The IBCLC Mentor

• The Research Recap: 25-LATCH, Anaphylaxis, Attitudes, and Nutrition

  Episode Title: Evaluating the Latch Score, Lactation Anaphylaxis, and Breastfeeding AttitudesIn this episode of The IBCLC Mentor Podcast, Margaret Salty reviews recent research findings that impact lactation consultants. From assessing the effectiveness of the Latch Scoring System to a rare case of lactation anaphylaxis and the role of healthcare providers in breastfeeding support, Margaret translates the latest studies into actionable insights for IBCLCs.Key Points Covered:1. Evaluating the Latch Scoring System for Breastfeeding AssessmentMargaret reviews a study on the effectiveness of the Latch Scoring System in identifying and correcting breastfeeding challenges. The study followed 80 mother-infant dyads and found that structured lactation interventions significantly improved latch scores, with cesarean-delivered mothers benefiting the most.Reference:Gautam, A., Singh, S. P., Narayani, V. K., Rathore, A., & Tripathi, M. (2025). LATCH Score for Identification and Correction of Breastfeeding Problems. International Journal of Life Sciences, Biotechnology and Pharma Research, 14(2), 345-350. https://doi.org/10.69605/ijlbpr_14.2.2025.64Practical Takeaways:The LATCH score is a useful tool for early identification of breastfeeding challenges.Targeted lactation interventions improve latch scores and breastfeeding outcomes.Cesarean-delivered mothers need additional lactation support due to positioning challenges and delayed skin-to-skin contact.2. Lactation Anaphylaxis with Cardiac Involvement – A Rare Case StudyMargaret discusses an alarming case study from Ireland where a postpartum mother developed severe anaphylaxis triggered by lactation, leading to temporary heart failure. This is the first reported case of lactation anaphylaxis with cardiac dysfunction.Reference:Al-Tikriti, S., Kumar, M., O’Brien, M., McMorrow, R., & Crosby, D. (2025). Lactation anaphylaxis complicated by reversible cardiac dysfunction in a multiparous woman with previous breastfeeding experience. Obstetric Medicine, 1-3. https://doi.org/10.1177/1753495X251317754Practical Takeaways:Lactation anaphylaxis, though rare, can be life-threatening and should be considered in cases of postpartum allergic reactions.Postpartum hormone shifts, especially the drop in progesterone, may destabilize mast cells and trigger anaphylaxis.IBCLCs should be aware of potential cardiac involvement and advocate for urgent medical evaluation in cases of severe allergic reactions during lactation.3. Breastfeeding Attitudes Among Mothers and Healthcare ProfessionalsA study from Croatia explored the gap between healthcare professionals’ perceived breastfeeding support and mothers’ actual experiences. While most providers believed they were offering strong support, not all mothers received skin-to-skin contact or early rooming-in.Reference:Zvigac, T. K., Fures, R., Hrgovic, Z., Rosic, D., Radic, L., Despot, A., Zivkovic, K., & Pekez, S. (2024). The attitudes of breastfeeding mothers and healthcare professionals about breastfeeding. Mater Sociomed, 36(4), 300-304. https://doi.org/10.5455/msm.2024.36.300-304Practical Takeaways:Healthcare providers strongly support breastfeeding, but this doesn’t always translate into consistent...

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• Understanding Tubular Breasts and Hypogalactia with Dr. Katrina Mitchell

  Episode Summary:In this episode of The IBCLC Mentor Podcast, Margaret Salty interviews Dr. Katrina Mitchell, a breast surgeon and breastfeeding medicine physician, about the complexities of low milk supply, tubular breasts, and why the term “insufficient glandular tissue” (IGT) may not be the best descriptor. They explore the anatomical and physiological factors that impact milk production and discuss how IBCLCs can best support families in these situations.Dr. Mitchell’s Background and Journey into Breastfeeding MedicineDr. Mitchell shares her unique path into breastfeeding medicine, including:Her work as a breast surgeon and lactation-focused physician in Santa Barbara, CaliforniaHer early exposure to breastfeeding in her family and her time living in Tanzania, where she developed a passion for public health and women's healthHow her personal breastfeeding journey shaped her clinical approach to lactation supportWhy We Should Stop Using “Insufficient Glandular Tissue” (IGT)Dr. Mitchell explains why she dislikes the term IGT and why it is misleading. Topics include:The problematic use of “insufficient” and how it differs from standard medical terminologyThe importance of using correct anatomical descriptions, such as tubular breast and hypogalactiaHow IGT lacks specificity and does not explain the underlying causes of low milk productionUnderstanding Tubular Breasts and Their Impact on LactationDr. Mitchell provides a deep dive into tubular breasts, a condition that affects breast morphology and may contribute to low milk supply:How tubular breasts develop due to a congenital issue during in-utero developmentThe key visual characteristics of tubular breasts, including:Asymmetry (one breast significantly larger than the other)Large areolas relative to the breast baseA narrow breast base and short distance between the nipple and the inframammary foldWhy tubular breasts should not be confused with small breasts that produce adequate milkChallenges in Diagnosing Tubular Breasts and Low Milk SupplyMargaret and Dr. Mitchell discuss why many cases of tubular breasts go unrecognized, including:The lack of provider education on breast anatomy beyond cancer screeningThe misconception that breast size determines milk productionWhy palpation of the breast does not reliably indicate glandular tissue volume or functionSupporting Parents with Low Milk SupplyDr. Mitchell emphasizes how IBCLCs can best support parents experiencing low supply due to tubular breasts or other factors:The importance of setting realistic expectations and avoiding unnecessary stressWhy the focus should be on optimizing milk supply rather than forcing "triple feeding" routinesHow to approach supplementation in a way that preserves the breastfeeding relationshipStrategies for using galactagogues, including Reglan (metoclopramide) trials to assess responsivenessThe Role of Hormones and Breast Growth in Subsequent PregnanciesMargaret and Dr. Mitchell discuss common questions about hormonal influences and whether breast tissue can develop more with each pregnancy:Why there is currently no conclusive evidence that tubular breasts respond to hormonal stimulationObservational trends that suggest milk production often improves in subsequent pregnanciesThe need for more research into the hormonal and structural changes of the breast over timeWhat We Still Don’t Know: The Gaps in Lactation ScienceDr. Mitchell...

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• The Research Recap: 24-Zucchini Seed Oil, Caffeine, Exclusive Breastfeeding, Hospitalization

  In this episode of The IBCLC Mentor Podcast, Margaret Salty shifts her focus to articles from Clinical Lactation, exploring key studies that can inform and enhance IBCLC practice. From innovative treatments for nipple pain to the effects of caffeine and hospital-based lactation support, Margaret translates the latest research into actionable strategies for lactation consultants. Whether you're a seasoned IBCLC or just starting out, this episode provides critical insights for evidence-based lactation care.Key Points Covered:1. Zucchini Seed Oil for Nipple Pain ReliefMargaret reviews a randomized controlled trial that tested the efficacy of zucchini seed oil for managing nipple pain in lactating women. The study found that the oil significantly reduced pain compared to expressed breast milk, suggesting its potential as a natural alternative for nipple pain relief.Reference:A Randomized Control Trial on the Effect of Zucchini Oil on Nipple Pain Among Lactating Women.Practical Takeaways:Consider zucchini seed oil as a plant-based alternative for managing nipple pain.Continue prioritizing latch correction and proper positioning before recommending topical treatments.Encourage further research comparing zucchini seed oil with lanolin and hydrogel pads.2. The Impact of Caffeine on Breastfeeding Mothers and InfantsA scoping review analyzed how caffeine consumption affects lactating parents and infants. While moderate caffeine intake has benefits, excessive intake (over 450mg/day) was linked to infant irritability, sleep issues, and anemia.Reference:Effects of Caffeine on Breastfeeding Mothers and Infants: A Scoping Review.Practical Takeaways:Recommend keeping caffeine intake below 300mg/day (about 2-3 cups of coffee).Educate parents on hidden caffeine sources (energy drinks, soda, chocolate).If an infant is fussy or has disrupted sleep, assess parental caffeine intake as a potential factor.3. Exclusive Breastfeeding at Six Months in Low-Income PopulationsMargaret examines an integrative review that explored factors influencing exclusive breastfeeding rates at six months among low-income parents. Findings highlighted the role of education, healthcare provider support, and social networks in breastfeeding success.Reference:Exclusive Breastfeeding Factors at Six Months Postpartum in Low-Income Populations: An Integrative Review.Practical Takeaways:Strengthen breastfeeding education in prenatal care and high school health classes.Address provider bias by advocating for consistent lactation guidance.Encourage community-based breastfeeding support groups and peer counseling.Advocate for policies that expand lactation care access for low-income families.4. Supporting Breastfeeding During HospitalizationA clinical practice study from Mexico examined how hospital-based lactation units help maintain breastfeeding when mother-baby separation occurs. Strategies included Kangaroo Mother Care, structured milk expression protocols, and hospital-based breast milk banks.Reference:Breastfeeding When the Mother and Baby are Hospitalized Together or Separately.Practical Takeaways:Advocate for hospital-based lactation units to ensure breastfeeding continuity.Educate parents on breast milk expression, storage, and safe handling.Promote collaboration between lactation consultants, NICUs, and pediatric units to prioritize human milk...

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• Ethics, Advocacy, and Bridging the Gap Between IBCLCs & Providers with Dr. Darby

  In this episode of The IBCLC Mentor Podcast, Margaret Salty interviews Dr. Darby, a physician, researcher, and advocate for maternal-infant health. Together, they explore ethical challenges in lactation consulting, the intersection of medicine and breastfeeding support, and how lactation professionals can better collaborate with healthcare providers.The Foundation for Milk:Dr. Darby shares her journey in founding The Foundation for Milk, a nonprofit dedicated to lactation education, research, and outreach. She discusses their work supporting breastfeeding families, hosting lactation tents at community events, and expanding lactation education to high school health classes to prepare future parents.A Case Study in Breastfeeding Through Medical Challenges:Dr. Darby discusses her personal experience navigating lactation while undergoing a partial mastectomy, chemotherapy, and blood treatment for a rare connective tissue disorder. She provides insight into how chronic illnesses and surgical interventions impact lactation, offering guidance for IBCLCs who support medically complex cases.Navigating Ethical Dilemmas in Lactation:Dr. Darby explains key ethical issues in lactation care, including:Cultural and religious influences on infant feeding decisionsDietary restrictions and failure to thrive in vegan familiesWhen and how lactation consultants should intervene in cases of medical neglect or weight concernsThe role of lactation professionals as mandated reporters and how to escalate concerns when necessaryBridging the Divide Between IBCLCs and Medical Providers:Dr. Darby and Margaret discuss the long-standing divide between physicians and lactation consultants, addressing:How IBCLCs can build referral relationships with pediatriciansThe importance of communicating lactation plans with providers through reports and direct callsWhy physicians often recommend formula and how lactation consultants can present breast milk alternatives in a way that aligns with medical goalsHow IBCLCs can use evidence-based research to gain credibility with healthcare providersCase Studies, Research, and Advancing Lactation Science:Dr. Darby encourages IBCLCs to document and publish case studies, highlighting the importance of:Writing about unique lactation cases to build evidence for future practitionersUnderstanding how breast milk composition can change due to health conditions and medical treatmentsHow case studies and research help fill gaps in the scientific understanding of lactationDr. Darby’s expertise in lactation, ethics, and medical research makes this episode a must-listen for IBCLCs, students, and healthcare providers. Whether you're a new lactation consultant or an experienced practitioner, you'll gain practical insights on navigating complex cases and strengthening professional relationships with physicians.Resources Mentioned in This Episode:The Foundation for Milk – https://foundation4milk.org/Family Practice Notebook (fpnotebook.com) – A medical reference site for understanding provider decision-making.UK NHS Baby Feeding Guidelines – https://www.nhs.uk/start-for-life/baby/feeding-your-baby/Connect with Me:Have questions or suggestions for future episodes? Reach out to Margaret at [email protected] or connect on social media:Instagram: @margaretsaltyFacebook: Margaret Salty’s IBCLC CommunityCredits:Hosted by: Margaret SaltyGuest: Dr. DarbyMusic by: The Magnifiers, "My Time Traveling Machine"Hashtags &...

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• The Research Recap: 23- Gut Microbiota, Microbial Adaptation, First Hour, and BFSE

  In this episode of The IBCLC Mentor Podcast, Margaret Salty dives into the latest research articles from her Google Scholar alerts, exploring how recent findings can enhance the practice of IBCLCs. Margaret breaks down complex research into actionable strategies for lactation consultants, focusing on how these insights can improve breastfeeding outcomes. Whether you're a seasoned IBCLC or just starting your journey, these episodes will keep you at the forefront of evidence-based lactation care.Key Points Covered:1. How Human Milk Shapes the Gut Microbiota in Preterm InfantsMargaret discusses a study by Thomson & Garrido (2025) that explores how human milk influences the gut microbiota in preterm infants and its potential for optimizing microbial development. The study highlights the role of human milk in establishing a healthy gut microbiome and the long-term benefits for preterm infant health.Reference:Thomson, P., & Garrido, D. (2025). How human milk shapes the gut microbiota in preterm infants: Potential for optimizing early-life microbial development. Microbiome Research Reports, 4(12), 1–11. https://doi.org/10.20517/mrr.2024.86Practical Takeaways:Advocate for breast milk as the primary nutrition source for preterm infants.Educate NICU staff and parents about the impact of human milk on microbial development.Support donor milk programs to ensure preterm infants receive optimal nutrition.2. Microbial Adaptation in Human MilkThis study by Hanumantharaju et al. (2025) analyzed how gestational age and lactation stage impact the microbiota of human milk. The findings suggest that preterm milk has lower bacterial diversity, emphasizing the need for targeted nutritional and probiotic support for preterm infants.Reference:Hanumantharaju, A., et al. (2025). Microbial adaptation in human milk: Unraveling the effects of gestational age and lactation stage among Indian mothers. Journal of Neonatology. https://doi.org/10.1177/09732179241308404Practical Takeaways:Support early milk expression for mothers of preterm infants.Encourage sustained breastfeeding for optimal microbial diversity.Promote further research on regional variations in milk microbiota.3. Obstetric Outcomes and Breastfeeding in the First Hour of LifeMargaret reviews a study by Faria et al. (2025) that examines how early breastfeeding initiation impacts obstetric outcomes, comparing data from before and during the COVID-19 pandemic. Findings reinforce the benefits of immediate skin-to-skin contact and early breastfeeding for both mothers and infants.Reference:Faria, A. P. V., et al. (2025). Obstetric outcomes in breastfeeding women in the first hour of delivery before and during the COVID-19 pandemic. BMC Pregnancy and Childbirth, 25, 24. https://doi.org/10.1186/s12884-024-06975-1Practical Takeaways:Advocate for uninterrupted skin-to-skin contact immediately after birth.Support policies ensuring early breastfeeding initiation, even in pandemic conditions.Educate healthcare providers on the long-term benefits of early breastfeeding.4. Ankyloglossia and Breastfeeding Self-EfficacyThis birth cohort study by Feldens et al. (2025) investigates the relationship between...

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