The Research Recap: 34-Staff Training, Roy Model, Marmet Technique, and Insufficient Milk Supply

In this episode of Behind the Latch, Margaret Salty reviews four recent articles from Clinical Lactation that offer powerful insights for IBCLCs. From training healthcare providers to improving exclusive breastfeeding through theory-based counseling, to comparing hand expression and pumping in the NICU, and exploring the link between nipple shields and the perception of insufficient milk—this episode translates current research into real-world clinical strategies.Key Studies and Takeaways:1. “Evaluation of a Breastfeeding Education Intervention for Healthcare Professionals in Idaho”Citation: Karroum, K., & Clarkson, G. (2024). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2023-0040A 50-minute training significantly improved provider knowledge, confidence, and intention to improve breastfeeding support60.5% of participants planned workflow changes, including improved screening and referral practicesTraining was based on Merrill’s First Principles and the Theory of Planned BehaviorIBCLCs can play a key role in designing and implementing similar in-service education to drive systems changeEven brief, focused interventions can shift primary care culture2. “The Effect of Counseling Based on the Roy Adaptation Model on Mothers’ Infant Feeding Attitude and Anthropometric Measurements of the Baby: A Randomized Controlled Study”Citation: Bilgiç, F. Ş., & Karaahmet, A. Y. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2024-0014RAM-based prenatal and postpartum counseling dramatically increased exclusive breastfeeding (95% vs. 40%)Improved maternal feeding attitudes and reduced early weaning considerationIntervention included prenatal education, phone support, and in-person follow-upsIBCLCs can use RAM as a structured, holistic counseling modelThis theory-driven approach addressed physiological, emotional, social, and role adaptations to breastfeeding3. “Effectiveness of Manual Expression of Breast Milk: Marmet Technique in Production of Breast Milk Among Mothers Whose Babies Are in the Neonatal Intensive Care Unit”Citation: Kotsu, K., Nayak, S., & Sunanda, B. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2023-0013Marmet hand expression produced significantly more milk than manual pumping in all sessionsTechnique, not maternal characteristics, determined milk volumeHighlights the value of teaching structured hand expression in NICU settingsOffers a zero-cost, accessible method for parents struggling with pumps or in low-resource settingsIBCLCs should integrate Marmet technique into both prenatal and NICU care plans4. “Risk Factors for the Perception of Insufficient Milk: A Prospective Study”Citation: Oliva-Pérez, J., Simonelli-Muñoz, A. J., Oliver-Roig, A., & Richart-Martínez, M. (2025). Clinical Lactation, 15(3–4), 231–239. https://doi.org/10.1891/CL-2024-001718.6% of mothers developed perception of insufficient milk (PIM) by 1–5 months postpartumNipple shield use during the hospital stay was the strongest predictor of later PIM (OR = 4.78)IBCLCs should monitor shield use closely and ensure appropriate follow-up

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