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.

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.

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!

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