『Behind the Latch』のカバーアート

Behind the Latch

Behind the Latch

著者： Margaret Salty
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The Behind the Latch with Margaret Salty is your essential companion for lifelong growth in the field of lactation consulting. Whether you're a student, a newly certified IBCLC, or an experienced consultant, this podcast is designed to support your ongoing journey. Each episode brings you expert interviews, real-world case studies, and the latest research updates—giving you practical insights you can apply directly to your work with breastfeeding families. Hosted by Margaret Salty, an experienced IBCLC, educator, and mentor, this podcast is here to guide you as you build your knowledge, sharpen your skills, and continue to evolve in your practice. The field of lactation is dynamic, and learning never stops. Behind the Latch will help you stay inspired, stay informed, and stay connected to your purpose.Copyright 2026 Margaret Salty 衛生・健康的な生活
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  • Rethinking the Lactating Breast with Dr. Donna Geddes

    Rethinking the Lactating Breast with Dr. Donna Geddes
    2026/09/16
    What if some of what we still teach about breast anatomy, milk supply, pumping, and milk ejection is based on an outdated understanding of how the lactating breast actually works?In this episode of Behind the Latch, Margaret sits down with internationally recognized human lactation researcher Dr. Donna Geddes to explore what more than two decades of imaging the living, lactating breast has taught us.Dr. Geddes’s groundbreaking ultrasound research challenged anatomical models that had remained largely unchanged for more than 160 years. Her work has helped demonstrate that the lactating breast is far more variable—and far more complex—than the simplified diagrams many clinicians were originally taught.Together, Margaret and Dr. Geddes discuss how these discoveries translate into real clinical practice.Margaret and Dr. Geddes discuss:How Dr. Geddes went from radiography and ultrasound to human lactation researchThe history behind the traditional anatomical models of the lactating breastWhat ultrasound revealed that older breast anatomy diagrams got wrongWhy the concept of large “lactiferous sinuses” does not match what we see in the living breastHow widely milk duct anatomy can vary between individualsWhy some people can hand express milk easily while others struggleWhether having fewer lobes necessarily means a person will have low milk productionWhat we currently understand—and still don't understand—about mammary hypoplasiaWhy breast size alone tells us very little about milk-making capacityBreast changes during pregnancy and what clinicians should be asking about prenatallyThe relationship between blood flow to the breast and milk productionPregnancy complications such as gestational diabetes, preeclampsia, and fetal growth restriction as potential clues to later lactation challengesMetabolic health, inflammation, and their possible relationship to milk productionWhy identifying risk does not mean predicting failureThe importance of anticipatory guidance for families at increased risk for low milk productionWhy intensive feeding plans such as triple feeding should have clear goals and endpointsWhat ultrasound has taught us about the milk ejection reflexWhy many people do not actually feel their milk ejectionsWhy watching milk flow—or watching the baby—may tell us more than asking whether a parent “felt a letdown”Why some babies choke, sputter, or struggle with fast milk flowThe difference between anatomy-driven fast flow and true oversupplyWhy automatically trying to decrease milk production can sometimes create a new problemHow milk storage capacity differs dramatically from one person to anotherWhy frequent feeding does not automatically indicate low milk supplyWhy infant growth, behavior, milk transfer, maternal experience, and the whole clinical picture matter more than feeding frequency aloneWhy the right and left breast should not necessarily be expected to function identicallyHow researchers estimate the percentage of available milk removed from the breastWhy simply comparing pumping volumes between people can be misleadingA Bigger Lesson for Lactation ProfessionalsThroughout the conversation, one theme keeps returning:Human lactation does not fit neatly into a checklist.Breasts vary between people. The two breasts of the same person can behave differently. Milk production is influenced by anatomy, development, metabolic health, blood flow, hormones, inflammation, infant behavior, milk removal, and many other interacting factors.Understanding the science should help us individualize care—not create another rigid set of rules.What’s Coming Next?Dr. Geddes also shares some of the research underway within her team, including work examining:Flange and breast shield sizingInfant body compositionBiomarkers associated with low milk productionProteomics and metabolomicsClinical measures that could help identify low milk production earlierAntenatal and early postpartum screening toolsGestational diabetes and lactation outcomesBundled-care interventionsUltrasound phenotypingAI-supported prediction tools that may eventually help clinicians identify patterns and risk factorsThe goal is not simply to understand lactation better—it is to translate that science into tools clinicians can actually use.About Dr. Donna GeddesDr. Donna Geddes is a leading researcher in human lactation based at The University of Western Australia in Perth, Western Australia. Her research has used technologies including ultrasound, Doppler imaging, human milk analysis, and other advanced laboratory techniques to investigate breast anatomy, milk production, milk ejection, infant feeding, and lactation physiology.Her work has played a major role in reshaping our understanding of the anatomy and function of the lactating breast.Learn MoreDonna Geddes — University of Western Australia profile: UWA Research Profile This is a great primary link because it includes her biography, research projects, ...
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    1 時間 6 分
  • It's Not Magic, It's Skill: Therapeutic Breast Massage with Maya Bolman, IBCLC

    It's Not Magic, It's Skill: Therapeutic Breast Massage with Maya Bolman, IBCLC
    2026/07/08
    We were taught to keep our hands in our pockets. Maya Bolman was taught the opposite — by her great-aunt, a midwife in Belarus, who could take an engorged, aching breast and leave it soft in an hour. In this episode, I sit down with Maya to talk about the skill most of us were never trained in: what to actually do with our hands.Maya Bolman is an IBCLC in Cleveland, Ohio, with 26 years in hospital lactation care and a second home at Breastfeeding Medicine of Northeast Ohio, where she works alongside Dr. Ann Witt. She's the clinician who named Therapeutic Breast Massage in Lactation (TBML), published the research behind it, and travels the world teaching manual skills to lactation professionals. In this conversation, she breaks down the physiology of engorgement (hint: it's not just milk), why we massage milk down but swelling up, and the deceptively simple technique she calls breast gymnastics. If you've ever felt underprepared the second a parent's breast is hard, painful, and stuck, this one is going to change how you practice.What You'll Learn:Why engorgement is really "lymphodynamic edema" — and why that one distinction changes how you use your handsThe moment Maya realized massage therapists move the breast up while lactation consultants are taught to move milk down (and why both are right)What breast gymnastics actually is, why it takes 20 seconds, and why she tells every parent to start it todayHow to know when you're "done" — the outcome to feel for instead of a number to hitWhy the 2022 mastitis protocol's silence on milk expression is, in Maya's words, "a big minus"The difference between overstimulating a working duct and actually moving milk from the one that's stuckWhy she calls herself a lactation therapist, not a consultant — and what that reframe unlocksHow mindful latching flips the script: the parent doesn't latch the baby, she positions so the baby can latchWhere to find milk you're missing (it's closer to the nipple than you were taught)The case for demonstrating instead of explaining — and what mirror neurons have to do with breastfeeding successResources Mentioned in This Episode:Maya Bolman's website (workshops, free breast gymnastics & massage video, BreastKindness LLC): https://www.mayabolman.comBolman, M., Saju, L., Oganesyan, K., Kondrashova, T., & Witt, A. M. (2013). Recapturing the art of therapeutic breast massage during breastfeeding. Journal of Human Lactation, 29(3), 328–331. https://doi.org/10.1177/0890334413475527Witt, A. M., Bolman, M., Kredit, S., & Vanic, A. (2016). Therapeutic breast massage in lactation for the management of engorgement, plugged ducts, and mastitis. Journal of Human Lactation, 32(1), 123–131. https://doi.org/10.1177/0890334415619439Witt, A. M., Bolman, M., & Kredit, S. (2016). Mothers value and utilize early outpatient education on breast massage and hand expression in their self-management of engorgement. Breastfeeding Medicine, 11(8), 433–439. https://doi.org/10.1089/bfm.2016.0100Your Next Steps:Learn with Me: https://margaretsalty.com/coursesRead the Blog: https://margaretsalty.com/blogEmail Me: hello@margaretsalty.comLinkedIn: https://www.linkedin.com/in/margaret-salty-drph-ibclc-ches-0133451b/Instagram: https://www.instagram.com/margaretsalty/Facebook: https://www.facebook.com/profile.php?id=61550829710885Music: The Magnifiers — "My Time Traveling Machine"
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    47 分
  • What Counts as Low Milk Supply? Measurement, Biomarkers, and What's Next with Dr. Katie Kivlighan

    What Counts as Low Milk Supply? Measurement, Biomarkers, and What's Next with Dr. Katie Kivlighan
    2026/07/02

    Low milk supply might be the most common concern we field—and one of the hardest things in lactation to actually measure. In this episode I sit down with researcher Dr. Katie Kivlighan to separate what we can quantify from what we're guessing at, and to look at the tools and technologies that are about to change how we assess it.

    Episode Summary

    "Low milk supply" gets used as a catch-all, but it isn't one thing—and treating it like one thing is part of why families get the wrong support. Dr. Katie Kivlighan, co-author of Measuring Low Milk Supply: Methods and Implications for Lactation Research and Clinical Practice (Journal of Human Lactation, 2026), joins me to walk through the difference between primary, secondary, and perceived low supply, and why our measurement methods have never fully caught up with the problem.

    We get into what the evidence actually supports right now: test weights, milk transfer, and biomarkers like sodium and conductance—plus the emerging technologies (bioimpedance, at-home milk sodium testing) that could give us objective data we've never had at the bedside. We also talk honestly about the flip side: how devices and social media can feed parental anxiety, how normal infant behavior gets misread as a supply problem, and where clinical judgment still has to lead. If you support families navigating supply concerns, this one is about sharpening how you assess, how you reassure, and how you decide when a number actually matters.

    What You'll Learn
    • The real difference between primary, secondary, and perceived low milk supply—and why the distinction changes your entire plan of care
    • Why milk supply is so hard to measure accurately, and what that means for how we interpret research
    • What biomarkers like sodium and conductance can (and can't) tell you about secretory activation
    • Where bioimpedance and at-home milk sodium testing are headed, and how to think about them before they land in your practice
    • The infant behaviors that get misread as low supply—so you can spot them and reframe them for families
    • How feeding technology and social media are driving parental anxiety, and your role in cutting through the noise
    • Why milk intake "standards" deserve a second look, and how normal supply variability fits in
    • When to bring in a breastfeeding medicine provider, and how that collaboration strengthens care
    • How to hold objective tools and clinical judgment together instead of letting one override the other

    Chapters
    • 00:00 — Introduction and Dr. Kivlighan's research background
    • 05:53 — Low milk supply: types and challenges
    • 08:12 — The role of perception in supply concerns
    • 10:31 — Evaluating milk supply: tools and techniques
    • 13:11 — Common misinterpretations of infant behavior
    • 15:46 — How technology feeds parental anxiety
    • 18:16 — Collaborating with lactation professionals
    • 20:40 — Reassessing milk intake standards
    • 26:39 — Understanding milk supply variability
    • 27:20 — Emerging technologies in lactation
    • 32:23 — Bioimpedance and milk measurement innovations
    • 34:58 — Addressing delayed secretory activation
    • 41:27 — The case for comprehensive lactation support
    • 43:02 — Closing thoughts

    Resources Mentioned
    • Kivlighan, K. T., & Demirci, J. R. (2026). Measuring low milk supply: Methods and implications for lactation research and clinical practice. Journal of Human Lactation, 42(1), 126–134. https://doi.org/10.1177/08903344261426744
    • Dr. Katie Kivlighan:
    • Faculty page
    • Research profile

    Your Next Steps
    • Learn with Me: https://margaretsalty.com/courses
    • Read the Blog: https://margaretsalty.com/blog
    • Email Me: hello@margaretsalty.com
    • LinkedIn: https://www.linkedin.com/in/margaret-salty-drph-ibclc-ches-0133451b/
    • Instagram: https://www.instagram.com/margaretsalty/
    • Facebook: https://www.facebook.com/profile.php?id=61550829710885

    Music: The Magnifiers — "My Time Traveling Machine"

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    43 分
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