Beyond the Basics: How Margaret Salty, MPH, IBCLC is Transforming Lactation Care Through Education and Advocacy
April 22nd, 2025
By: Margaret Salty, MPH, IBCLC
How has your personal background influenced your approach to lactation care, and what unique perspectives do you bring to the field?
As a mother of five, a hospital-based lactation consultant, and a private practice owner, I bring a deeply personal and multifaceted perspective to lactation care. I understand the pressures families face in both clinical and home settings, and I draw on my background in public health to always zoom out and look at the broader systems at play—barriers to access, structural inequities, and community gaps. My work as a Pathway 2 instructor also keeps me grounded in evidence-based practice and mentorship. I don’t just support families—I also help shape the next generation of IBCLCs, which I see as part of my responsibility to the profession.
Can you describe a transformative moment in your career that shaped your current practice as a lactation care provider?
Becoming a Pathway 2 instructor was a transformative moment for me. Teaching future IBCLCs completely shifted my perspective on what lactation consultants truly need to know—not just to pass the exam, but to practice safely and effectively. It made me deeply committed to teaching evidence-based care, the importance of staying within scope, and understanding how to apply critical thinking in real-world situations. I realized how much misinformation circulates in our field and how easily students can be misled by trends or anecdotal teachings. That experience sharpened my focus on helping others develop strong clinical reasoning, recognize credible sources, and stay grounded in ethical practice. It didn’t just make me a better educator—it made me a better lactation consultant, too.
What misconceptions about lactation consulting do you frequently encounter, and how do you address them?
One major misconception I see—especially among new IBCLCs—is the belief that we have to wear all the hats because so many other providers aren’t well-educated in lactation. And while I completely understand where that instinct comes from, it can be really problematic. We’re not pediatricians, physical therapists, or speech-language pathologists, and stepping outside of our scope can lead to ethical issues and poor outcomes. Instead of trying to do it all, we need to focus on building strong referral networks—finding providers who do understand lactation, like breastfeeding medicine physicians, supportive ENTs, or infant bodyworkers who truly collaborate. When we stay grounded in our role and surround ourselves with a solid team, everyone benefits—especially the families we’re serving. I emphasize this constantly when teaching, because knowing your limits is part of practicing with integrity.
How do you advocate for improved lactation support within your community, particularly for underserved populations?
A big part of my advocacy work happens through local and state breastfeeding task forces. These groups are essential for bringing together public health professionals, community advocates, and lactation consultants to identify gaps and push for better resources. Through this work, I’ve been able to contribute to initiatives aimed at expanding access to lactation care, supporting policies that reduce barriers for underserved families, and ensuring lactation is part of broader maternal-child health conversations. It’s a way to advocate beyond the individual level—because real change happens when we improve the systems that support families.
What has been your most challenging case as a lactation care provider, and how did it contribute to your professional growth?
One of the most challenging—and ultimately most rewarding—cases I’ve worked on involved a breastfeeding parent with a history of stroke. It presented unique clinical and emotional complexities, from physical limitations to navigating medications and provider hesitancy. The case required me to think critically, dig deep into the evidence, and collaborate closely with other healthcare providers to develop a plan that honored both safety and the parent’s strong desire to breastfeed. The experience impacted me so deeply that I decided to write a case study about it—not just to reflect, but so my students and other IBCLCs could learn from the situation. Case studies are such a powerful tool in our field. They bridge the gap between textbook knowledge and real-world application, helping us all grow in clinical reasoning, scope awareness, and compassionate care.
About the Author:
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