Exclusive pumping? Why would some one do this? Barbara and Nancy discuss the latest research on exclusive pumping. They look at who is exclusive pumping and why. This has shifted in the past 2o years or so. It used to be that the majority of exclusive pumpers were pumping for their preterm babies while they go mature enough to directly nurse. Not true anymore. Some people choose to exclusively pump from the very beginning but the majority of exclusive pumpers end up exclusively pumping because they had problems with breast/chestfeeding that they couldn’t resolve. There is also new research that shows maybe our suggestions in the past aren’t as accurate as we thought they were.

Listen to find out what the latest research says!

Important references:

Eden, C. (2024). Shifting the paradigm for establishing and maintaining milk production in the setting of mother/infant separation. Journal of Human Lactation, 40(4), 535-538. https://pubmed.ncbi.nlm.nih.gov/39313928/

Hoban, R., Pei, Q., Medina Poeliniz, C., Golan Maor, Y., Walker, R. E., Meier, P. P., Monk, A., & Parker, L. A. (2025). Maternal complications of pregnancy and achievement of secretory activation and coming to volume in breast pump-dependent mothers of preterm infants. Breastfeeding Medicine, 20(7), 512-520. https://pubmed.ncbi.nlm.nih.gov/40626629/

Levene, I., Fewtrell, M., Quigley, M. A., & O’Brien, F. (2024). The relationship of milk expression pattern and lactation outcomes after very premature birth: A cohort study. PLoS One, 19(7), e0307522. https://pubmed.ncbi.nlm.nih.gov/39074108/

Mago-Shah, D. D., Athavale, K., Fisher, K., Heyward, E., Tanaka, D., & Cotten, C. M. (2023). Early pumping frequency and coming to volume for mother’s own milk feeding in hospitalized infants. Journal of Perinatology, 43(5), 629-634. https://pubmed.ncbi.nlm.nih.gov/37037987/

Yuan, S., Wang, H., Xu, X., & Li, Q. (2025). A randomized control trial of early breast milk pumping interventions for mothers of moderately pretermi infants. Breastfeeding Medicine. https://pubmed.ncbi.nlm.nih.gov/40768317/

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Let Nancy and Barbara help!

The 3 exam eligibility pathways are open to individuals from a variety of backgrounds. Each person must decide which pathway will work best for them. For more info, go here: https://ibclc-commission.org/step-1-prepare-for-ibclc-certification/lactation-specific-clinical-experience/

Pathway 1 involves using appropriately supervised clinical experience obtained through paid employment or volunteer service as a health professional or mother support counselor. The kind of supervision that is considered appropriate depends upon the candidate’s professional background and scope of practice.

Under Pathway 2 and Pathway 3, the candidate completes clinical practice in lactation care under the direct supervision of experienced IBCLCs. Individuals with no paid or volunteer experience in providing care to breastfeeding families or those who desire a more structured way of learning lactation care clinical skills may choose to follow one of these pathways.

Pathway 1

Many candidates use clinical practice they have obtained through paid employment or volunteer service to qualify for the IBCLC certification exam. If you fall into one of the following categories, Pathway 1 is a reasonable choice to make.

Pathway 1 candidates must complete at least 1000 hours of clinical practice experience in lactation care that were accrued in the 5 years immediately prior to applying for the IBCLC certification exam.

Pathway 2

We don’t have a lot of information on Pathway 2.

Pathway 3

Individuals seeking qualification through Pathway 3 must have an approved Pathway 3 Plan on file with IBLCE. This mentorship plan must be developed according to the specifications found in https://ibclc-commission.org/ibclc-information/pathway-3-plan-guide/ and must be approved by IBLCE prior to beginning the mentorship.

The first step toward qualification for the  IBCLC certification examination through Pathway 3 is to develop and submit a mentorship plan to IBLCE. Details about Pathway 3 Plan development can be found in https://ibclc-commission.org/ibclc-information/pathway-3-plan-guide/

Pathway 3 requires a minimum of 500 hours of clinical experience in lactation care that were directly supervised by experienced IBCLCs and accrued within the 5 years immediately prior to applying for the IBCLC certification examination.

If you are considering Pathway 3, you must locate and contract with one or more IBCLCs. These IBCLCs will serve as your mentors and will provide the direct supervision of your clinical practice in lactation care.

Listen to the podcast to find the best places to connect with others to obtain your clinical hours.

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Barbara takes the time to sit down with her LactaLearning co-founder, Nancy Mohrbacher to discuss her journey in the field of lactation.

Nancy Mohrbacher, IBCLC, FILCA fell in love with breastfeeding while nursing her three sons, Carl, Peter, and Ben, who are now grown.  In 1982, before the lactation profession existed, she began working as a volunteer peer-supporter and found her passion: helping families meet their lactation goals.

Board-certified as a lactation consultant in 1991, from 1993 to 2003 Nancy started and grew a large private lactation practice in the Chicago area, where she saw thousands of families. Since then, she’s worked for a major breast-pump company and a national corporate lactation program. Currently, Nancy speaks at events around the world and trains aspiring and recertifying lactation consultants online via LactaLearning.com. She also contracts with hospitals to help improve breastfeeding practices.

Nancy’s mission is to simplify life for new families, many of whom–without realizing it–make breastfeeding more complicated than it needs to be.

To accomplish this mission, Nancy develops innovative lactation education and tools. Her textbooks for lactation specialists, Breastfeeding Answers, Second Edition and its Pocket Guide, are used worldwide.  Her Natural Breastfeeding Professional Package provides digital resources for professionals for staff training and one-on-one work with families.

Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, Working and Breastfeeding Made Simple, and her tiny troubleshooting guide Breastfeeding Solutions: Quick Tips for the Most Common Nursing Challenges. Its companion Breastfeeding Solutions app is used worldwide and is available on the App Store and Google Play. Her YouTube channel is viewed by millions of families.

In 2008 the International Lactation Consultant Association officially recognized Nancy’s contributions to the field of lactation by awarding her the designation FILCA, Fellow of the International Lactation Consultant Association. Nancy was one of the first group of 16 to be recognized for their lifetime achievements in breastfeeding.

You can follow Nancy on Facebook, Twitter (@BFReporter), Pinterest, and YouTube.

If you work with breast/chestfeeding families and are passionate about lactation support OR you want to turn your passion for nursing into professional practice, check out LactaLearning.com and consider following us on social media!

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From Barbara Robertson:

Barbara spent some time with Dr. Kathy Kendall-Tackett. She is a health psychologist and International Board Certified Lactation Consultant, and the Owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women’s health. Dr. Kendall-Tackett was the Editor-in-Chief of Clinical Lactation and is still the Editor-In-Chief for  Psychological Trauma. She is Fellow of the American Psychological Association in Health and Trauma Psychology, Past President of the APA Division of Trauma Psychology, and a member of the Board for the Advancement of Psychology in the Public Interest. Dr. Kendall-Tackett specializes in women’s-health research including breastfeeding, depression, trauma, and health psychology. Her research interests include the psychoneuroimmunology of maternal depression and the lifetime health effects of trauma. Dr. Kendall-Tackett is Clinical Professor of Nursing at University of Hawai’i at Manoa.

Dr. Kendall-Tackett has won several awards for her work including the 2016 Outstanding Service to the Field of Trauma Psychology Award from the American Psychological Association’s Division of Trauma Psychology, the 2011 Community Faculty Award from the Department of Pediatrics, Texas Tech University School of Medicine, and the 2011 John Kennell and Marshall Klaus Award for Excellence in Research from DONA International (with co-recipient, Thomas Hale). She has authored more than 400 articles or chapters, and is currently completing her 35th book, a social history of The Phantom of the Opera. Her most recent books include: Depression in New Mothers, 3rd Edition (2016, Routledge, in press), Psychology of Trauma 101 (2015), The Science of Mother-Infant Sleep (2014), and The Psychoneuroimmunology of Chronic Disease (2010). She is also co-author of the bestselling book, Breastfeeding Made Simple, 2nd Edition (2010). Her websites are UppityScienceChick.com, BreastfeedingMadeSimple.com, KathleenKendall-Tackett.com, and PraeclarusPress.com.

If you work with breast/chestfeeding families and are passionate about lactation support OR you want to turn your passion for breast/chestfeeding into professional practice, check out LactaLearning.com and consider following us on social media!

Instagram @lacta.learning

Facebook LactaLearning

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Nancy and Barbara are celebrating that LactaLearning, Inc is now 3 years old!

It is hard to believe that what started out as a dream for Barbara has evolved with Nancy into a thriving business.

Now three years later, they offer lactation courses that are different than anyone else’s. Really, they have set up LactaLearning to be able to meet anyone’s lactation education needs!

They are also celebrating 10 years and 100 episodes of this podcast! Many new podcasts are in the hopper to continue to deliver interesting and informative topics on lactation. Barbara started the podcast in 2015 with the guidance of Barb Demske, then continued with Jessica Beemsterboer, and now Nancy has been added! Busy bees.

With a growing social media following, LactaLearning continues to offer posts on Facebook and Instagram that help keep their followers entertained and up to date on lactation happenings.

LactaLearning is offering a one day seminar on Low Milk Supply on Saturday, October 25th and in the winter of 2026 a new book group, Working and Breastfeeding Made Simple.

Nancy has recently been working on the LactLearning Youtube channel as well to help round things off.

Again, as they celebrate three years in business, founders Barbara Robertson and Nancy Mohrbacher, along with the LactaLearning team, Jessica, Veronica, Heather, Janelle, and Carrie, unveil a new look and introduce easier-than-ever access to all things lactation. With a new glossary of terms, clear class descriptions, and resources designed to empower your lactation journey, we aim to be your go-to resource as you pursue lactation consulting.  We invite you to visit lactalearning.com to browse our many options for lactation education. Barbara and Nancy are always available to answer your questions and to make your lactation goals attainable.

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Kimberly Seals Allers’ words, “I’m a femtech founder, writer, speaker and maternal and infant health strategist with a bold vision to transform the experience of motherhood for all and to eradicate racial disparities in birth and breastfeeding.”

Kimberly is someone who sees an issue and works on solutions! She gets things done! Barbara was lucky to be able to catch up with Kimberly on All Things Breastfeeding.

From her website: “Veteran journalist and five-time author turned maternal and infant health advocate and femtech founder. A former senior editor at ESSENCE and writer at FORTUNE magazine, I created Irth, as in birth but we dropped the B for bias, as the first-of-its kind, doctor and hospital review & rating platform just for Black and brown women and birthing people. I leveraged decades of media experience and a passion for mothering into a vision and platform to use technology to amplify community voices to address racism and bias in Black maternal and infant care. Irth is a non-profit project of my 501C3, Narrative Nation, which also produces the Birthright podcast, where I share positive Black birthing stories as a direct counter to the doom and gloom narrative too common in mainstream media coverage of Black maternal health.”

Kimberly’s new project has been connecting families with a maternal loss at birth with a human milk bank so the baby can receive human milk for the beginning of their life. So powerful. Human Milk Justice for Infants “Powered by HMBANA & Kimberly Seals Allers. The Restoration Project (TRP) is an innovative national response mechanism that addresses the nutritional needs of newborns who have lost their mothers due to pregnancy-related deaths. A partnership between the Human Milk Banking Association of North America (HMBANA) and Kimberly Seals Allers, this initiative builds a nationwide network to collect and distribute donor milk to medically and economically vulnerable populations. Human milk is critical for infant health. TRP ensures that infants impacted by childbirth-related maternal loss receive compassionate care and immediate access to human milk, the best first food for an infant’s health and development.”

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In this episode Nancy and Barbara discuss the latest findings on relacation and induced lactation.

According to University of Western Australia’s LactaPedia, an online comprehensive glossary of human lactation terms freely available to professionals and parents (https://lactapedia.com/lactapedia-site/homee), relactation is defined as the re-establishment of lactation after the immediate post-birth period. This restricts relactation only to mothers and other birthing parents who delivered the current baby. This differs from the broader definition used in the 2020 Breastfeeding Answers and other lactation textbooks, which includes anyone who had ever given birth to any baby. Due to the breast-tissue growth during pregnancy, this previous definition assumed those who had ever given birth had an advantage in bringing in milk. Now, establishing milk production by anyone who did not give birth to the current baby is defined as induced lactation.

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Barbara first meet Kay Hoover at her favorite conference, Lactation Consultants in Private Practice about 18 years ago. Kay and her dear friend Chris Mulford, created the conference to help private practice folks improve their skills. Kay has been in the field for years, in many different roles, working in private practice, at the hospital, and in public health.

From the introduction to The Breastfeeding Atlas, 7th Ediction, Kay…”retired from her hospital job as a lactation consultant at the end of 2019. During the pandemic she provided many on-line presentations to maintain her career-long commitment to educating the next generation of lactation consultants. Kay became an International Board Certified Lactation Consultant in 1985 and was recognized as a Fellow of the International Lactation Consultant Association in 2008.

During her career she served as a lactation consultant for four different hospitals. Kay was also employed as a lactation consultant by the Pennsylvania Department of Health for the Breastfeeding Awareness and Support Program, the Philadelphia Department of Public Health in the Division of Maternal, Child and Family Health, and the Center of Childhood Obesity Research at the Pennsylvania State University. In addition, she maintained a private practice for over 20 years. Kay has an international reputation as a lecturer, author, and clinical photographer.

Since 1971 she has been a La Leche League Leader and a member of the Pennsylvania Breastfeeding Coalition since its inception in 1992. She served for six years on the Board of Directors of the International Board of Lactation Consultant Examiners. Kay and Charlie, her husband of 55 years, raised their sons, Douglas, Steven, and David, in the Philadelphia area and are the grandparents of Daniel, Eric, and Robert.”

Articles Kay referred to:

Vazirinejad R, Darakhshan S, Esmaeili A, et al. The effect of maternal breast variations on neonatal weight gain in the first seven days of life. International Breastfeeding Journal Nov 2009 https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-4-13

Claesson IM, Larsson L, Steen L, et al. “You just need to leave the room when you breastfeed” Breastfeeding experiences among obese women in Sweden – A qualitative study. BMC Pregnancy Childbirth 18(1):39, 2018 https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1656-2

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Wanting to get to know some of her favorite mentors who are the leaders in the field of lactation, Barbara Robertson is creating a series of podcasts to share with all of you! The first is with Dr. Anne Eglash. Barbara did an interview with Dr. English in 2015 about pain that is published here. Since that time Barbara became an advid fan of IABLE, the Institute for the Advancement of Breastfeeding & Lactation Education that Anne is a huge part of. This organization has a great find lactation support including breastfeeding medicine doctors. It also has one of my favorite brain teasers, Clinical Questions.

In this podcast, Barbara and Anne talk about how Anne became interested and involved in the field of lactation, tracing her roots back to medical school.

Anne Eglash MD, IBCLC, FABM, is a clinical professor with the University of Wisconsin School of Medicine and Public Health, in the Department of Family and Community Medicine. In addition to practicing family medicine, she has been a board certified lactation consultant since 1994. Dr. Eglash is a cofounder of the Academy of Breastfeeding Medicine, the Medical Director and cofounder of the Mothers’ Milk Bank of the Western Great Lakes, and the Medical Director of the University of Wisconsin Lactation Services. She has published many peer- reviewed articles on breastfeeding medicine, and has special research interests in chronic breast pain, human milk storage, nipple shield use, and outpatient breastfeeding education for health professionals. She sits on the editorial board for Breastfeeding Medicine Journal. She co-hosts and produces a free breastfeeding medicine podcast series, co-sponsored by The Academy of Breastfeeding Medicine, called The Breastfeeding Medicine Podcast, available on i-tunes. Dr. Eglash is founder and president of The Milk Mob, a nonprofit organization dedicated to the creation of breastfeeding-friendly medical systems and communities.

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What’s the deal with lipase?

There was a recent paper published called Food-Derived Compounds Extend the Shelf Life of Human Milk.

Nancy and Barbara found this very interesting and discuss the merits of the findings from this paper, what we actually know about lipase and human milk, and what should we be doing about lipase, if anything. They had many questions about this paper including the fact it was not peer reviewed, not published in a journal, they didn’t actually measure the lipase levels of individuals, and address the question of fresh expressed milk sometimes smelling “lipasey”.

Let’s start with what is lipase? We know it is an enzyme that helps break down food. Not everyone agrees about what is true concerning lipase and human milk. Dr. Katrina Mitchell says, “There is no scientific evidence to support the concept of high lipase breastmilk from the freezer.  Milk may smell bad after thawing, but it is from general breakdown of fatty acids rather than an abnormally high content of lipase.  Because the breast is an endocrine organ and sweat gland, breastmilk may smell in the same way our armpits or groins smell. Humans are smelly animals :). In addition, babies may dislike bottle milk because they prefer feeding at mom’s breasts, with her warmth and smell. The Academy of Breastfeeding Medicine Human Milk Storage Protocol reviews the fact there is no evidence to support the concept of “high lipase” and IABLE has an excellent podcast on this topic as well.”

So, do we even have a problem? It does seem like some parent’s milk becomes “smelly” after it has been expressed and some babies don’t seem to want to drink it. So what is going on? The fact is we are still not sure.

From the new article. “We developed a first-of-its-kind high-throughput screening platform to identify food-derived compounds and combinations of compounds that, when added to human breastmilk, preserve fat content, retain antioxidant capacity, and reduce production of rancid-associated free fatty acids during extended freezer storage. These formulations represent leads for the development of safe and affordable frozen breastmilk shelf-life extenders for easy at-home use to increase the longevity of stored breastmilk.”

But do we need this? Nancy and Barbara worry that people will use this compound in their milk preemptively, even when they very well might not have a “lipase” issue.  Are we “solving” a problem that doesn’t need to be solved? In other words, exploiting worried families?

The author does note this:

The authors disclose affiliation with and equity in PumpKin Baby Inc., a Princeton University spinout and for-profit public benefit corporation formed over the course of this work. PumpKin Baby Inc. is working to develop and commercialize the technology presented in this report, as the organization's stated purpose is to provide access to scientific research and products that aim to improve access to breastmilk, breastfeeding, and maternal and infant health. Several patents related to the technology described in this manuscript are pending and assigned to Princeton University.”

Clearly, he wants to make money off of this, well meaning or not.

If you come across colleagues or parents wondering about this, let them know the jury is still out. At this time we cannot say that this is a good solution to the problem.

My expressed breastmilk doesn’t smell fresh. What can I do?

https://llli.org/breastfeeding-info/smell-human-milk/

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