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

Connect with Margaret

📧 Email: [email protected]

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Sandra Cole

🎵 Music by: The Magnifiers, My Time Traveling Machine

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!