Behind the Latch

As more people pursue the IBCLC credential, mentorship has become one of the most critical—and misunderstood—components of lactation education. In this episode, Kristina and I take a close look at Pathway 2 and Pathway 3 mentorship, clarifying what mentors are actually responsible for and why mentorship must go beyond observation and paperwork.
Kristina explains that effective mentorship is engaged, relational, and intentional. We discuss how mentors model professionalism, communication, boundaries, and ethical care—not just clinical skills. We also talk openly about the fears many IBCLCs have about becoming mentors, including concerns about readiness, time, liability, and “doing it right,” and why those fears shouldn’t stop experienced clinicians from stepping into mentorship roles.
This conversation also highlights the structural supports built into Pathway 2 programs, the additional lift often required in Pathway 3 mentorship, and why access to high-quality mentorship remains a major barrier to growing and diversifying the IBCLC workforce. Throughout the episode, Kristina shares practical, experience-based strategies for both mentors and mentees—and a hopeful vision for how mentorship could be better supported and valued across the profession.
🔍 What We Talk About
The difference between mentoring vs. supervising clinical hours
What IBCLC mentors are truly responsible for in Pathway 2 and Pathway 3
How students should be gradually and ethically integrated into hands-on care
Common gaps students face when transitioning from coursework to clinical practice
Tools that support mentorship, including IBLCE outlines and LEAARC skill checklists
Why learning from multiple mentors can strengthen clinical competence
Liability, affiliation agreements, and student protections in Pathway 2 programs
The professional and personal benefits of becoming a mentor
Charging for mentorship: ethics, equity, and value exchange
Why mentorship is part of our professional obligation as IBCLCs
What Kristina hopes the future of lactation mentorship will look like

🧠 Key Takeaways
Mentorship is an active teaching relationship, not passive oversight.
Students need meaningful, hands-on experience—not observation alone.
You do not need to be a “perfect” IBCLC to be an effective mentor.
Mentorship strengthens clinical skills, confidence, and professional growth.
Supporting mentors is essential to the future of the lactation profession.

👩‍🏫 Guest

In this episode of Behind the Latch, Margaret sits down with Ellen Chetwynd, IBCLC, PhD, and longtime Editor-in-Chief of the Journal of Human Lactation, to explore a fundamentally different way of understanding breastfeeding challenges: body-led breastfeeding and the Infant Suck Strength Exam (ISSE).
Dr. Chetwynd shares how years of clinical practice—and noticing what wasn’t explained by common diagnoses like thrush, Raynaud’s, or tongue-tie—led her to focus more closely on the infant’s body, neurology, and suck function. Together, Margaret and Ellen unpack how the ISSE helps clinicians move beyond appearance-based latch assessment to identify where suck strength is weak, how the tongue is functioning at the breast, and how infant compensation patterns often drive pain, inefficiency, and feeding struggles.
This conversation bridges lactation science, cranial nerve physiology, and gentle body-based intervention, offering clinicians practical tools while challenging reductionist approaches to infant oral dysfunction.
🔍 What We Talk About
How Ellen entered the field of lactation through nursing and public health
Why “bucket diagnoses” (yeast, Raynaud’s, tongue-tie) persist in lactation care
What body-led breastfeeding means—and why the baby is often the primary driver
The clinical gap that inspired development of the Infant Suck Strength Exam (ISSE)
Why digital oral exams miss what’s happening at the breast
How the ISSE is performed and what each pull-back reveals about suck strength
Why the ISSE often functions as both assessment and treatment
Infant compensation patterns: jaw movement, lip use, body tension, and asymmetry
The role of cranial nerves and the cranial base in feeding function
Why asymmetric latch and “guppy pose” can sometimes worsen dysfunction
Gentle, parent-taught techniques to support infant regulation and suck strength
How bottle-feeding strategies must align with breastfeeding goals
When to consider referral for craniosacral or body-based therapy
Why frenotomy alone may destabilize function if body tension isn’t addressed
What future research is needed to validate and study the ISSE

🧠 Key Takeaways for Clinicians
A visually “good” latch can hide significant internal dysfunction.
Infant suck strength and tongue function must be assessed during active feeding.
Many breastfeeding problems originate in infant neuromuscular coordination—not...

In this episode of Behind the Latch, Margaret sits down with former student and practicing IBCLC Maya Lott to explore culturally responsive lactation care through the lens of working with Jewish families. Drawing from Maya’s clinical experience, academic background in Jewish philosophy and law, and her widely shared paper on counseling Jewish families, this conversation offers practical guidance for IBCLCs seeking to build trust, reduce friction, and deliver truly family-centered care.
Maya shares how cultural norms, religious practices, and community structures can shape breastfeeding decisions—and how IBCLCs can approach these dynamics with curiosity rather than assumptions. From baby naming practices and modesty considerations to Shabbat, donor milk logistics, and the role of rabbis in healthcare decision-making, this episode provides concrete, respectful strategies clinicians can use immediately in practice.
🔍 What We Talk About
Maya’s path to becoming an IBCLC through Pathway 2—and why it worked well for her as a parent
Why cultural humility matters in lactation care (and what it looks like in real visits)
Breastfeeding as a cultural norm in many Jewish communities—and the pressures that can create
Baby naming practices in observant Jewish families and why asking “Does your baby have a name yet?” matters
Modesty, family roles, and how they can influence in-home lactation visits
Preparing infants for circumcision (bris) and how this can intersect with feeding support
Shabbat, milk removal, and how IBCLCs can collaborate respectfully without practicing religious law
The role of rabbis in health-related decisions—and why this can be empowering for families
Donor milk, milk sharing, and kosher kitchen logistics
How informal milk sharing functions in tight-knit communities
Parallels with other cultural and religious practices (including Muslim milk-kinship laws)
Practical language IBCLCs can use to avoid alienation and build rapport
Why curiosity—not expertise in religious law—is the key clinical skill

🧠 Key Takeaways for Clinicians
Cultural competence starts at the doorstep—small language choices can shape the entire visit.
You don’t need to be an expert in religious law to provide excellent care; awareness of considerations is enough.
Asking open, respectful questions helps families integrate lactation care with lifelong values.
Rabbis (and other faith leaders) often serve as supportive collaborators, not barriers, in healthcare decisions.

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 About
How Meaghan entered infant craniosacral therapy after her own postpartum and breastfeeding experience
What craniosacral therapy is, how it works, and how it differs from chiropractic, osteopathy, and physical therapy
Fascia, tension patterns, and why the body must be viewed as a single integrated system
The role of cranial nerves in infant feeding, suck strength, and oral coordination
How gestational positioning, birth interventions, and delivery mechanics influence feeding outcomes
Why babies may feed well on one side but struggle on the other
Weak suck, poor oral sensation, and why some infants “can’t feel” the nipple
The limitations of appearance-based tongue-tie assessment and why function must come first
How craniosacral therapy may improve frenotomy outcomes and reduce reattachment risk
Why cutting a dysfunctional tongue without addressing body tension can worsen feeding
What a typical infant craniosacral session looks like, including assessment and treatment flow
How many sessions are typically needed and why “snapback” can occur
How craniosacral therapy supports nervous system regulation and reflex integration
What families may notice after treatment, including emotional release and behavior changes
How to talk with parents about craniosacral therapy in clear, non-alarming language
Safety considerations, training standards, and how to identify qualified practitioners
What the current research does—and does not—tell us about craniosacral therapy
Options for families who cannot access or afford bodywork services

🧠 Key Takeaways for Clinicians
Infant 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 About
How 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 development
How colostrum supports gut closure, immune regulation, microbiota seeding, and skin barrier maturation
Why 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 feeding
The striking finding that no infants who received ≥9 colostrum feeds developed peanut allergy by 12–18 months
What early formula exposure does to the infant microbiome weeks and months later
How parental allergy risk influences—but does not override—the protective effect of colostrum
Why exclusive breastfeeding data often overlook the critical first 72 hours
The interplay between infant skin permeability, environmental exposure, detergent use, and allergy sensitization
What mouse models teach us about colostrum, mature milk, and developmental programming
Why donor milk does not replicate colostrum’s early immunological function
The concept of exclusive colostrum feeding as a distinct clinical and public health priority
Future research avenues: colostrum-derived metabolites, donor colostrum banks, and early-life allergy prevention strategies

🧠 Key Takeaways for Clinicians
Colostrum’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...