Behind the Latch

Margaret Salty
  • 5.0 (20)
  • Education
  • Updated Weekly

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.

  1. 6d ago

    It's Not Magic, It's Skill: Therapeutic Breast Massage with Maya Bolman, IBCLC

    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 success Resources 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.2016.0100 Your 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=61550829710885 Music: The Magnifiers — "My Time Traveling Machine"

    47 min

  2. Jul 2

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

    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 LearnThe real difference between primary, secondary, and perceived low milk supply—and why the distinction changes your entire plan of careWhy milk supply is so hard to measure accurately, and what that means for how we interpret researchWhat biomarkers like sodium and conductance can (and can't) tell you about secretory activationWhere bioimpedance and at-home milk sodium testing are headed, and how to think about them before they land in your practiceThe infant behaviors that get misread as low supply—so you can spot them and reframe them for familiesHow feeding technology and social media are driving parental anxiety, and your role in cutting through the noiseWhy milk intake "standards" deserve a second look, and how normal supply variability fits inWhen to bring in a breastfeeding medicine provider, and how that collaboration strengthens careHow to hold objective tools and clinical judgment together instead of letting one override the other Chapters00:00 — Introduction and Dr. Kivlighan's research background05:53 — Low milk supply: types and challenges08:12 — The role of perception in supply concerns10:31 — Evaluating milk supply: tools and techniques13:11 — Common misinterpretations of infant behavior15:46 — How technology feeds parental anxiety18:16 — Collaborating with lactation professionals20:40 — Reassessing milk intake standards26:39 — Understanding milk supply variability27:20 — Emerging technologies in lactation32:23 — Bioimpedance and milk measurement innovations34:58 — Addressing delayed secretory activation41:27 — The case for comprehensive lactation support43:02 — Closing thoughts Resources MentionedKivlighan, 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/10.1177/08903344261426744Dr. Katie Kivlighan:Faculty pageResearch profile Your Next StepsLearn 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=61550829710885 Music: The Magnifiers — "My Time Traveling Machine"

    43 min

  3. Jun 17

    Inside the Milk Bank: Donor Milk, NEC Prevention, and the Myths That Hold Us Back with Dr. Lisa Stellwagen

    In this episode, Dr. Lisa Stellwagen shares the journey of establishing a hospital-based milk bank, the science behind donor milk, and the future of infant nutrition and milk banking. Discover how policies, safety standards, and community efforts are transforming neonatal care and supporting vulnerable infants. Chapters: 00:00 Introduction to Milk Banking and Its Importance04:07 The Journey to Establishing a Milk Bank05:24 The Supporting Premature Infant Nutrition Program08:43 The Need for More Milk Banks in California11:45 Building a Milk Bank: Challenges and Triumphs16:52 Understanding Hambana and Milk Bank Structures20:14 Pasteurization Standards and Safety in Milk Banking23:58 Fortification of Human Milk and Its Implications30:18 The Importance of Accreditation and Safety Standards34:39 The Donor Process: Ensuring Safety and Efficiency35:33 Processing Milk: From Donation to Quality Control37:27 Nutritional Targeting: Tailoring Milk for Tiny Patients40:11 Analyzing Milk: Understanding Composition and Quality43:23 Raising Awareness: The Importance of Milk Donation44:30 Barriers to Access: Challenges in Milk Banking46:16 The Role of Nonprofit Milk Banks: A Community Approach51:58 The Cost of Donor Milk and NICU Decisions57:21 Vision for the Future of Milk Banking1:00:21 Honoring Bereaved Donors: The Cherry Blossom Program1:04:49 Outro Resources Human Milk Banking Association of North America (HMBANA) Promoting Human Milk and Breastfeeding for the Very Low Birth Weight Infant: Clinical Report Find a Milk Bank Guest Links HMBANA-Dr. Stellwagen UC Health Milk Bank Connect with Margaret Email: hello@margaretsalty.com Instagram: @margaretsalty Facebook: Margaret Salty Music by: The Magnifiers – My Time Traveling Machine

    1h 5m

  4. May 28

    What COVID and the Formula Shortage Taught Us About Breastfeeding Support with Dr. Elizabeth Kar

    In this conversation, Dr. Elizabeth Kar discusses her research on breastfeeding promotion and the challenges faced by breastfeeding families during the COVID-19 pandemic, particularly the impact of reduced lactation support and the infant formula shortage. She emphasizes the importance of lactation consultants and community support in successful breastfeeding, critiques the marketing strategies of formula companies, and calls for better policies to protect and promote breastfeeding. In this conversation, Margaret Saltysiak and Elizabeth Kar discuss the complexities surrounding infant feeding choices, particularly the challenges of breastfeeding and formula feeding. They highlight the fragility of the infant feeding infrastructure in the U.S., the lessons learned from the pandemic regarding breastfeeding support, and the critical need for paid family leave to support new parents. The discussion also emphasizes the importance of addressing the needs of vulnerable populations and ensuring equitable access to breastfeeding support and resources. Chapters 00:00 Introduction to Elizabeth Kar and Her Work 03:03 Exploring the Triple Threat to Breastfeeding Families 06:00 The Impact of COVID-19 on Lactation Support 09:02 The Role of Lactation Consultants 11:59 The Formula Shortage and Its Effects 14:58 The Marketing Influence of Formula Companies 18:06 The Need for Better Infant Feeding Policies 21:43 The Challenges of Infant Feeding Choices 24:15 Fragility of Infant Feeding Infrastructure 27:20 Lessons from the Pandemic on Breastfeeding Support 30:25 The Need for Paid Family Leave 33:48 Addressing Vulnerable Populations in Breastfeeding Support Guest Elizabeth Kar, RDN, PhD, IBCLC Triple Threat or Mere Inconvenience? Exploring the Effect of COVID-19 Precautions, Lack of Access to Lactation Care, and the Infant Formula Shortage on Breastfeeding Behavior of Parents in the Midwest of the United States Connect with Margaret 📬 Email: hello@margaretsalty.com 📸 Instagram: @margaretsalty 📘 Facebook: Margaret Salty Music by: The Magnifiers – My Time Traveling Machine

    40 min

  5. May 6

    Informal Milk Sharing in the U.S. with Molly Waymouth

    Margaret interviews, Molly Waymouth, a senior policy analyst at RAND, and they discuss her research on informal milk sharing, its prevalence, risks, and policy implications. They explores how systemic barriers and economic factors influence families' choices and what can be done to improve access to safe, affordable donor milk and lactation support. Chapters 00:00 Introduction to the Conversation 05:37 Molly's Background and Research Focus 07:10 Exploring Milk Sharing Practices 09:35 The Economics of Donor Milk 11:23 Understanding the Support Gaps 13:48 Equity and Access in Milk Sharing 16:27 Risks of Informal Milk Sharing 16:50 The Need for Comprehensive Support 18:34 Innovative Approaches to Milk Sharing 18:50 Designing an Ideal Support System 20:27 Conclusion and Future Directions 21:22 outro.mp3 Resources JAMA Open Network Publication - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2841048 RAND Corporation - https://www.rand.org/ LinkedIn Profile of Molly Waymouth - https://www.linkedin.com/in/mollywaymouth/ Connect with Margaret mail: hello@margaretsalty.com Instagram: @margaretsalty Facebook: Margaret Salty Music by: The Magnifiers – My Time Traveling Machine

    22 min

  6. Apr 22

    Rethinking Elimination Diets in Breastfeeding: What the Research Actually Shows with Dr. Trillitye Paullin

    In this episode of Behind the Latch, Margaret Salty interviews Trillitye Paullin, CEO and co-founder of Free to Feed, who shares her groundbreaking work translating emerging research on food reactivity in breastfeeding into practical clinical guidance. Together, they unpack one of the most misunderstood topics in lactation: how dietary proteins transfer into breast milk and what that actually means for managing elimination diets. Trillitye explains why the long-standing belief that proteins remain in breast milk for weeks is not supported by current evidence—and how confusing “transfer timing” with “healing timing” has led to unnecessary dietary restriction and early weaning. They also explore the realities of non-IgE-mediated food allergies, why traditional allergy testing often fails these families, and how IBCLCs can more effectively assess, manage, and refer these cases. This conversation offers a practical, evidence-based framework that has the potential to change how clinicians support breastfeeding dyads navigating food reactivity. Key Takeaways for CliniciansFood proteins transfer into breast milk quickly—often within minutes—and typically clear within hours, not weeksThe timeline we see clinically is often driven by infant healing, not ongoing exposureElimination diets should be reassessed early (around 5 days) to determine effectivenessNot all symptoms warrant elimination—rule out more common causes firstMost infants with food reactivity will have symptoms emerge between 2–4 monthsCow’s milk and soy are the most common triggers, but other foods may be involvedReintroduction is critical to avoid unnecessary long-term restrictionSevere symptoms or lack of improvement beyond dairy/soy elimination should prompt referralNon-IgE-mediated allergies cannot be diagnosed with standard allergy testingSupporting parental mental health is essential—elimination diets are a significant burden GuestTrillitye Paullin, PhD, CEO & Co-Founder, Free to Feed Free to Feed Supporting Families as They Navigate Infant Food Allergies Connect with Margaret📬 Email: hello@margaretsalty.com 📸 Instagram: @margaretsalty 📘 Facebook: Margaret Salty Music by: The Magnifiers – My Time Traveling Machine

    1h 1m

  7. Apr 15

    Lactation During Bereavement with Victoria Fonville: A Research Review

    In this episode of Behind the Latch, Margaret Salty interviews Victoria Fonville, MS, PhD candidate in Nutrition at UNC Greensboro, about her recent scoping review on lactation during perinatal bereavement. Together, they explore what the research actually tells us about lactation after infant loss—from the lived experiences of bereaved families to the gaps in care from healthcare providers. Victoria shares the key findings from her paper, including the four major areas studied—producing milk, support, stopping lactation, and donating milk—and the six themes that emerged: hurting, lacking, valuing, succeeding, connecting, and redeeming. They discuss how lactation can serve as a powerful source of connection and identity for grieving mothers, why suppression is often presented as the default (and why that’s problematic), and how milk donation can be experienced as a deeply meaningful and even healing process for families navigating loss. This episode challenges the way we approach bereavement care and emphasizes the importance of presenting all options—so families can make informed decisions that align with their goals and their grief. Key Takeaways for CliniciansLactation after perinatal loss is common due to normal physiology, but remains poorly addressed in clinical care.Bereaved mothers often experience both physical pain and emotional distress related to lactation, requiring compassionate and informed support.“Lacking” was a dominant theme across studies, highlighting significant gaps in provider knowledge, training, and communication.Lactation suppression is frequently presented as the only option, but this does not reflect the full range of choices available.Producing milk can help maintain maternal identity and connection to the infant after loss.Milk donation is often experienced as “redeeming,” helping families create meaning and process grief.Healthcare providers should present all options—suppression, expression, donation, and keepsakes—without bias.There is an urgent need for quantitative research to better understand care practices, outcomes, and donation patterns.Compassion, presence, and individualized care are critical when supporting bereaved families. GuestVictoria Fonville, MS, PhD Candidate in Nutrition, University of North Carolina at Greensboro Lactation During Perinatal Bereavement From the Perspective of Families and Support Providers: A Scoping Review Connect with Margaret📬 Email: hello@margaretsalty.com 📸 Instagram: @margaretsalty 📘 Facebook: Margaret Salty Music by: The Magnifiers – My Time Traveling Machine

    26 min

  8. Apr 8

    More Than Milk: The Science, Systems, and Future of Human Lactation with Dr. Lars Bode

    Dr. Bode shares his journey into human milk research and the founding of the Human Milk Institute—the only institute in the world dedicated entirely to studying human milk in all its complexity. Together, they explore how human milk research is evolving from isolated disciplines into a collaborative, systems-based science that integrates molecular biology, clinical care, and public health. The conversation dives deep into human milk oligosaccharides (HMOs), the limitations of reductionist thinking in lactation science, and the urgent need to translate research into real-world clinical impact. Dr. Bode also shares his vision for the future, including the development of “lactology” as a formal field of study and what it would take to truly normalize breastfeeding on a global scale. Key Takeaways for Clinicians Human milk is far more than nutrition—it is a dynamic system of signaling, protection, and communication.HMOs play multiple roles beyond the microbiome, including direct immune and systemic effects.Donor milk retains key bioactive components like HMOs even after pasteurization.Variation in milk composition across individuals and time is expected and biologically meaningful.Clinical care must align with real-world problems—research must start with the needs of families.Multidisciplinary collaboration is essential to advancing both science and clinical outcomes.Maternal health directly influences milk production and composition.Breastfeeding provides significant long-term health benefits for both infants and mothers.Formula can improve—but it cannot replicate the adaptive, responsive nature of human milk.Early identification of barriers and inequities is critical to improving breastfeeding outcomes.The future of lactation care depends on bridging research, clinical care, and public health systems. Guest Dr. Lars Bode, PhD Director, Human Milk Institute Human Milk Institute Triton Giving Day 04.29.2026 Connect with Margaret 📬 Email: hello@margaretsalty.com 📸 Instagram: @margaretsalty 📘 Facebook: Margaret Salty Music by: The Magnifiers – My Time Traveling Machine

    42 min
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5
out of 5
20 Ratings

About

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.

Information

  • Creator
    Margaret Salty
  • Years Active
    2024 - 2026
  • Episodes
    122
  • Rating
    Clean
  • Copyright
    © Copyright 2026 Margaret Salty
  • Show Website
    Behind the Latch

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