Behind the Latch

• 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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• Adapted Baby-Led Weaning: A Feeding Approach for Every Baby with Jill Rabin

  In this episode of Behind the Latch, Margaret Salty interviews Jill Rabin, MA, CCC-SLP/L, IBCLC, speech-language pathologist, lactation consultant, and co-author of Your Baby Can Self-Feed, Too. Known for her pioneering work in Adapted Baby-Led Weaning (ABLW), Jill specializes in responsive feeding for infants with Down syndrome, prematurity, oral motor challenges, feeding aversion, and medical complexity.Together, they explore how ABLW bridges the gap between traditional baby-led weaning and therapeutic feeding support—giving all babies, including those with motor delays or complex medical needs, a safe and developmentally aligned path to solids. Jill breaks down the misconceptions about gagging vs. choking, readiness cues beyond age, and why starting solids is about skill first, nutrition second. She also shares practical guidance for IBCLCs supporting families in the transition to solids while staying within scope—and how to identify when a referral to a feeding specialist is needed.They discuss:What Adapted Baby-Led Weaning is and how it differs from traditional baby-led weaningUnderstanding gagging, choking risk, and oral motor developmentHow chewing skills develop and why strip-shaped foods build safe feeding foundationsSigns of developmental readiness for solids in breastfed babiesSupporting preterm and medically complex infants during feeding transitionsHow to introduce allergenic foods safelyResponsive feeding and avoiding pressure-based feeding practicesWhen IBCLCs should refer to SLPs or feeding therapistsCultural and socioeconomic accessibility of responsive feeding approachesHow ABLW promotes feeding confidence and reduces aversion👩‍⚕️ Guest InfoJill Rabin, MA, CCC-SLP/L, IBCLC🌐 Website: https://jillrabin.com📸 Instagram: @jillrabin_ablw📘 Book: Your Baby Can Self-Feed, Too🎓 Transition to SolidsAdapted Baby Led Weaning📝 Connect with Margaret📬 Email: [email protected]📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙️ Podcast: Behind the LatchHosted by: Margaret SaltyGuest: Jill Rabin, MA, CCC-SLP/L, IBCLCMusic by: The Magnifiers – My Time Traveling Machine#BehindTheLatch #AdaptedBabyLedWeaning #ABLW #FeedingTherapy #IBCLC #BreastfeedingSupport #OralMotorDevelopment #ResponsiveFeeding #SLP #DownSyndromeFeeding #PediatricFeeding #LactationConsultant #FeedingAversion #EarlyIntervention🎧 Listen now on your favorite podcast app — and don’t forget to subscribe and leave a review!

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• Telelactation Through a Cultural Lens: Gabriela Alvarado on Latina Parents’ Experiences

  In this episode of Behind the Latch, Margaret Salty interviews Gabriela Alvarado, MD, maternal health policy researcher at the RAND Corporation and current Pathway 2 student. Drawing from both her professional expertise as a physician and researcher, and her personal experience as a breastfeeding parent, Gaby shares insights from her recent qualitative study exploring Latina parents’ experiences with telelactation support—part of a larger randomized controlled trial on telehealth lactation services.Together, they explore how telelactation fits into the broader landscape of breastfeeding support, the “breastfeeding support escalation protocol” her team identified, and what this research reveals about accessibility, cultural responsiveness, and the evolving role of IBCLCs in telehealth. Gaby also shares how her equity-centered research approach shaped the study design and offers practical takeaways for lactation professionals supporting diverse families.They discuss:How Latina parents navigate different sources of breastfeeding support—from Google to family to IBCLCs—through a natural “escalation” process.The convenience and limitations of telelactation, including the need for “support to get support” during virtual visits.How messaging platforms and asynchronous communication could enhance lactation care.The impact of telelactation access on breastfeeding outcomes and parental confidence.Opportunities for pediatric practices to integrate telelactation services to improve continuity of care.The importance of cultural humility, linguistic accessibility, and authentic engagement in research and clinical care.Policy implications for equitable telelactation access and Medicaid coverage.👩‍⚕️ Guest InfoGabriela Alvarado, MD🌐 RAND Corporation 💼 LinkedIn: Gaby Alvaradohttps://doaj.org/article/947b3c1d6b424a2ca093e35ceb59ae5chttps://journals.sagepub.com/doi/full/10.1177/08903344241274760https://www.liebertpub.com/doi/full/10.1089/tmj.2022.0159https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830786📝 Connect with Margaret📧 Email: [email protected]📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Gabriela Alvarado, MD🎵 Music by: The Magnifiers, My Time Traveling Machine#BehindTheLatch #LactationResearch #Telelactation #IBCLC #BreastfeedingSupport #LatinaParents #CulturalHumility #MaternalHealth #LactationConsultant #HealthEquity #RAND🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

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• Bridging the NICU Gap: Supporting Families and Building Collaborative Care with Dr. Jess Daigle

  In this episode of Behind the Latch, Margaret Salty interviews Dr. Jess Daigle, pediatric hospitalist, NICU physician, founder of Tiny Steps NICU Grad Care, and NICU mom. Drawing from both her professional expertise and personal experience, Dr. Daigle shares how her own NICU journey shaped her passion for supporting families through the vulnerable transition from hospital to home.Together, they explore the emotional landscape of NICU parenting, the unique lactation challenges that arise in this setting, and how IBCLCs can play a transformative role in bridging gaps between families and the medical team. Dr. Daigle offers practical insights for improving interdisciplinary collaboration, building trust with families, and approaching care with cultural humility and genuine curiosity.They discuss:The emotional toll of the NICU experience for parents, including grief, loss of control, and isolation—and how lactation consultants can approach families with sensitivity.How inconsistent messaging across NICU teams can confuse families, and why standardized feeding pathways and shared language are essential.The IBCLC’s role in educating and empowering families—especially around premature infant feeding skills, confidence-building, and preparing for discharge.Practical strategies for integrating lactation consultants into the NICU care team, moving from “guest” status to core collaborators.The importance of recognizing breastfeeding as medicine and addressing the dyad holistically, rather than through siloed disciplines.How cultural humility, curiosity, and individualized support can create more equitable and compassionate care for families from diverse backgrounds.Dr. Daigle’s vision for systemic change: embedding lactation education early in medical and allied health training to build a unified, dyad-focused model of carechat-with-dr-jess-daigle👩‍⚕️ Guest InfoDr. Jess Daigle, MD, FAAP🌐 Instagram: @momandme_md💼 LinkedIn: Jess Daigle, MDAnchored in Hope📝 Connect with Margaret📧 Email: [email protected]📸 Instagram: @margaretsalty📘 Facebook: Margaret Salty🎙 Hosted by: Margaret Salty🎧 Guest: Dr. Jess Daigle🎵 Music by: The Magnifiers, My Time Traveling Machine#BehindTheLatch #NICU #IBCLC #LactationConsultant #BreastfeedingSupport #MaternalHealth #LactationEducation #FamilyCenteredCare #CulturalHumility #NICUGradCare🎧 Listen now on your favorite podcast app—and don’t forget to subscribe and leave a review!

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• 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

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