Behind the Latch

• Why Early Colostrum Feeding Matters: Insights from Dr. Valérie Verhasselt

  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...

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• Inside the Lactating Breast: Ultrasound, Adiposity & Milk Production with Dr. Zoya Gridneva

  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: [email protected]📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret...

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• Why Outpatient IBCLC Care Matters: A Conversation with Dr. Anita Lugo

  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: [email protected]📸 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!

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• How Babies Sleep: A Conversation with Dr. Helen Ball

  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: [email protected]📸 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!

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• Exclusive Pumping: Redefining Breastfeeding Through Research with Dr. Kelsey Bianca

  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: [email protected]📸 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!

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