Behind the Latch

• The Role of Silver Nipple Protectors in Breastfeeding Support with Maya Nakamura

  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

  --------  

  19:00

  --------

  19:00
• Breastfeeding Late Preterm Infants: Insights with Sandra Cole, IBCLC

  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: [email protected]📸 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!

  --------  

  48:38

  --------

  48:38
• Supporting Queer and Trans Families in Lactation: A Conversation with Jacob Engelsman, IBCLC

  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: [email protected]📸 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

  --------  

  48:03

  --------

  48:03
• Breastfeeding, History, and Public Health: Lessons from Dr. Jacqueline Wolf

  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🌐

  --------  

  57:46

  --------

  57:46
• Sleep Sense: Supporting Families with Infant Sleep

  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: [email protected]📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Dana Obleman🎵 Music by: The Magnifiers, My Time Traveling...

  --------  

  28:31

  --------

  28:31

More Education podcasts

Trending Education podcasts

About Behind the Latch