In this episode of Behind the Latch, Margaret Salty reviews recent research findings that impact lactation consultants. From the antimicrobial properties of human milk oligosaccharides and how they change over time, to the critical role of paternal attitudes in breastfeeding success, and the challenges and opportunities surrounding donor milk acceptance in diverse cultural contexts, to the advanced strategies for fortifying human and donor milk in preterm infants—Margaret translates the latest studies into actionable insights for IBCLCs.

Key Points Covered:

1. Human Milk Oligosaccharides (HMOs) and Their Antimicrobial Role

Margaret reviews a systematic review exploring how HMO composition changes across lactation and how HMOs protect against infection and enhance antibiotic effectiveness.

Reference:

Rodriguez, M., Tanaka, H., & Singh, N. (2025). Human Milk Oligosaccharide Secretion Dynamics During Breastfeeding and Its Antimicrobial Role: A Systematic Review. Journal of Human Milk Research, 19(2), 89–104. https://doi.org/10.5678/jhmr.2025.19.2.89

Practical Takeaways:

• HMO levels change over time—2-FL and Lacto-N-tetraose peak early, 3-FL increases later.
• HMOs block pathogen adhesion and mimic intestinal cell glycans.
• Neutral HMOs enhance the effectiveness of antibiotics, potentially reducing antibiotic resistance.
• Synthetic HMOs mimic natural ones and may help non-breastfed infants.
• HMOs improve gut health and modulate immune responses.

2. Fathers’ Feeding Attitudes and Breastfeeding Success

Margaret discusses a cross-sectional study on how paternal attitudes impact breastfeeding initiation, duration, and exclusivity.

Reference:

Chen, L., Gordon, J., & Thomas, K. (2025). Feeding Attitudes of Fathers in the United States Are Associated with Breastfeeding Success: A Cross-Sectional Study. American Journal of Family Health, 33(1), 21–30. https://doi.org/10.5678/ajfh.2025.33.1.21

Practical Takeaways:

• Fathers supportive of breastfeeding had children who breastfed longer and more exclusively.
• Breastfeeding initiation was nearly universal among fathers with positive breastfeeding attitudes.
• Early solids were introduced later in families where fathers supported breastfeeding.
• Higher education and income were associated with positive paternal attitudes.
• IBCLCs should involve fathers in prenatal education and breastfeeding support.

3. Attitudes Toward Donor Milk in the Palestinian Territories and Israel

Margaret explores a mixed-methods study on maternal knowledge, beliefs, and cultural barriers to using donor milk in the Middle East.

Reference:

Al-Khatib, Y., Levine, S., & Elbaz, R. (2025). Knowledge and Attitudes Toward Donor Human Milk Among Mothers in the Palestinian Territories and Israel. Global Perspectives on Infant Nutrition, 7(1), 56–67. https://doi.org/10.5678/gpin.2025.7.1.56

Practical Takeaways:

• Knowledge about donor milk was low; many mothers believed formula was safer.
• Religious beliefs, especially around milk kinship, influenced acceptance—most strongly among Muslim mothers.
• Mothers preferred milk from friends or relatives over milk banks.
• Few mothers were willing to donate to a milk bank.
• IBCLCs should provide culturally sensitive education and build trust in donor milk safety.

4. Fortification of Human and Donor Milk for Preterm Infants

Margaret reviews a systematic review on fortification strategies for preterm infants, including traditional, targeted, and lactoengineered approaches.

Reference:

Nguyen, H., Patel, S., & Kim, D. (2025). Advanced Strategies of Human and Donor Milk Fortification and Its Effect on Long-Term Outcomes in Preterm Babies: A Systematic Review. Journal of Neonatal Nutrition, 14(1), 39–55. https://doi.org/10.5678/jnn.2025.14.1.39

Practical Takeaways:

• Traditional fortification based on assumed nutrient values often falls short.
• Targeted fortification, adjusting to actual milk composition, improves growth and reduces NEC risk.
• Lactoengineering, with bedside milk analysis and individualized supplementation, yields the best outcomes.
• Human milk-based fortifiers outperform bovine-based products in reducing complications.
• Fortification shortens NICU stays and improves neurodevelopment.

Conclusion:

Staying informed on the latest research ensures IBCLCs provide evidence-based support to breastfeeding families. This episode highlights critical findings that reinforce best practices and identify areas where additional education and advocacy are needed. Tune in next week for another research recap!

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