Behind the Latch

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.

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.

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.

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

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

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.

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

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

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

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

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

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.

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

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

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

📧 Email: [email protected]

🌍 BlueSky: @bioanthmags.bsky.social

📧 Email: [email protected]

📸 Instagram: @margaretsalty

📘 Facebook: facebook.com/margaretsalty

🎙 Hosted by: Margaret Salty

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

🎵 Music by: The Magnifiers, My Time Traveling Machine

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

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In this episode of Behind the Latch, Margaret Salty reviews recent research findings that impact lactation consultants. From feeding method and frequency in toddlers, to the lived experiences of adolescent mothers, maternal diet’s role in neurodevelopment, healthcare professional training gaps, and the underutilized role of pharmacists—Margaret translates the latest studies into actionable insights for IBCLCs.

Margaret shares findings from a qualitative study of adolescent mothers in Iran that explores the emotional, physical, and social dynamics shaping their breastfeeding experiences.

Reference:

Yas, A., Karimi, F. Z., Heydari, A., Moghri, J., & Khadivzadeh, T. (2025). Breastfeeding in the midst of adversity: An interpretative phenomenological analysis of breastfeeding in adolescent mothers. BMC Public Health, 25, 1363. https://doi.org/10.1186/s12889-025-22605-7

Practical Takeaways:

• Young mothers face stigma, isolation, and pressure to formula feed.
• Breastfeeding shapes maternal identity and healing.
• Cultural sensitivity and non-judgmental support are essential.
• Midwives and grandmothers can play pivotal support roles.

Margaret reviews a 10-year prospective study from Denmark linking maternal diet and breastfeeding duration to child IQ and head growth.

Reference:

Horner, D., Jepsen, J. R. M., et al. (2025). Maternal dietary patterns, breastfeeding duration, and their association with child cognitive function and head circumference growth: A prospective mother–child cohort study. PLOS Medicine, 22(4), e1004454. https://doi.org/10.1371/journal.pmed.1004454

Practical Takeaways:

• A varied diet is linked to higher IQ and brain growth.
• Head circumference growth is a proxy for cognitive development.
• Longer breastfeeding supports better neurodevelopment.
• Nutrition counseling should start in pregnancy.

Margaret discusses findings from a national survey of Irish healthcare workers assessing breastfeeding knowledge, training, and confidence.

Reference:

McGuinness, D., Frazer, K., et al. (2025). Breastfeeding-related knowledge, attitudes, perceptions and practices of primary healthcare professionals in Ireland: A national cross-sectional survey. PLOS ONE, 20(4), e0320763. https://doi.org/10.1371/journal.pone.0320763

Practical Takeaways:

• Less than half received breastfeeding education; only 18% had hands-on training.
• 94% want more training, but face time and cost barriers.
• GPs were more confident than trainees or nurses.
• IBCLCs must be partners in professional education.

Margaret explores a prospective observational study showing how pharmacist counseling prevented early weaning and saved families money.

Reference:

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.

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.

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

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

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.

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.

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

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

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

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

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

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

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

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.

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

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

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

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: [email protected]

📌 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

Have questions or suggestions for future episodes? Reach out to Margaret at [email protected] or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty’s IBCLC Community

🎙 Hosted by: Margaret Salty

🎧 Guest: Eileen Fitzpatrick, CEO of Baby-Friendly USA

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #BabyFriendly #BreastfeedingSupport #BreastfeedingMedicine #LactationConsultant #BFHI #BreastfeedingEquity #IBCLCMentorPodcast #MargaretSalty

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In this episode of Behind the Latch, Margaret Salty reviews recent research findings that impact lactation consultants. From nutrient intake differences based on feeding type, to the power of food-based galactagogues, the emotional complexity of breastfeeding decisions, and the long-term effects of early breastfeeding initiation—Margaret translates the latest studies into actionable insights for IBCLCs.

Margaret reviews a secondary cross-sectional analysis from the Baby-Act Trial, which explores nutrient intake in breastfed, mixed-fed, and formula-fed infants in a WIC population in Puerto Rico.

Reference:

Palacios, C., Alvarez, E., Kallis, M. G., Valle, Y., Pomeroy, J., & Campos, M. (2025). Infant feeding practices and their association with early-life nutrient intake: Baseline findings from the Baby-Act Trial. Dietetics, 4(2), 15. https://doi.org/10.3390/dietetics4020015

Practical Takeaways:

• Exclusively breastfed infants consumed fewer calories but still met energy needs.
• Formula-fed babies had higher energy and protein intakes, which may contribute to faster growth and future obesity risk.
• IBCLCs should normalize slower growth in breastfed babies and support families in underserved communities.

Margaret shares findings from a quasi-experimental study in Indonesia comparing the effects of red bean juice and green bean juice on milk adequacy in postpartum mothers.

Reference:

Suwiyani, S., Nikmawati, N., & Masini, M. (2025). The effectiveness of administering red bean juice and green bean juice on adequate milk production in postpartum mothers. Midwifery and Nursing Research Journal, 7(1), 7–13. http://ejournal.poltekkes-smg.ac.id/ojs/index.php/MANR

Practical Takeaways:

• Red bean juice led to greater improvements in milk adequacy than green bean juice.
• Red beans contain protein, phytoestrogens, and isoflavones that may stimulate lactation.
• Food-based galactagogues are accessible, culturally relevant, and evidence-supported.

Margaret explores a narrative review using the Extended Theory of Planned Behavior to understand the emotional, psychological, and social dimensions of breastfeeding.

Reference:

Wu, L., Li, X., Ismail, H. N., Guo, P., & Yang, J. (2025). Understanding the psychosocial dilemma in breastfeeding: A narrative review of extended theory of planned behavior and its intervention strategies. Reproductive Health, 22(46). https://doi.org/10.1186/s12978-025-02001-5

Practical Takeaways:

• Emotional attitude and self-efficacy predict breastfeeding duration more than knowledge alone.
• Guilt and social pressure can hinder sustained breastfeeding.
• Tailored education and emotional support—especially from partners and family—can boost success.

Margaret discusses a longitudinal cohort study from Brazil examining how early breastfeeding initiation affects exclusive breastfeeding duration and complementary feeding habits.

Reference:

Ficagna, C. R., Menezes, V. M., Kretzer, D. C., Moreira, P. R., Goldani, M. Z., da Silva, C. H., & Bernardi, J. R. (2025). Breastfeeding within the first hour: Associations with exclusive breastfeeding duration and complementary feeding. Revista Brasileira de Saúde Materno Infantil, 25, e20230367. https://doi.org/10.1590/1806-9304202500000367-en

Practical Takeaways:

• Early initiation improves exclusive breastfeeding rates at 2 months.
• Infants breastfed in the first hour were less likely to be introduced to salt, sugar, or honey early.
• IBCLCs should advocate for golden hour practices—even in surgical births

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 engagement.

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

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.

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

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

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

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

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

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

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

🔗 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.

🌍 Website: https://www.rebeccanthompson.com/

📅 Upcoming Events & Book Tour: Visit her website for book signings, live readings, and podcast appearances.

📧 Email: [email protected]

📸 Instagram: @margaretsalty

📘 Facebook: facebook.com/margaretsalty

🎙 Hosted by: Margaret Salty

🎧 Guest: Dr. Rebecca Thompson, Family Medicine Physician & Author

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #PerinatalMentalHealth #HeldTogether #PregnancyLoss #FamilyMedicine #CompassionInHealthcare #LactationConsultant #MargaretSalty

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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.

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.

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!

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

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

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

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

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

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

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

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

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.

📌 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

Have questions or suggestions for future episodes? Reach out to Margaret at [email protected] or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Sarah Quigley, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #LactationTraining #Mentorship #LactationConsultant #BreastfeedingSupport #LactationEducation

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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.

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:

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!

📷 Instagram: @margaretsalty

🎙️ Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #LactationConsultant #BreastfeedingResearch #LactationMentor #EvidenceBasedPractice

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.

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

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

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

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

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

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

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

📌 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

Have questions or suggestions for future episodes? Reach out to Margaret at [email protected] or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Christine Staricka, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #LactationSupport #BabyCafe #BreastfeedingCommunity #LactationTraining #BreastfeedingMedicine #MargaretSalty

🎧 Listen Now!

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