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 Info

Claire Eden, IBCLC

📚 Author: Shifting the Paradigm for Establishing and Maintaining Milk Production in the Setting of Mother–Infant Separation

🌐 Georgia Chapter – American Academy of Pediatrics: gaaap.org

Papers Discussed

Randle 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 disparities in breast milk feedings in US neonatal intensive care units. Pediatr Res. 2021 Jan;89(2):344-352. doi: 10.1038/s41390-020-01263-y. Epub 2020 Nov 13. PMID: 33188286; PMCID: PMC7662724.

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🎙 Hosted by: Margaret Salty

🎧 Guest: Claire Eden

🎵 Music by: The Magnifiers, My Time Traveling Machine

#BehindTheLatch #NICU #IBCLC #BreastfeedingSupport #InfantFeeding #MaternalHealth #LactationEducation

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