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 hands - The 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 today - How to know when you're "done" — the outcome to feel for instead of a number to hit - Why 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 stuck - Why she calls herself a lactation *therapist*, not a consultant — and what that reframe unlocks - How mindful latching flips the script: the parent doesn't latch the baby, she positions so the baby *can* latch - Where 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.com - Bolman, 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/10.1177/0890334413475527 - Witt, 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/10.1177/0890334415619439 - Witt, 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/courses - Read the Blog: https://margaretsalty.com/blog - Email Me: [hello@margaretsalty.com](mailto:hello@margaretsalty.com) - LinkedIn: 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"