Dear Members, Dear Colleagues,
Breastfeeding support is grounded in the interplay between scientific evidence, clinical expertise and the individual needs of families. As lactation professionals, we are called upon to critically appraise emerging research, therapeutic interventions and commercial products, and to guide families with empathy and on the basis of sound evidence. The articles in this issue address questions that frequently arise in clinical practice and strengthen our ability to distinguish between established knowledge, promising approaches and recommendations that are not yet sufficiently supported by evidence.
Sore nipples are among the most common challenges during the first days and weeks after birth. In addition to identifying and addressing the underlying causes, pharmacological support may sometimes be indicated. In our interview with pharmacist and IBCLC Kristin Kneuß, we therefore explore an important question: Which pharmaceutical interventions are truly beneficial? The article provides an evidence-based overview of analgesics, antiseptics, antibiotics and other commonly used treatments, combining pharmacological expertise with practical guidance for clinical practice.
An equally challenging issue is the assessment of probiotic products marketed for the prevention and treatment of mastitis. In his review article, paediatrician and founder of the online database e-lactancia, José María Paricio Talayero, examines the current evidence and demonstrates how a scientific hypothesis can rapidly evolve into clinical recommendations and commercial products. For lactation consultants, this highlights the importance of weighing therapeutic expectations against the strength of the evidence and of recognising the central role of skilled breastfeeding support in the face of seemingly simple solutions.
Questions surrounding maternal weight and weight reduction during lactation are a recurring theme in breastfeeding support, together with the uncertainties, social attitudes and expectations that accompany them. At the same time, pharmacological treatments for obesity and bariatric surgery are becoming increasingly relevant. Pharmacist Elise Armoiry and dietitian Marie-Xavier Laporte explore different aspects of this topic in two complementary articles. Their first article focuses on breastfeeding in the context of obesity and on the impact of weight stigma on breastfeeding outcomes. It highlights how careful preparation during pregnancy and respectful, non-judgemental communication can support breastfeeding success. In their second article, the authors discuss lactation support for mothers receiving pharmacological treatment for obesity and for those who have undergone bariatric surgery. They analyse the compatibility of commonly used medications with breastfeeding, explain how bariatric surgery may affect nutrient absorption, and outline strategies to support milk production under these circumstances. This topic is complemented by a handout from our editorial team on weight loss during lactation. It offers practical guidance for mothers and places mindfulness, realistic expectations and the long-term health of both mother and child at the centre of care.
We hope that this issue will provide valuable insights and practical guidance for your work with breastfeeding families.
With warm regards,
Eva Bogensperger-Hezel and the entire editorial team – Mihaela Nita and the ELACTA board