Tuesday, October 2, 2012

Calculated Risk: New Milkscreen Calculator Product for Breastfeeding Mothers

There's a new product hitting the aisles. Milkscreen Calculator claims to evaluate a lactating woman's supply and tell her whether her production is adequate. Is it designed to reassure nursing mothers, or to prey on their insecurities? Who designed this? And how exactly does it work?

Brought to you by Upspring Baby, the same company that created the alcohol test strips for breastmilk, Milkscreen Calculator is introduced on their webpage like so:

Many moms wonder: How much breastmilk do I make, and is it enough for my baby?
Take the new Milkscreen Calculator test and learn:
  • How much breastmilk you are making
  • If you need to increase breastmilk production
  • Baby's weight gain and weight percentiles
  • How to naturally increase breastmilk production
  • How to overcome common breastfeeding problems
It's no secret that anxiety and insecurity about milk supply are leading causes of premature weaning. Milkscreen Calculator states that "50% of moms stop breastfeeding because they are concerned they are not making enough for their baby." In a video interview,  Dr. Susan Landers, a fellow of the Academy of Breastfeeding Medicine who helped develop the Calculator, she explains that the product was indeed intended primarily to reassure mothers who have unfounded fears about their supply.

How does this work? From what I can tell on the site, the product you purchase is basically just a container into which you measure your pumping output. After registering on their site and filling out a questionnaire which collects more data on you and your baby, you are given a pumping schedule. In the example cited in the FAQ video, you are to nurse your baby at a set time, then pump three different times at hourly intervals. You will then enter your data online and receive an analysis of your supply, such as this example:

I should fully admit right up front that I have a hard time being objective about this. As someone who works with nursing mothers in my clinical training to become an IBCLC (supervised by preceptors at all times), it breaks my heart to think that a mother who was producing well but did not respond well to pumping (or had a faulty pump, or poorly fitted flanges, or any number of other variables) could potentially be told that her supply was inadequate by this product. There are mothers who have successfully breastfed their babies exclusively, with perfectly healthy weight gain, who report never being able to elicit more than a few drops from a pump. Perhaps it was an equipment issue, perhaps hand expression might have worked for her, who knows? What would Milkscreen Calculator tell a mother like this?

Conversely, if it's used on a newborn (they state not to use it prior to 8 days old, but day 9 is still very, very early), honestly, mom might still be producing well due to that postpartum hormonal abundance . . . and baby might actually have some issues that prevent them from actively transferring well. So baby feeds passively on mom's surplus letdown for a while, and a few weeks later, her supply actually does start to dwindle because the demand end of the supply & demand equation was never strong enough. But hey, the Milkscreen told her everything was just fine.

In a few places on the site, the company mentions that moms that were found to have low supply according to their calculations may want to consult with a pediatrician or a lactation consultant (after trying some of their automated suggestions for increasing supply). Which, in my mind, begs the question, wouldn't a better effort be to increase access to IBCLCs in the first place? By the time a mother in this position seeks professional help - if in fact she does or can - she may be facing an uphill battle to bring her supply back on top of addressing the root cause of the baby's poor transfer.

To give the company the benefit of the doubt, I do believe the intention was to create a product that would reassure most mothers that their supply is normal and healthy - after all, for most women, it is, as long as poor management doesn't interfere with the natural process. Does it succeed in this goal? Or is it more likely to just exploit their fears? A little from column A, a little from column B?

What do YOU think? Am I overreacting in my concern? (It would hardly be the first time. True fact.) If this product is a helpful and accurate one, and my reasoning is faulty, I would love to be reassured by an explanation. Building confidence in new mothers is a very, very good thing; I am far from convinced that a preprogrammed Calculator is the right tool for that job.


UPDATE 10/5/12:

Yesterday, I received an email from the CEO of Upspring Baby. I share it here with her permission,

Dear Dou-la-la,

I am the CEO of UpSpring Baby and saw your recent post about our new product, Milkscreen Calculator.  I thought you raised some very reasonable questions, and many of the same ones that were raised when we launched the product at the annual ILCA conference in July. 

We recognize that this is a complex product that is intended to address a common concern of new moms:  that their milk production may not be sufficient to support their baby’s needs.  Milkscreen Calculator’s mission is to help moms overcome this common worry, either by reassuring her that her production is normal (in most cases), or by helping her overcome a high or low supply by directing her to an LC.  We know many moms quit breastfeeding, or begin formula supplementation, because they think they are not making enough breast milk.  The main purpose of this product is to educate mom and help her gain the confidence she needs to continue breastfeeding.  And for women with low or high production, we hope the test will give them the extra encouragement they need to seek professional help so they can increase or decrease their production.

If you are interested in discussing the product further, I would appreciate the opportunity to speak with you directly.  While we have tried to anticipate most of the basic issues, I’m sure there are more things we can learn from experts in the field.  Prior to launching the product, we sought input from LC’s and pediatricians who have specific expertise in breastfeeding medicine in order to be as thorough as possible. 
Thank you,


What do you think?