In this episode of Behind the Latch, Margaret Salty reviews four recent studies covering the power of the breast milk microbiome, maternal confidence in NICU milk expression, cultural insights into human milk donation, and the reality of prescription drug use during lactation. Each study offers timely, practical takeaways to inform how IBCLCs support families in clinical and community settings.

Study 1: The Breast Milk Microbiome and Infant Immunity

Citation: Rebello, S. J., et al. (2025). Journal of Pure and Applied Microbiology, 19(2), 902–913. https://doi.org/10.22207/JPAM.19.2.51

🔍 What They Studied:

A literature review of the breast milk microbiome’s impact on gut colonization, immune development, and disease prevention in infants—especially in preterm populations.

🧠 Key Findings:

• Breast milk contains active strains like Lactobacillus and Bifidobacterium
• Breastfed infants have healthier microbiota than formula-fed infants
• Milk microbes help prevent NEC, infections, colic, and eczema
• Supplemental probiotics (when used appropriately) are generally safe and effective

✅ Implications for IBCLCs:

• Reinforces that breast milk is immunologically active—not just nutrition
• IBCLCs can educate families and advocate for milk as medicine
• Understanding probiotic research supports informed collaboration in NICU care

Study 2: Maternal Self-Efficacy & Donor Milk in the NICU

Citation: Kheawlamyong, R., et al. (2025). Journal of Health Research, 39(3), 244–252. https://doi.org/10.56808/2586-940X.1138

🔍 What They Studied:

Which maternal perceptions (based on the Health Belief Model) best predict breastfeeding preparation behaviors in mothers of preterm infants receiving donor milk.

🧠 Key Findings:

• Only self-efficacy significantly predicted positive lactation behaviors
• Risk awareness, benefits, and barriers weren’t correlated with milk expression efforts
• Mothers who believed in their ability to succeed were more likely to store and prepare milk

✅ Implications for IBCLCs:

• Building confidence, not just providing education, is key in NICU support
• Donor milk can reduce urgency—so reinforce the value of MOM (mother’s own milk)
• Effective support includes hands-on help, emotional validation, and tailored plans

Study 3: Global Voices on Milk Donation

Citation: Mahdikhani, Z., et al. (2025). International Breastfeeding Journal, 20(50). https://doi.org/10.1186/s13006-025-00740-6

🔍 What They Studied:

A meta-synthesis of 36 qualitative studies exploring the lived experiences of milk donors, recipients, and healthcare providers worldwide.

🧠 Key Findings:

• Donating milk can be healing, especially after infant loss
• Cultural beliefs, stigma, and religion heavily influence donor milk decisions
• Healthcare provider encouragement increases milk bank participation
• Systemic barriers—like transport, lack of access, and misinformation—limit engagement

✅ Implications for IBCLCs:

• We play a central role in normalizing donor milk and offering trauma-informed support
• Cultural sensitivity and evidence-based reassurance are critical
• Bereaved donors deserve compassionate care and informed options
• Push for system improvements: access, education, and provider training

Study 4: Prescription Drug Use During Breastfeeding

Citation: Gotfredsen, D. R., et al. (2025). British Journal of Clinical Pharmacology. https://doi.org/10.1002/bcp.70139

🔍 What They Studied:

A register-based cohort study in Denmark analyzing over 534,000 breastfeeding dyads to understand medication use and the availability of lactation safety data (RID).

🧠 Key Findings:

• 54.5% of breastfeeding mothers used at least one prescription drug
• Most common: antibiotics, IUDs, and pain medications
• 51.5% of systemic drugs lacked Relative Infant Dose (RID) data
• Major gaps in evidence limit clinical guidance for safe use

✅ Implications for IBCLCs:

• Prescription drug use is common—knowledge and referral are essential
• Lack of data can lead to over-caution or unnecessary weaning
• Collaborate with prescribers and refer to LactMed, Hale’s, or InfantRisk
• Advocate for policy change to improve data collection and transparency

Connect with Margaret:

📧 Email: [email protected]

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎵 Music by: The Magnifiers, “My Time Traveling Machine”

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