uploads/2021/06/IBCLC-Code-of-Professional-Conduct.pdf
Continuing Education for IBCLCs
Website: https://www.lactationtraining.com/

If you found this episode helpful, be sure to subscribe to Behind the Latch and leave a review.

Have questions or want to suggest a topic? Reach out to me at https://margaretsalty.com/ or connect with me on social media at https://www.instagram.com/margaretsalty/.

Don't forget to share this episode with fellow IBCLCs or students who could benefit from a deeper understanding of their scope of practice.

Contact Information:

Website: https://margaretsalty.com/
Instagram: https://www.instagram.com/margaretsalty/

Credits:

Hosted by: Margaret Salty
Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #ScopeOfPractice #LactationEducation #LactationMentor

My Journey to Becoming an IBCLC and How You Can Too

Sun, 01 Sep 2024 09:00:00 -0500

In this episode of Behind the Latch, Margaret Salty shares her personal journey to becoming an International Board Certified Lactation Consultant (IBCLC). She reflects on the challenges, motivations, and key moments that shaped her path, offering insights and inspiration for those considering or actively pursuing a career in lactation consulting. Margaret also breaks down the various pathways to becoming an IBCLC, with a special focus on the Pathway 2 program. Whether you're just starting to explore this profession or you're already on your way, this episode provides practical advice and encouragement to help you achieve your goals.

International Board of Lactation Consultant Examiners (IBLCE)

Information about the pathways to becoming an IBCLC, including detailed requirements for Pathway 1, Pathway 2, and Pathway 3.

https://iblce.org/certify/pathways/

Academy of Lactation Policy and Practice (ALPP)

Overview of the Certified Lactation Counselor (CLC) program and its role in meeting some prerequisites for the IBCLC certification.

https://www.alpp.org/certifications/certified-lactation-counselor-clc

Lactation Education Resources

Resources and courses for obtaining the required 95 hours of lactation-specific education.

https://www.lactationtraining.com/

IBCLC Scope of Practice

Details about the roles and responsibilities of an IBCLC, as defined by the IBLCE.

https://iblce.org/about-iblce/role-and-scope/

Pathway 2 Programs

Specific information about the Pathway 2 program, including university-based programs that offer clinical hours and lactation-specific education.

https://iblce.org/pathway-2/

Become An IBCLC: https://margaretsalty.com/so-you-want-to-become-an-ibclc/

https://margaretsalty.com/

https://www.instagram.com/margaretsalty/

The IBCLC Mentor Podcast Trailer

Sun, 25 Aug 2024 09:00:00 -0500

Welcome to The IBCLC Mentor Podcast with Margaret Salty, your essential resource for navigating the journey to becoming a successful lactation consultant. Whether you're just starting out, actively studying, or new to the field, this podcast is designed with you in mind.

Join Margaret, a seasoned IBCLC, as she breaks down real-world cases and theoretical scenarios, providing step-by-step guidance on how to manage each situation effectively. Each episode offers a deep dive into evidence-based practices, practical management strategies, and expert insights to help you build your skills and confidence.

Are you searching for answers on how to handle complex lactation cases? Wondering how to translate what you've learned into real-world practice? Curious about the latest research and how it applies to your work? The IBCLC Mentor Podcast is here to answer these questions and more, providing you with the tools you need to thrive in your lactation consulting career.

Tune in to gain the knowledge, support, and inspiration you need to become a skilled and confident IBCLC. Your journey to expertise starts here.