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.

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

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:

1. Conduct a thorough assessment using validated tools.
2. Prioritize breastfeeding support strategies, including latch adjustments and positioning techniques.
3. Collaborate with pediatricians and other healthcare providers for a multidisciplinary approach.
4. 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

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.

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:

1. IBCLC Scope of Practice - IBLCE
2. Website: https://iblce.org/about-iblce/role-and-scope/
3. IBCLC Code of Professional Conduct - IBLCE
4. Website: https://iblce.org/wp-content/uploads/2021/06/IBCLC-Code-of-Professional-Conduct.pdf
5. Continuing Education for IBCLCs
6. 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

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/

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.