Breastmilk tracking app shows promising results at YNHH Bridgeport campus

Courtesy Yale School of Medicine

Breastfeeding has undeniable health benefits for babies and nursing parents.

Knowing this, Eliza Myers, Associate Professor of Clinical Pediatrics and Medical Director at YNHH Bridgeport Campus NICU, pioneered TrackMyMilk, a smartphone app that allows breastfeeding parents to monitor their own milk supply. When parents express milk, they can enter the data into the app, which adds them to their electronic medical record. TrackMyMilk also helps them keep track of how close they are to meeting their daily goals – at the end of the day, the 24-hour milk yield is sent straight to their doctor.

“This form of patient-driven data and this discrete subset of parent-driven data about their child is…really the future of healthcare,” Myers said.

When it comes to breastfeeding, Myers recognizes that milk from a baby’s own parents is the gold standard. “Mother’s milk saves lives,” says their mission statement. Breast milk provides necessary immunity and nutrients to babies, which protects them from infection or disease.

According to the Centers for Disease Control and Prevention, breastfed babies show lower risks diabetes, asthma and obesity, while parents reduce their risk of various cancers and diseases by pumping milk.

However, according to Myers, inefficiencies in hospitals and healthcare illiteracy limit the effectiveness of breastfeeding. Without a practical tracking process, patients are often unsure of how much or how often they are pumping in a day. At YNHH Bridgeport Hospital, Myers recalled how, in the past, parents kept their records on paper slips — which were later almost never returned to her and the other doctors.

Her difficulties in collecting this data, as well as a conversation with a senior nurse, ultimately led Myers to develop TrackMyMilk to streamline patient-physician communication about milk supply. She found a team of software developers knowledgeable about Epic, the software company that owns the digital medical record apps for YNHH patients, and worked with Michelle DeWitt. Epic Pharmacy App and Order Coordinator at YNHH.

“Before joining YNHHS ITS, I was a neonatal intensive care unit nurse,” DeWitt wrote to the news. “I have a passion for helping new moms breastfeed. When Eliza first approached her, she wanted to integrate an app and Epic. [I had] the idea to create an Epic solution to this problem and allow us to provide vendors with all the information they need in one place.”

last august, Myers and DeWitt, along with the rest of their team, were recognized with the Yale New Haven Health Innovation Award for getting their project off the ground. The grant is awarded to early-stage projects that promise novel solutions in healthcare development. Since then, TrackMyMilk has been integrated into the workflow and training program at Bridgeport Hospital’s NICU.

“The YNHHS Innovation Awards is a new initiative launched in FY2022 that aims to provide the resources needed for YNHHS staff and Yale University faculty working on promising ideas with potential to make an impact.” Lisa Stump, chief information and digital transformation officer at YNHHS, wrote to the news. “Selection winners will work closely with the YNHHS Center for Health Care Innovation to implement their proposals according to the milestones outlined in their submission.”

With this support, TrackMyMilk has made the data exchange process more efficient and accessible due to its smartphone format. On the patient side, Myers likens its benefits to a “Fitbit effect,” where people with a Fitbit are motivated to walk because they can see their real-time step count. Similarly, parents who use TrackMyMilk are more likely to achieve their doctor-assigned pumping goals because they have both an incentive and a convenient way to monitor their daily progress. \

On the other hand, the consistency of this data collection can help doctors to identify possible irregularities in the parents’ milk supply.

In one case, a mother who produced enough milk for her newborn – at least relative to her baby’s size and weight – was always considered healthy. However, it was only when Myers looked closely at TrackMyMilk that she realized that the mother should have been producing much more milk and was not following the natural progression of escalation and plateauing at a normal maintenance rate.

Myers undertook a more comprehensive health evaluation that found low levels of prolactin — a hormone necessary for breastfeeding — and prescribed medical treatment.

“She was excited about this procedure, which would never have happened if we hadn’t had that daily data point over the course of a week or two,” Myers said.

On the contrary, TrackMyMilk caught a woman who was pumping a dangerous amount of breast milk at 2,000 milliliters a day — an anomaly that Myers says would have gone unnoticed without TrackMyMilk. The medical team intervened to regulate the patient down to a normal milk supply.

Crucially, TrackMyMilk has helped empower Myers’ patients by giving them agency in their own medical process. Myers noted that teaching patients about TrackMyMilk required that they also teach them how to use MyChart, the more comprehensive digital health record app that includes information about a patient’s appointments, test results, immunizations, and more.

By proxy, parents engaging with this platform can see their babies’ medical records and any progress notes written by their doctor. Myers noted how patients who used the app increasingly learned to ask more specific questions — and receive more specific answers about all aspects of caring for their babies.

“The parent … reads the daily progress note and comes back with questions like, ‘Oh, I saw you did another bilirubin test — what was the result? Okay, so what does that mean?’” Myers said. “They are collaborating with the medical team in a meaningful way.”

This type of training is particularly important for people with less medical knowledge. Non-English speakers, who make up a significant portion of YNHHS’s patient base, are less likely to take home a baby on a breastmilk diet simply because they don’t know milk production best practices — or how to ask their doctor for lessons.

Myers hopes TrackMyMilk can create a more equitable system of care and education for these populations, while acknowledging the infrastructural limitations that exist: MyChart, owned by Epic, was only developed for the English and Spanish languages.

“Mobile apps can be expensive for patients, often require a subscription fee, and don’t all fully integrate with Epic,” DeWitt wrote to the News. “I hope that as a leading organization, we can share this solution with organizations and they can offer the same experience to their patients and providers.”

As such, Myers and DeWitt are passionate about expanding TrackMyMilk’s patient-centric approach to a larger demographic and slowly changing the lactation landscape. Myers’ immediate goal is to expand her app to the other YNHHS campuses, as well as facilities and hospitals outside of Yale.

She briefly entertained a day in which Epic Corporation recognizes the merits of TrackMyMilk and incorporating it into its software as a ubiquitous, permanent feature — but also recognizes the difficulty of getting even one group of employees to implement a new system.

Even though she’s taking small steps forward, Myers is satisfied just hearing her patients share their stories of taking charge of their breastfeeding.

“It was a labor of love [with] the amount of work and time that went into it, but I feel like it’s already paid off,” Myers said.

Bridgeport Hospital was founded in 1878.