Behind the Latch

Lactation Exam Mastery Course! Master the IBCLC Exam Today!In this episode of Behind the Latch, Margaret interviews Meaghan Beames, Registered Massage Therapist, educator, and infant craniosacral therapy specialist based in Toronto. Meaghan shares her journey into craniosacral therapy following her own early breastfeeding struggles and explains how this gentle, hands-on modality can support infants experiencing feeding difficulties, poor latch, weak suck, reflux, tension patterns, and post-birth dysregulation.Together, Margaret and Meaghan unpack what craniosacral therapy actually is—and what it is not—moving beyond common misconceptions of it as “woo” or energy work. Meaghan offers a clear, physiology-based explanation grounded in fascia, cranial nerve function, nervous system regulation, and developmental biomechanics, helping clinicians understand how subtle tension patterns from gestation and birth can profoundly affect infant feeding and behavior.Throughout the conversation, they explore the clinical intersections between lactation care and bodywork, including the role of cranial nerves in suck function, the relationship between birth mechanics and oral dysfunction, and how craniosacral therapy may improve outcomes before and after frenotomy. Meaghan also provides practical language clinicians can use with families, guidance on practitioner training and safety, and insight into when referrals to other disciplines are appropriate.🔍 What We Talk AboutHow Meaghan entered infant craniosacral therapy after her own postpartum and breastfeeding experienceWhat craniosacral therapy is, how it works, and how it differs from chiropractic, osteopathy, and physical therapyFascia, tension patterns, and why the body must be viewed as a single integrated systemThe role of cranial nerves in infant feeding, suck strength, and oral coordinationHow gestational positioning, birth interventions, and delivery mechanics influence feeding outcomesWhy babies may feed well on one side but struggle on the otherWeak suck, poor oral sensation, and why some infants “can’t feel” the nippleThe limitations of appearance-based tongue-tie assessment and why function must come firstHow craniosacral therapy may improve frenotomy outcomes and reduce reattachment riskWhy cutting a dysfunctional tongue without addressing body tension can worsen feedingWhat a typical infant craniosacral session looks like, including assessment and treatment flowHow many sessions are typically needed and why “snapback” can occurHow craniosacral therapy supports nervous system regulation and reflex integrationWhat families may notice after treatment, including emotional release and behavior changesHow to talk with parents about craniosacral therapy in clear, non-alarming languageSafety considerations, training standards, and how to identify qualified practitionersWhat the current research does—and does not—tell us about craniosacral therapyOptions for families who cannot access or afford bodywork services🧠 Key Takeaways for CliniciansInfant feeding difficulties are often rooted in whole-body tension patterns, not isolated oral anatomy.Cranial nerve dysfunction can impair suck, coordination, and sensation even when oral anatomy appears “normal.”Craniosacral therapy uses extremely light touch to identify and release fascial restrictions affecting function.Birth mechanics, including fetal position and obstetric interventions, can significantly impact feeding.Frenotomy without addressing underlying body tension...

Lactation Exam Mastery Course! Master the IBCLC Exam Today!In this episode of Behind the Latch, Margaret interviews Dr. Valérie Verhasselt, Professor of Immunology at the University of Western Australia and Head of the LRF Centre for Immunology and Breastfeeding. Dr. Verhasselt discusses her groundbreaking research on colostrum and food allergy prevention, focusing on her recent study demonstrating that partial colostrum feeding in the first 72 hours of life increases the risk of peanut allergy, while exclusive colostrum feeding appears profoundly protective. Her findings offer a powerful reframing of early postpartum lactation care: the risk may not stem solely from early cow’s milk exposure, but from reduced colostrum intake during the critical adaptation period when the newborn’s gut, immune system, and microbiota are being programmed. She explains how colostrum’s unique concentration of growth factors, IgA, vitamin A, and immune-modulating bioactive components help seal the gut, seed the microbiome, strengthen the skin barrier, and establish immune tolerance—laying the foundation for lifelong resilience. Dr. Verhasselt also shares insights from mouse models, discusses why donor mature milk is not a substitute for colostrum, and explores future directions including donor colostrum banks, colostrum-derived therapeutics, and new research on colostrum’s role in brain development. https://pubmed.ncbi.nlm.nih.gov/40968490/🔍 What We Talk AboutHow Dr. Verhasselt entered lactation immunology after a “flash” inspiration during her early research career Why the transition from intrauterine to extrauterine life makes newborns uniquely vulnerable to allergy developmentHow colostrum supports gut closure, immune regulation, microbiota seeding, and skin barrier maturationWhy giving formula in the first days displaces colostrum intake rather than simply “topping up” Evidence showing a five-fold increase in peanut allergy among infants who received partial colostrum feedingThe striking finding that no infants who received ≥9 colostrum feeds developed peanut allergy by 12–18 monthsWhat early formula exposure does to the infant microbiome weeks and months laterHow parental allergy risk influences—but does not override—the protective effect of colostrumWhy exclusive breastfeeding data often overlook the critical first 72 hoursThe interplay between infant skin permeability, environmental exposure, detergent use, and allergy sensitizationWhat mouse models teach us about colostrum, mature milk, and developmental programmingWhy donor milk does not replicate colostrum’s early immunological functionThe concept of exclusive colostrum feeding as a distinct clinical and public health priorityFuture research avenues: colostrum-derived metabolites, donor colostrum banks, and early-life allergy prevention strategies🧠 Key Takeaways for CliniciansColostrum’s immunological role is unique and time-sensitive—its composition cannot be replicated by mature milk, donor milk, or formula.Supplementation in the first days displaces colostrum volume, which may be the primary mechanism increasing allergy risk.As few as nine colostrum feeds in the first 72 hours appear profoundly protective against peanut allergy.Early formula exposure—even brief—can alter the infant gut...

LACTATION EXAM MASTERY COURSE- Stop Guessing How to Study for the IBCLC Exam. In this episode of Behind the Latch, Margaret interviews Dr. Zoya Gridneva, Research Fellow with the Geddes–Hartmann Human Lactation Research Group. Zoya discusses her research exploring maternal adiposity, glandular tissue distribution, breast anatomy, milk production, puberty timing, parity, and breast development across lactations, using ultrasound imaging to examine the lactating breast in a way few studies have before Her findings help illuminate why some parents experience low supply despite doing “everything right,” and demonstrate how maternal factors—especially adiposity—may influence glandular tissue development, breast storage capacity, and milk removal efficiency. She also shares emerging tools that may help clinicians screen for lactation risk prenatally and why early identification may matter profoundly for parental experience and outcomes.🔍 What We Talk AboutHow Zoya entered lactation research after her own breastfeeding experience Why adiposity is emerging as a central factor in milk production outcomes What ultrasound can tell us about ductal branching, glandular volume, and breast storage capacity Why more ductal development doesn’t always equal meaningful clinical increase in supply The relationship between puberty timing, parity, contraception, adiposity & milk output — what we know and what we don’t Why breast size ≠ glandular volume, and why small breasts may produce normal volumes The need for better screening for primary low supply and insufficient glandular tissue (IGT)A new 5-minute lactation risk screening tool used in Western Australia & its clinical promise Why single-feed weights are not enough — and why 24-hour production is more meaningful Where research must go next: larger samples, longitudinal data, and early-life glandular development🧠 Key Takeaways for CliniciansAdiposity may influence breast growth, glandular proportion, and storage capacity, mediating supply outcomes.Ultrasound can visualize breast structure but requires skill, training, and access — not yet feasible for routine care.We may be able to identify high-risk parents prenatally using simple clinical screening tools, improving early intervention timing.Puberty, hormonal exposure, and menarche timing could play a significant role in final glandular development — a research area wide open for exploration.24-hour test-weighing is one of the most reliable ways to identify low production early, long before a “weight problem” appears.Clinically, risk awareness + early frequent milk removal support may be key for at-risk families.👩‍🏫 GuestDr. Zoya Gridneva, PhDMaternal Factors, Breast Anatomy & Milk Production — An Ultrasound-Based Look Inside LactationResearch Fellow, Geddes–Hartmann Human Lactation Research GroupUniversity of Western Australia📝 Connect with Margaret📬 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret...

In this episode of Behind the Latch, Margaret Salty interviews Dr. Anita Lugo, Pediatric Nurse Practitioner, IBCLC, researcher, and Assistant Professor at Moravian University in Pennsylvania.Dr. Lugo’s work focuses on one of the most critical—and often overlooked—components of breastfeeding success: outpatient lactation care after hospital discharge. Her recent review highlights the powerful impact of early, skilled IBCLC support on breastfeeding exclusivity and duration, and shines a light on the persistent gaps families face when navigating the postpartum period.Together, they explore the evidence behind outpatient IBCLC interventions, the systemic barriers that prevent equitable access to care, and the urgent need for stronger policies, better reimbursement models, and more consistent pathways for families to receive the level of support they truly need.Dr. Lugo also discusses how timing, frequency, and modality of lactation care—whether in-person, outpatient clinic, in-home, or telehealth—shape outcomes, and what future research should focus on to strengthen breastfeeding support across diverse communities.They discuss:Why many breastfeeding challenges intensify after families leave the hospitalEvidence showing that IBCLC support at 3 days and 2 weeks postpartum yields the best outcomesGaps in outpatient access, especially for families with Medicaid or grandfathered plansGeographic disparities in IBCLC availability and why they matterThe limitations of relying solely on prenatal classes or hospitalization supportThe role of telelactation and what parents find helpful—or challenging—about virtual consultsThe need for clearer distinctions between lactation credentials and their scopes of practiceHow policy, insurance reform, and better public awareness could improve breastfeeding equityFuture research needed on optimal visit numbers, timing, and support models👩‍🏫 Guest InfoDr. Anita Lugo, DNP, PNP, IBCLCAn integrative review of the impact of International Board Certifed Lactation Consultants in outpatient postnatal settings in the United StatesAssistant Professor, Moravian UniversityPediatric Nurse Practitioner & IBCLCPrenatal Educator, St. Luke’s University HospitalLinkedIn: Anita Lugo📝 Connect with Margaret📬 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret SaltyMusic by: The Magnifiers – My Time Traveling Machine#BehindTheLatch #BreastfeedingSupport #LactationResearch #OutpatientLactation #IBCLC #PostpartumCare #BreastfeedingEquity #MaternalHealth #LactationPolicy #PublicHealthLactation #Telolactation #BreastfeedingOutcomes #InfantFeeding #NewParentSupport🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Dr. Helen Ball, Professor of Anthropology and Director of the Infancy and Sleep Centre at Durham University in the United Kingdom.Dr. Ball is one of the world’s leading researchers on infant sleep and parent–infant nighttime behavior. Her work bridges anthropology, public health, and clinical practice, offering an evidence-based understanding of what “normal” infant sleep truly looks like—and why so much of modern sleep advice clashes with biology.Together, they discuss Dr. Ball’s new book, How Babies Sleep, which explores the evolution, science, and culture of infant sleep across the world. Dr. Ball challenges long-standing myths about “good sleepers,” sheds light on the risks and realities of common practices like bedsharing and sleep training, and highlights how social expectations shape parental stress and decision-making.She also shares practical, research-based insights for lactation consultants and health professionals supporting families as they navigate infant sleep, feeding, and nighttime care—emphasizing empathy, evidence, and cultural awareness.They discuss:How How Babies Sleep reframes the narrative around “normal” infant sleepThe cultural roots of Western sleep expectationsWhy frequent night waking is biologically typical—and protectiveHow breastfeeding and sleep are deeply intertwinedWhat anthropological research reveals about co-sleeping across culturesCommon misconceptions about bedsharing safetySupporting families to make informed, individualized sleep choicesThe importance of aligning sleep advice with human biology and family context👩‍🏫 Guest InfoDr. Helen L. BallProfessor of Anthropology, Durham UniversityDirector, Infancy and Sleep Centre📘 Book: How Babies Sleep (Pinter & Martin, 2025)🌐 Website: https://www.dur.ac.uk/research/institutes-and-centres/durham-infancy-sleep-centre/📝 Connect with Margaret📬 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret SaltyMusic by: The Magnifiers – My Time Traveling Machine#BehindTheLatch #InfantSleep #HowBabiesSleep #HelenBall #Anthropology #LactationConsultant #IBCLC #CoSleeping #Bedsharing #Breastfeeding #ParentInfantSleep #SleepScience #LactationResearch #InfantFeeding #PublicHealthLactation🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Dr. Kelsey Bianca, psychology professor at Cecil College in Maryland, whose groundbreaking research focuses on the lived experiences of exclusively pumping mothers.Kelsey’s work shines a light on an often-overlooked population in lactation research—parents who feed their babies human milk through expression rather than at the breast. Her dissertation challenges the traditional “breast or bottle” binary and explores exclusive pumping as a legitimate, empowering, and deeply human form of infant feeding.Together, they discuss how exclusive pumping fits within the broader breastfeeding landscape, what her qualitative research uncovered about motivation and identity, and how systemic barriers—like language, support gaps, and policy limitations—shape parents’ experiences.Kelsey also shares her insights on how lactation professionals can better support exclusively pumping families with empathy, inclusivity, and evidence-based care.They discuss:Why exclusive pumping deserves recognition as a form of breastfeedingHow language and terminology shape support and self-perceptionThe emotional and psychological experiences of exclusive pumpersCommon challenges and identity shifts in the exclusive pumping journeyWhat research reveals about resilience and motivation in pumping parentsThe gap between policy, practice, and lived experienceHow IBCLCs and educators can create inclusive spaces for all milk-feeding familiesFuture directions for research in human milk expression👩‍🏫 Guest InfoDr. Kelsey BiancaProfessor of Psychology, Cecil CollegeBianca, K.P. (2025). A narrative review of breastmilk expression. Breastfeeding Review; 33(2): 14-24. Bianca, K. P. (2023). Framing infant feeding practices with bioecological theory: A theoretical review. Breastfeeding Review; 31(3): 6-16.  📝 Connect with Margaret📬 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret SaltyGuest: Dr. Kelsey BiancaMusic by: The Magnifiers – My Time Traveling Machine#BehindTheLatch #ExclusivePumping #LactationResearch #HumanMilkFeeding #IBCLC #LactationConsultant #MaternalIdentity #PumpingJourney #BreastfeedingSupport #LactationScience #HumanMilkResearch #PublicHealthLactation 🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Jill Rabin, MA, CCC-SLP/L, IBCLC, speech-language pathologist, lactation consultant, and co-author of Your Baby Can Self-Feed, Too. Known for her pioneering work in Adapted Baby-Led Weaning (ABLW), Jill specializes in responsive feeding for infants with Down syndrome, prematurity, oral motor challenges, feeding aversion, and medical complexity.Together, they explore how ABLW bridges the gap between traditional baby-led weaning and therapeutic feeding support—giving all babies, including those with motor delays or complex medical needs, a safe and developmentally aligned path to solids. Jill breaks down the misconceptions about gagging vs. choking, readiness cues beyond age, and why starting solids is about skill first, nutrition second. She also shares practical guidance for IBCLCs supporting families in the transition to solids while staying within scope—and how to identify when a referral to a feeding specialist is needed.They discuss:What Adapted Baby-Led Weaning is and how it differs from traditional baby-led weaningUnderstanding gagging, choking risk, and oral motor developmentHow chewing skills develop and why strip-shaped foods build safe feeding foundationsSigns of developmental readiness for solids in breastfed babiesSupporting preterm and medically complex infants during feeding transitionsHow to introduce allergenic foods safelyResponsive feeding and avoiding pressure-based feeding practicesWhen IBCLCs should refer to SLPs or feeding therapistsCultural and socioeconomic accessibility of responsive feeding approachesHow ABLW promotes feeding confidence and reduces aversion👩‍⚕️ Guest InfoJill Rabin, MA, CCC-SLP/L, IBCLC🌐 Website: https://jillrabin.com📸 Instagram: @jillrabin_ablw📘 Book: Your Baby Can Self-Feed, Too🎓 Transition to SolidsAdapted Baby Led Weaning📝 Connect with Margaret📬 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret SaltyGuest: Jill Rabin, MA, CCC-SLP/L, IBCLCMusic by: The Magnifiers – My Time Traveling Machine#BehindTheLatch #AdaptedBabyLedWeaning #ABLW #FeedingTherapy #IBCLC #BreastfeedingSupport #OralMotorDevelopment #ResponsiveFeeding #SLP #DownSyndromeFeeding #PediatricFeeding #LactationConsultant #FeedingAversion #EarlyIntervention🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Gabriela Alvarado, MD, maternal health policy researcher at the RAND Corporation and current Pathway 2 student. Drawing from both her professional expertise as a physician and researcher, and her personal experience as a breastfeeding parent, Gaby shares insights from her recent qualitative study exploring Latina parents’ experiences with telelactation support—part of a larger randomized controlled trial on telehealth lactation services.Together, they explore how telelactation fits into the broader landscape of breastfeeding support, the “breastfeeding support escalation protocol” her team identified, and what this research reveals about accessibility, cultural responsiveness, and the evolving role of IBCLCs in telehealth. Gaby also shares how her equity-centered research approach shaped the study design and offers practical takeaways for lactation professionals supporting diverse families.They discuss:How Latina parents navigate different sources of breastfeeding support—from Google to family to IBCLCs—through a natural “escalation” process.The convenience and limitations of telelactation, including the need for “support to get support” during virtual visits.How messaging platforms and asynchronous communication could enhance lactation care.The impact of telelactation access on breastfeeding outcomes and parental confidence.Opportunities for pediatric practices to integrate telelactation services to improve continuity of care.The importance of cultural humility, linguistic accessibility, and authentic engagement in research and clinical care.Policy implications for equitable telelactation access and Medicaid coverage.👩‍⚕️ Guest InfoGabriela Alvarado, MD🌐 RAND Corporation 💼 LinkedIn: Gaby Alvaradohttps://doaj.org/article/947b3c1d6b424a2ca093e35ceb59ae5chttps://journals.sagepub.com/doi/full/10.1177/08903344241274760https://www.liebertpub.com/doi/full/10.1089/tmj.2022.0159https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830786📝 Connect with Margaret📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Gabriela Alvarado, MD🎵 Music by: The Magnifiers, My Time Traveling Machine#BehindTheLatch #LactationResearch #Telelactation #IBCLC #BreastfeedingSupport #LatinaParents #CulturalHumility #MaternalHealth #LactationConsultant #HealthEquity #RAND🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Dr. Jess Daigle, pediatric hospitalist, NICU physician, founder of Tiny Steps NICU Grad Care, and NICU mom. Drawing from both her professional expertise and personal experience, Dr. Daigle shares how her own NICU journey shaped her passion for supporting families through the vulnerable transition from hospital to home.Together, they explore the emotional landscape of NICU parenting, the unique lactation challenges that arise in this setting, and how IBCLCs can play a transformative role in bridging gaps between families and the medical team. Dr. Daigle offers practical insights for improving interdisciplinary collaboration, building trust with families, and approaching care with cultural humility and genuine curiosity.They discuss:The emotional toll of the NICU experience for parents, including grief, loss of control, and isolation—and how lactation consultants can approach families with sensitivity.How inconsistent messaging across NICU teams can confuse families, and why standardized feeding pathways and shared language are essential.The IBCLC’s role in educating and empowering families—especially around premature infant feeding skills, confidence-building, and preparing for discharge.Practical strategies for integrating lactation consultants into the NICU care team, moving from “guest” status to core collaborators.The importance of recognizing breastfeeding as medicine and addressing the dyad holistically, rather than through siloed disciplines.How cultural humility, curiosity, and individualized support can create more equitable and compassionate care for families from diverse backgrounds.Dr. Daigle’s vision for systemic change: embedding lactation education early in medical and allied health training to build a unified, dyad-focused model of carechat-with-dr-jess-daigle👩‍⚕️ Guest InfoDr. Jess Daigle, MD, FAAP🌐 Instagram: @momandme_md💼 LinkedIn: Jess Daigle, MDAnchored in Hope📝 Connect with Margaret📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Dr. Jess Daigle🎵 Music by: The Magnifiers, My Time Traveling Machine#BehindTheLatch #NICU #IBCLC #LactationConsultant #BreastfeedingSupport #MaternalHealth #LactationEducation #FamilyCenteredCare #CulturalHumility #NICUGradCare🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Maya Nakamura, CNM, PhD(c)—a midwife researcher from Sapporo, Japan—about her work on nipple trauma and her recent study on silver nipple protectors. Maya shares how years of bedside experience, watching mothers struggle with painful nipple damage, pushed her into research and innovation in clinical assessment (including AI-based image analysis) and practical tools that may reduce pain and promote healing. Together, they explore how culture, access, and methodology shape nipple-trauma research; what we do and don’t yet know about silver nipple protectors; and how IBCLCs can translate emerging evidence into compassionate, realistic care for families. Maya also talks about the realities of conducting trials in Japan (declining birth rates, ethics, and single-site constraints), and why standardized outcome measures are critical for future meta-analyses. They discuss:Why study nipple trauma? Night-shift realities, mother distress, and the limits of common “friction-reduction” hacks that sparked formal inquiry. Silver nipple protectors 101: what they are, how they’re used postpartum, and potential mechanisms (barrier + moisture + antimicrobial silver). Study design trade-offs: why a non-randomized comparative design with historical controls was chosen, and steps taken to minimize bias. Key findings from Maya’s trial: reductions in severe nipple trauma indicators and day-4 pain—alongside a clean safety profile in the study setting. Real-world considerations: availability in Japan, cost barriers (≈¥10,000) and ideas like unit-level lending to improve access. What’s next: the call for standardized criteria, longer follow-up, comparisons with other treatments, and the promise (and limits) of AI for consistent nipple-trauma classification. Maya emphasizes a practical, parent-centered approach: protect the nipple, relieve pain, and sustain breastfeeding—while staying honest about evidence gaps and equity barriers in accessing devices and follow-up care. Guest InfoMaya Nakamura, CNM, PhD(c)Midwife & doctoral researcher (Sapporo, Japan)Focus: nipple-trauma classification, wound-care adjuncts, and AI-assisted assessment in lactation care. Publications: Nipple Skin Trauma in Breastfeeding Women During Postpartum Week One. , Breastfeeding Medicine, Nakamura M, Asaka Y, Ogawara T, Yorozu Y, 2018 Sep;13(7):479-484.https://www.researchgate.net/publication/326818739_Nipple_Skin_Trauma_in_Breastfeeding_Women_During_Postpartum_Week_One・An evaluation of the signs of nipple trauma associated with breastfeeding: A Delphi Study, Journal of human lactation, Maya Nakamura, Yoko Asaka, 2022 Feb; 38(3) 548–558. DOI: 10.1177/08903344221076527journals.sagepub.com/home/jhlhttps://journals.sagepub.com/doi/10.1177/08903344221076527・Effectiveness of moisturizing therapy in treating nipple trauma: a systematic review protocol, BMJ Open, Nakamura M, Luo Y, Ebina Y. 2024;14:e083389. doi: 10.1136/bmjopen-2023-083389

In this episode of Behind the Latch, Margaret Salty interviews Claire Eden, BA, IBCLC, author of Shifting the Paradigm for Establishing and Maintaining Milk Production in the Setting of Mother–Infant Separation. Claire shares her journey from NICU lactation consulting to statewide advocacy, and how her clinical experiences inspired her to propose a new framework for supporting families when babies are admitted to the NICU.Together, they explore why the traditional “pump every 3 hours” model is often overwhelming for families, and how more flexible, evidence-based strategies can help parents establish and maintain their milk supply. Claire provides practical insights on supporting parents through separation, reshaping hospital policy, and rethinking how IBCLCs approach milk expression education.They discuss:Why rigid pumping schedules can overwhelm families and affect both supply and mental health.The evidence behind the “5 × 5 rule” (expressing at least 5 times a day by Day 5) and the importance of one overnight pumping session.The five-step paradigm shift that emphasizes antenatal education, personalized discharge planning, and structured follow-up.How individualized lactation care improves outcomes for preterm and sick infants in the NICU.The role of hospital policy in prioritizing lactation support as a standard of care.Practical ways IBCLCs can empower parents while making pumping more achievable.Claire emphasizes the importance of evidence-based, parent-centered lactation care that not only protects milk supply but also supports family well-being during the difficult experience of mother–infant separation.Guest InfoClaire Eden, IBCLC📚 Author: Shifting the Paradigm for Establishing and Maintaining Milk Production in the Setting of Mother–Infant Separation🌐 Georgia Perinatal Quality Collaborative: Georgiapqc.orgPapers DiscussedRandle J. From the Field - The Case for a Paradigm Shift in Lactation Care for NICU Families: A Comprehensive Lactation Care Model. J Hum Lact. 2025 Feb;41(1):34-38. doi: 10.1177/08903344241299722. Epub 2024 Nov 26. PMID: 39588739.Mago-Shah DD, Athavale K, Fisher K, Heyward E, Tanaka D, Cotten CM. Early pumping frequency and coming to volume for mother's own milk feeding in hospitalized infants. J Perinatol. 2023 May;43(5):629-634. doi: 10.1038/s41372-023-01662-z. Epub 2023 Apr 10. PMID: 37037987.Parker LA, Sullivan S, Kruger C, Mueller M. Timing of milk expression following delivery in mothers delivering preterm very low birth weight infants: a randomized trial. J Perinatol. 2020 Aug;40(8):1236-1245. doi: 10.1038/s41372-020-0688-z. Epub 2020 May 27. PMID: 32461626.Parker LA, Hoban R, Bendixen MM, Medina-Poeliniz C, Johnson TJ, Meier PP. Milk Biomarkers of Secretory Activation in Breast Pump-Dependent Mothers of Preterm Infants: An Integrative Review. Breastfeed Med. 2024 Jan;19(1):3-16. doi: 10.1089/bfm.2023.0107. PMID: 38241129; PMCID: PMC10818056.Hoban R, McLean L, Sullivan S, Currie C. Proactive Lactation Care is Associated With Improved Outcomes in a Referral NICU. J Hum Lact. 2022 Feb;38(1):148-155. doi: 10.1177/0890334421993467. Epub 2021 Feb 13. PMID: 33586505; PMCID: PMC8814956.Hoban R, Bigger H, Schoeny M, Engstrom J, Meier P, Patel AL. Milk Volume at 2 Weeks Predicts Mother's Own Milk Feeding at Neonatal Intensive Care Unit Discharge for Very Low Birthweight Infants. Breastfeed Med. 2018 Mar;13(2):135-141. doi: 10.1089/bfm.2017.0159. Epub 2018 Jan 29. PMID: 29377728; PMCID: PMC5863077.Patel AL, Johnson TJ, Meier PP. Racial and socioeconomic

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.comApplying nipple shield with tube: https://www.milkmadeeasy.com/post/how-to-apply-a-nipple-shieldConnect with Margaret📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Sandra Cole🎵 Music by: The Magnifiers, My Time Traveling MachineHashtags & Keywords#BehindTheLatch #LatePreterm #IBCLC #BreastfeedingSupport #InfantFeeding #MaternalHealth🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Jacob Engelsman, IBCLC and author of Lactation for the Rest of Us: A Guide for Queer and Trans Parents and Helpers.**Special Discount: Receive 20% off until 10/31/25 on Jacob's book with code "LACTATION20" here.**Jacob shares his journey into the lactation field, from working in restaurants to finding his calling as an IBCLC and writer. His work centers on supporting queer, trans, and non-binary families who are often left out of mainstream lactation education. His book fills a long-standing gap by providing practical information, first-person stories, and affirming guidance for families who want to chestfeed, induce lactation, or navigate infant feeding after top surgery.Together, Margaret and Jacob explore how lactation consultants can expand their knowledge and language to better serve all families. They discuss topics such as:Inclusive language and recovering gracefully from missteps.Lactation after top surgery and the realities of chestfeeding.Binding while lactating and the balance between supply and mental health.Induced lactation for adoptive, queer, and non-gestational parents.The power of personal stories to reshape how we understand parenting and feeding.Jacob also shares about his unique childbirth education program for first-time fathers, originally taught in a bar with wings and beer, and why creating approachable spaces for dads—including queer dads—can change the way families prepare for birth and early parenting. Looking ahead, he highlights the importance of more training, advocacy, and resources that affirm the diversity of today’s families.Links:https://www.badoulatrainings.org/blog/5-meaningful-ways-to-be-a-gender-inclusive-providerhttps://www.badoulatrainings.org/blog/top-surgery-and-lactation-what-you-need-to-knowhttps://www.lactationtraining.com/shopping/online-shop/continuing-education/gender-diverse-clinic-spaces-detailGuest Info:📚 Author: Lactation for the Rest of Us🌐 Website: JacobEngelsmanIBCLC.com📸 Instagram: @JacobIBCLCConnect with Margaret:📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Jacob Engelsman🎵 Music by: The Magnifiers, My Time Traveling Machine#BehindTheLatch #QueerParenting #IBCLC #InclusiveLactation #TransInclusiveCare #Chestfeeding #InfantFeeding

In this episode of Behind the Latch, Margaret Salty interviews Dr. Jacqueline H. Wolf, medical historian and author of Don’t Kill Your Baby: Public Health and the Decline of Breastfeeding in the 19th and 20th Centuries. Dr. Wolf is a professor at Ohio University whose research focuses on the history of breastfeeding, childbirth, and maternal-child health.Together, they explore the historical forces that shaped infant feeding practices in the United States, how breastfeeding came to be mistrusted in the late 19th century, and what lessons today’s IBCLCs and public health professionals can draw from this history. Dr. Wolf shares insights into the rise of pediatrics, the role of wet nurses, the dangers of the early cow’s milk industry, and how “scientific feeding” transformed cultural attitudes toward women’s bodies and infant nutrition.Dr. Wolf’s Journey into Medical HistoryDr. Wolf shares how:Her personal experience of motherhood during graduate school inspired her dissertation on breastfeeding history.She transitioned from environmental history to medical history through this research.Teaching at a medical school gave her the rare opportunity to influence how future doctors think about breastfeeding and maternal health.Why Breastfeeding DeclinedThey discuss:How rigid feeding schedules and cultural shifts tied to industrialization eroded breastfeeding success.Why mothers began reporting “not enough milk” for the first time in human history.How the medical community framed lactation as a disappearing biological function, legitimizing pediatricians’ growing role in infant feeding.Wet Nurses, Class, and ExploitationDr. Wolf explains:The rise of wet nurse registries in Chicago and other cities.How poor women, often forced to abandon their own babies, sustained the lives of wealthy families’ infants.Why wet nurses remained invisible in history, even as they were central to infant survival.The Birth of Infant FormulaThey explore:How pediatricians partnered with dairy farmers to create “certified milk” and later milk laboratories.The origins of the term formula as mathematical prescriptions for modifying cow’s milk.Why formula became necessary for survival but should not be treated as a growth industry today.Lingering Mistrust of Women’s BodiesDr. Wolf reflects on:How formula companies continue to market by exploiting doubts about women’s ability to produce enough milk.Why free samples, aggressive advertising, and partnerships with IBCLCs undermine breastfeeding.The importance of respecting women’s choices while advocating for systemic change, like paid maternity leave and stronger formula marketing regulation.Lessons for Today’s Public Health LeadersThey emphasize:Why public health campaigns should empower rather than shame families.The urgent need for paid parental leave to support breastfeeding success.How IBCLCs can serve as advocates by challenging formula marketing and promoting evidence-based breastfeeding education.Guest InfoDr. Jacqueline H. Wolf📚 Author of Don’t Kill Your Baby and several books on childbirth and maternal-child health🌐 Substack: Urgent Care: Medical Historians Respond to Attacks on Public Health🌐

In this episode of Behind the Latch, Margaret Salty interviews Dana Obleman, creator of the Sleep Sense program and founder of the Sleep Sense Certification, where she trains sleep consultants worldwide. Dana has been a pioneer in the field of infant and toddler sleep for more than two decades, helping families find rest through practical, age-appropriate strategies.Together, they explore how sleep and feeding are deeply intertwined, why parents often struggle to discern hunger cues from fatigue, and how small changes can set families on the path to better rest. Dana shares her own journey into this work—born out of exhaustion and necessity with her first child—and explains the philosophy behind Sleep Sense, which emphasizes teaching babies healthy, independent sleep habits while still respecting their needs.Dana’s Journey into Sleep WorkDana shares how:Her own struggles with her first baby’s sleep sparked a passion for finding solutions.Research and trial led her to see how independent sleep skills transformed not only her child’s rest, but his temperament.Spreading this knowledge became a mission to fill a missing piece in parenting support.The Sleep Sense PhilosophyThey discuss:Why waking at night is normal—but needing parental rescue every time is not.How guiding babies early helps them develop lifelong healthy sleep patterns.Why a positive relationship with sleep is essential for both children and families.Supporting Breastfeeding FamiliesDana explains:How sleep guidance complements breastfeeding and avoids “cry it out” approaches for newborns.Why discerning hunger vs. fatigue is one of the hardest skills for new parents—and how to pause and assess before assuming hunger.The importance of bedtime routines and how introducing a bottle at the right time can empower families while protecting breastfeeding.Sleep Challenges and SolutionsThey explore:Why common sleep struggles aren’t necessarily “normal”—and how to spot when help is needed.Why older babies and toddlers who aren’t sleeping well benefit from structured, age-appropriate approaches.The balance between teaching skills and respecting family values around sleep.Sleep Sense Certification and EducationDana shares:How the Sleep Sense Certification trains consultants with mentorship, practicums, and global community support.Why sleep coaching is a natural complement to other perinatal roles like lactation consultants, doulas, and therapists.A new education course designed specifically for IBCLCs who want foundational knowledge about newborn sleep without becoming certified coaches.Guest InfoDana Obleman🌐 Website: sleepsense.net📸 Instagram: @sleepsenseFree resource: 7 Best Sleep Tips for Lactation Consultants http://sleepsense.net/lactationConnect with Margaret📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Dana Obleman🎵 Music by: The Magnifiers, My Time Traveling...

In this episode of Behind the Latch, Margaret Salty interviews Jasmine Creighton, owner of Yaya's Hands Perinatal and Lactation Services in Southern California. Jasmine is also president-elect of the Inland Empire Breastfeeding Coalition, leader of its Black Breastfeeding Task Force, a board member for the California Breastfeeding Coalition, and a perinatal health specialist at a local hospital.Together, they explore lactation equity, advocacy, and mentorship—and why representation and culturally relevant care are vital for families. Jasmine shares her powerful story of birth and breastfeeding, including her hospital birth, her home water birth, and how those experiences inspired her to support families navigating barriers to care.They also discuss systemic racism in healthcare, the historic and current challenges Black families face with breastfeeding, and how predatory formula marketing continues to impact communities of color. Jasmine explains how equity means more than equal access—it means care and resources tailored to each family’s needs.Jasmine’s Journey into Lactation and AdvocacyJasmine shares how:Her own birth and breastfeeding experiences shaped her passion for this work.She found community during the COVID pandemic that connected her to birth workers and advocates.Navigating her IBCLC pathway revealed inequities in access to mentorship, hours, and certification support—and why she now mentors others to make the journey easier.Lactation Equity as a Core ValueThey discuss:How systemic racism and bias still shape perinatal care experiences.Why Black women are often offered formula more frequently than other groups in hospitals—and how this impacts breastfeeding duration.The importance of reclaiming breastfeeding as both a health issue and a form of reproductive justice.Barriers and SolutionsJasmine highlights:The lack of culturally responsive care and providers who reflect the communities they serve.Economic and insurance barriers that limit families’ access to lactation support.The need for advocacy, scholarships, mentorship, and coalition-building to change systems and increase representation.Advice for Aspiring IBCLCsJasmine encourages providers to:Network intentionally—both online and in person.Find mentors and be a resource in return, making relationships reciprocal.Persevere despite barriers, remembering that mentorship and community are key to success.Guest InfoJasmine Creighton🌐 Website: jasminecreighton.com📸 Instagram: @jasminecreighton💼 LinkedIn: Jasmine CreightonConnect with Margaret📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Jasmine Creighton🎵 Music by: The Magnifiers, My Time Traveling MachineHashtags & Keywords#BehindTheLatch #LactationEquity #IBCLC #BlackBreastfeeding #MentorshipMatters #PerinatalHealth #CulturallyResponsiveCare #ReproductiveJustice🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

In this episode of Behind the Latch, Margaret Salty interviews Jeanne Pichoff, MS, OTR/L, IBCLC, owner of Flourish Pediatric Therapy and Lactation in Lafayette, Louisiana. Together, they explore the unique and often misunderstood role of occupational therapists in lactation care—how OT skills complement IBCLC expertise, when a referral to OT can make all the difference for a feeding dyad, and how collaborative care improves outcomes for families. Jeanne shares how her personal experience with a tongue-tied baby fueled her passion to bridge the gap between therapy and lactation, and why understanding infant development, muscle tone, and sensory integration is essential for comprehensive feeding support.They discuss the overlap between OT, PT, and SLP roles in infant feeding, how to identify when an OT referral is warranted, and the nuances of managing tongue tie cases both before and after frenotomy. Jeanne also explains why “suck training” can fall outside the IBCLC scope if practiced without an additional license, and how to work within scope while still supporting progress.Jeanne’s Journey into Lactation and OT SpecializationJeanne shares how:Her early work in general pediatrics and early intervention revealed a major gap in lactation knowledge among OTs.A challenging personal breastfeeding experience with her second child, who had an obvious tongue tie, became the catalyst for pursuing IBCLC training.Combining her OT skill set with lactation expertise allowed her to provide more comprehensive, dyad-centered care.The OT Role in Infant FeedingThey discuss:How OT scope of practice includes feeding, sensory processing, and motor skill development.The unique lens OTs bring to infant feeding, from muscle tone assessment to sensory integration.Overlap with PT and SLP roles, and why individual continuing education shapes a therapist’s feeding expertise.When to Refer to OTJeanne explains:Key red flags—such as abnormal muscle tone, dysphagia signs, sensory processing challenges, torticollis, or developmental delays—that warrant OT involvement.How therapy addresses both feeding mechanics and developmental milestones.Why early intervention leads to better long-term outcomes.Managing Tongue Tie CasesThey explore:Why not all tongue-tied babies need therapy before release—and when conservative management is best.How OT can support post-frenotomy recovery, from suck training to addressing body tension.The risks of prophylactic releases “just in case” and why function should always guide decision-making.Scope, Collaboration, and AdvocacyJeanne shares:Why IBCLCs without another license should avoid direct “suck training” and instead refer to an appropriately licensed provider.How billing under OT benefits families by increasing insurance coverage for feeding-related visits.The importance of building trust across disciplines to ensure safe, effective care for families.Advice for IBCLCs and Perinatal ProfessionalsJeanne encourages providers to:Learn the strengths of the OTs, PTs, and SLPs in their community.Focus on collaborative, dyad-centered care rather than trying to “do it all.”Recognize and respect scope of practice boundaries to improve outcomes and maintain professional safety.**DISCOUNT CODE BEHINDTHELATCH for 20% off either one Jeanne's courses:https://www.lactationot.com/totshttps://www.lactationot.com/weightgainGuest Info:Jeanne Pichoff, MS, OTR/L, IBCLC, is...

In this episode of Behind the Latch, Margaret Salty interviews Dr. Lisa Anders, assistant professor at the University of North Carolina at Greensboro and IBCLC. Together, they explore Dr. Anders’ groundbreaking research on flange sizing for pumping parents—an area that has been historically under-researched and inconsistently practiced. Dr. Anders shares how using nipple tip diameter rather than base diameter may improve comfort, milk expression, and overall pumping experience.They discuss the practical implications of her findings for private practice IBCLCs, how to apply the research in clinical care, and what this means for the future of pumping support.Anders, L., Frem, J.M., & McCoy, T.P. (2024). Flange Size Matters: A Comparative Pilot Study of the Flange FITS Guide Versus Traditional Sizing Methods. Journal of Human Lactation, 41(1). https://doi.org/10.1177/08903344241296036Lisa’s Journey into Lactation ResearchDr. Anders shares how:Her own experience as a mother and lactation consultant led her to question standard flange fitting guidance.She noticed patterns of discomfort and underperformance in pump use that weren’t being addressed in the literature.Her academic background in health and human sciences helped her design a pilot study to explore alternative approaches to flange sizing.Why Flange Fit MattersThey discuss:How incorrect flange sizing contributes to nipple pain, reduced output, and early weaning.Why standard recommendations based on base diameter may not reflect the functional part of the nipple used during pumping.How measuring nipple tip diameter (as little as 3–5mm) and using smaller flanges improved outcomes for many of her study participants.Clinical Application and Research GapsDr. Anders explains:How IBCLCs in private practice can begin to implement this approach now, even before larger-scale studies are done.The importance of individualized care, particularly for exclusive pumpers who may struggle in silence.Why pump support deserves the same evidence-based attention as direct breastfeeding.Equity and Access in Pumping SupportThey explore:How a lack of evidence-based flange fitting disproportionately impacts marginalized communities.The cost and access barriers involved in finding the right flange—and how that contributes to inequities in breastfeeding outcomes.The need for culturally responsive, inclusive pumping support.Looking AheadDr. Anders shares:What future research she hopes to conduct to validate and expand her pilot findings.Why community-based IBCLCs play a vital role in gathering observational data and sharing clinical insights.Her encouragement to providers to challenge assumptions and keep asking: is this really working for our clients?Advice for IBCLCs and Perinatal ProfessionalsDr. Anders encourages providers to:Reconsider flange fitting practices with a focus on comfort, efficiency, and individualized care.Learn more about pump mechanics and nipple anatomy.Advocate for more inclusive and accessible tools to support all pumping parents.Guest Info:Dr. Lisa Anders is an assistant professor at UNC Greensboro and a board-certified lactation consultant. Her research focuses on maternal health, infant feeding, and improving care experiences through interdisciplinary and inclusive approaches.📘 LinkedIn: Dr. Lisa Anders📚 Read the study: Anders, L....

In this episode of Behind the Latch, Margaret Salty interviews Dr. Emily Little researcher and founder of Nurturely. Together, they explore how a baby’s sensory world influences their development, the impact of culture on parent-infant interactions, and why early sensory experiences—like babywearing, skin-to-skin, and gentle handling—can have profound effects on feeding, regulation, and bonding. Dr. Little shares evidence-based insights into nurturing the whole baby while advocating for a more inclusive, anti-racist model of perinatal health.Emily’s Journey into Perinatal PsychologyDr. Little shares how:Her early research focused on infant sensory systems and regulation.Time spent in cross-cultural research opened her eyes to the variety of parenting norms around the globe.She founded Nurturely to bridge research and equity-centered community care, bringing together science, support, and systems change.Why Sensory Development Matters in Early LifeThey discuss:How babies rely on touch, sound, movement, and smell to make sense of their world.How common Western parenting norms—like placing babies in containers and using less skin-to-skin—can lead to sensory mismatch and dysregulation.Why “fussy” behavior may be a clue to unmet sensory needs rather than a temperament issue.Cultural Norms, Racism, and Equity in Perinatal CareDr. Little explains:How colonization and racism have disrupted culturally grounded parenting practices.The importance of reclaiming and honoring ancestral knowledge—especially in Black, Indigenous, and Latinx communities.That perinatal care must move beyond individual-level support and into system-level change to be truly equitable.Rethinking the Babywearing “Trend”They explore:How babywearing is often dismissed as “optional” in Western medicine—but is the norm globally.The developmental, emotional, and regulatory benefits of babywearing for both parents and infants.How Nurturely’s programs provide access to baby carriers, workshops, and community support—especially for BIPOC families.Creating Systemic Change in Perinatal HealthDr. Little describes:Why research alone is not enough—we need community-driven change.Nurturely’s model of working with BIPOC-led organizations to co-create programs that address real-world challenges.Why dismantling racism in perinatal health is a lifelong commitment, not a checkbox.Advice for IBCLCs and Perinatal ProfessionalsDr. Little encourages providers to:Stay curious—question what you consider “normal” parenting practices.Understand the deep connection between sensory development and feeding behaviors.Partner with community organizations to expand access and inclusion in perinatal care.Guest Info:Dr. Emily Little is a researcher and the founder of Nurturely, a nonprofit dedicated to promoting equity in perinatal wellness and strengthening the connection between culture, science, and care.🌐 www.nurturely.org📘 LinkedIn: https://www.linkedin.com/in/emilylittlephdConnect with Margaret:📧 Email: hello@margaretsalty.com📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Dr. Emily Little🎵 Music by: The Magnifiers, “My Time Traveling Machine”Hashtags &...

In this episode of Behind the Latch, Margaret Salty interviews Cierra Murphy-Higgs, M.Ed, IBCLC, didactic coordinator for the Pathway 2 program at North Carolina A&T State University and a perinatal behavioral health coach. Cierra shares how her own postpartum struggles led her into the world of lactation and mental health advocacy. Drawing from her experience as a high school counselor turned lactation consultant, she offers powerful insights into the link between perinatal mental health and infant feeding—and how lactation professionals can be better equipped to recognize and support families through it.Cierra’s Journey into Lactation and Mental HealthCierra shares how:Her traumatic postpartum experience in early 2020 sparked a passion for advocacy and support.She found community and education through Instagram, which eventually led her to pursue the IBCLC pathway.Her previous work as a high school counselor naturally integrated into her lactation practice as she noticed mental health struggles at the core of many consults.The Link Between Feeding and Mental HealthCierra explains:Unmet feeding goals and infant feeding challenges can worsen symptoms of postpartum depression, anxiety, OCD, or PTSD.Mental health symptoms don’t always look like sadness—hypervigilance around pumping, obsessive logging, and intrusive thoughts are red flags.Lactation consultants must recognize how our language can affirm or harm, and why offering a bottle isn’t “just” a feeding option—it can trigger shame.Clinical Tools and Community ConnectionsThey discuss:How lactation consultants are uniquely positioned to catch early mental health symptoms—often before OBs or pediatricians do.Why warm handoffs to perinatal mental health providers are essential.The value of screening tools like the PHQ-9 and trusting your gut when a client seems overwhelmed.Trauma-Informed, Culturally Competent CareCierra outlines:Black birthing people experience the highest rates of perinatal mental health disorders and the least access to support—due to mistrust, systemic racism, and real fear of punitive responses.Representation matters. So do community partnerships. Working with local churches, doula collectives, and trusted organizations helps bridge the gap.It’s not just about individual education—it’s about healing generational harm, rebuilding trust, and empowering entire families.Local Impact and National ImplicationsMargaret and Cierra explore:The ripple effect of peer counseling, community classes, and representation in lactation education.How grassroots programs in Greensboro are building trust and increasing breastfeeding rates.Why workforce development and mentorship—especially for aspiring IBCLCs of color—are key to equity in lactation care.Advice and Action for IBCLCsCierra encourages listeners to:Educate yourself on perinatal mental health—you don’t need to be a therapist, but you do need to know the signs.Map your referral network. Know who to call, what groups exist, and how to do warm handoffs.Take care of yourself. Burnout is real in this work, and we can’t pour from empty cups.Guest Info:Cierra Murphy-Higgs, M.Ed, IBCLC, is the didactic coordinator for the Human Lactation Pathway 2 program at North Carolina A&T and serves as a perinatal behavioral health coach with Family Well Health. She is a passionate educator, advocate, and public speaker working at the intersection of lactation, equity, and mental health.📧