International Business Dev Lead at LactApp
Today, in 2022, no country in the world fully meets the WHO recommended health standards for breastfeeding; exclusive breastfeeding for 6 months and as part of a varied diet until 2 years of the child’s age. So the World Health Organisation has set an ambitious target to increase breastfeeding rates to at least 50% by 2030. However, the achievement of these without a substantial investment in breastfeeding support for mothers and targeted upskilling of healthcare professionals who care for them - is questionable.
The benefits of breastfeeding to mother and child are scientifically undisputed and regularly new findings reach the press, such as this recent research in the headlines stating that not breastfeeding increases the risk of cardiovascular disease and stroke for mothers. But more research is needed that actually improves clinical practice and not only praises the benefits of human milk, the baseline of human evolution.
Each year over 100 million new mothers worldwide initiate breastfeeding, but by 3 months only 46% do so in the US, compared to 17% in the UK, where exclusive breastfeeding rates drop to a jaw-dropping 1% at 6 months, one of the lowest rates in the world. We don’t know and will not know how many (or better, how few) of them reach the WHO two-year target, as even the public funding to collect the data has been cut. So if breastfeeding is as easy as it appears and an apparently individual personal choice of preference that a mother makes, why is it, that so many mothers have the intention to start and yet so few of them achieve their own goals? The answer is, simply put, that breastfeeding is neither easy nor an individual, isolated choice on its own.
Contrary to common belief, which seems to often be shared by many healthcare professionals, breastfeeding is something like an instinct for mothers and breastmilk just easily flows once a mother somehow puts her child to the breast. But lactation is a bodily function that needs information and education for the mother, like an acquired skill and even then it might not work so well again with a second or third baby. Correct attachment and positioning needs to be seen, learned and can very easily be done ineffectively, especially without any examples to copy. Do you remember how many women you have actually observed breastfeeding close up? All this, as well as persistent wrong myths and outdated advice, such as “feed every 3 hours” or “never wake a baby” combined with no training for healthcare professionals on the physiological function of the mammary gland, don’t exactly set up mothers for success. Persistent unsolicited opinions disguised as “advice”, without any scientific evidence, also misguide mothers to experience poor lactation experiences that then often end in them rather reluctantly “moving on” to mixed feeding which often eventually spirals down milk supply into the plan B of formula feeding.
Breastfeeding pain is conceived as normal, when in fact it is a sign that something is going wrong and has to be checked with the help of a qualified professional, so this mother can continue to feed pain-free for as long as she and her baby wish to do so. But the medical establishment has quite literally looked away from any issues related to breastfeeding and our knowledge on pathologies like hypogalactia or mastitis are in its medical and research infancy. This lack of expertise and trust of the whole society in the topic has fomented mothers persisting feeling of lack and they wonder “do I have enough milk?” as everybody continuously questions their milk supply. But, babies can also have a common oral anatomy phenomenon such as tongue-tie, that prevents them from achieving an effective latch and milk transfer, however, few healthcare professionals are trained on diagnosing them, let alone treating them correctly and essential post-natal follow-up appointments to sort all these problems out have been the victim of more budget cuts in maternity care.
This is where new technology can come into the picture to assist mothers and healthcare professionals alike. Mothers can download an App, the breastfeeding expert in your pocket, LactApp, for their Android or iPhone. They will get individualized answers according to their personal profile in an automatic way, straight from their smartphones and 24/7, even at all hours during those interrupted and long postnatal nights. The in-house team of international board-certified lactation consultants (IBCLC), midwives, nutritionists and psychologists constantly review and update the automatic answers according to the latest state of medical research in lactation, a field that has been overlooked, underfunded and excluded in teaching plans in medicine so far.
LactApp’s female-led IT team is also taking the vast amount of data, that the huge organic traction of 600,000 downloads has gathered, as a base to develop a worldwide unique machine learning model, so the proprietary AI can eventually answer mother’s questions autonomously. This will translate into a highly scalable solution that will outperform any telemedicine platform in cost-efficiency, whilst maintaining a high clinical standard that minimalizes personal bias, which is often present in postnatal care: studies show, black mothers in the US are 8x more likely to be offered formula milk.
To meet WHO targets and improve breastfeeding rates, healthcare professionals also need to upskill on the topic of lactation quickly and get fast and targeted access to additional specialized information on their individual patient cases. The LactApp Medical App makes this possible in a pocket-size mobile format and is also available to download worldwide. The premium version even allows them to access a medical case study of the week, drawn from the vast experience of the LactApp clinical team, where they can test their knowledge in a fun and interactive way.
We all have been explained in school how our heart and lungs work, but none of us has been taught how the mammary gland actually produces milk. Few mothers and not all healthcare workers really know that breasts work like factories and not like a warehouse and only produce on-demand when stimulated by the baby. And no, not all breasts will make enough milk for a baby, as some clinical pathologies do not allow for enough milk supply in the mother and donor milk or breastmilk substitutes will be necessary. But just like with heart failure or kidney problems, the inability to produce breastmilk does not affect over half of the entire population of all mothers, as our poor breastfeeding rates would suggest. Is there another bodily function that is put so much in doubt and distrusted as breastfeeding? Well, certainly more research is needed and can be done. As a comparison, there are over 10,000 research publications on pubmed.gov of mastitis, a common complication of lactation, in cows and only just over 1,000 in human females, slightly more than sheep (750+) and goats (around 600).
In conclusion, if we want to improve breastfeeding rates amongst mothers, not only do we need a real commitment in terms of the public health budget and a proper legal framework for enhanced maternity rights, but also more investment in practical, evidence-based and professional lactation support for mothers in person as well as digitally. Furthermore, healthcare professionals need to fast-track the corresponding upskilling in lactation education through technology and much more medical research into the practical complications of breastfeeding needs to be done. Our modern society needs to find its way back to trust the body function of lactation as the base of a healthy start of every human life like all mammals have done so through evolution. Innovative applications of technology, such as LactApp, will prove to be the path to get us back there faster, more efficiently and in the most scalable cost-effective way.