Courtesy of Yale School of Medicine

Breastfeeding has indisputable health benefits for babies and lactating parents.

Knowing this, Eliza Myers, associate professor of clinical pediatrics and medical director at the neonatal intensive care unit at the YNHH Bridgeport campus, pioneered TrackMyMilk, a smartphone app where lactating parents can monitor their own milk supply. When a parent expresses milk, they can input the data into the app, which adds it to their electronic medical record. TrackMyMilk also helps them note how close they are to fulfilling daily goals — at the end of the day, the twenty-four hour milk volume is sent directly to their doctors. 

“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 recognized that milk from a baby’s own parent is the gold standard. “Human milk saves lives,” states her mission statement. Breastmilk passes down necessary immunities and nutrients to babies, which protects them against infections or diseases. 

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

However, hospital inefficiencies and health illiteracy limit the efficacy of breastfeeding, according to Myers. Without a convenient tracking process, patients are often unsure of the volume or frequency of breast pumping in a day. At the YNHH Bridgeport hospital, Myers recalled how in the past, parents recorded their data on paper slips — which subsequently almost never circulated back to her and the other doctors.

Her difficulties gathering this data, along with a conversation with a high-level nurse, ultimately drove Myers to create TrackMyMilk to streamline patient-to-doctor communication about milk supply. She found a team of software builders well-versed with Epic, the software company that owns the digital health record apps for YNHH patients, and partnered with Michelle DeWitt, Epic pharmacy app and orders application coordinator at YNHH. 

Before I joined YNHHS ITS I was a Neonatal ICU Nurse,” DeWitt wrote to the News. “I have a passion for helping new moms with breastfeeding. When Eliza first approached, she wanted to integrate with an app and Epic. [I had] the idea to create an Epic solution for this issue and allow us to give providers all the necessary information in one place.”

Last August, Myers and DeWitt, along with the rest of their team, were awarded the Yale New Haven Health Innovation Award to help kickstart their project. The grant is given to early-stage projects which promise novel solutions in healthcare development. Since then, TrackMyMilk has become integrated into the workflow and educational programming in the neonatal intensive care unit of Bridgeport Hospital. 

“The YNHHS Innovation Awards is a new initiative launched in FY22 with the goal to provide needed resources to YNHHS employees and Yale University faculty working on promising ideas with potential for impact,” Lisa Stump, chief information and digital transformation officer at YNHHS, wrote to the News. “Winning selections are working closely with the YNHHS Center for Health Care Innovation to implement their proposals according to milestones outlined in their submission.”

With this support, TrackMyMilk has rendered the data-sharing process more efficient and accessible due to its smartphone format. From the patient side, Myers likens its benefits to a “Fitbit effect,” in which individuals with a Fitbit become motivated to walk because they can see their step counts in real time. Similarly, parents who use TrackMyMilk are more likely to meet the pumping goals assigned to them by their doctor because they have both an incentive and a convenient means to monitor their daily progress. 

On the other end, the consistency of this data collection can help doctors flag possible irregularities in the parent’s milk supply. 

In one instance, a mother who produced enough milk for their newborn — at least in proportion to her baby’s size and weight — had always been considered healthy. However, it was not until Myers looked closely at TrackMyMilk that she realized the mother should have been making much more milk in actuality and that she did not follow the natural progression of escalating and plateauing at a normal maintenance rate.

Myers ran a more comprehensive health assessment which detected low levels of prolactin — a hormone necessary for breastfeeding — and prescribed medical treatment. 

“She was thrilled with that intervention, which never would have happened if we hadn’t had that daily data point for over the course of a week or two,” Myers said. 

In an opposite case, TrackMyMilk picked up on a woman who was expressing dangerously high levels of breastmilk at 2000 milliliters per day — an anomaly that would have gone unnoticed if not for TrackMyMilk, according to Myers. The medical team intervened to downregulate the patient to a normal amount of milk. 

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

By proxy, parents who engage with this platform can view their babies’ medical record and any progress notes written by their doctor. Myers noticed how, increasingly, patients using the app learned to ask more specific questions — and get more specific answers — about all aspects of their babies’ care.

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

This kind of education is especially important for individuals less well-versed in medical knowledge. Non-English speaking individuals, who comprise a significant portion of YNHHS’s patient base, are less likely to take home a baby on a human milk diet simply because they do not know the best practices for producing milk — nor how to ask their physicians to teach them. 

Myers hopes that TrackMyMilk can create a more equitable system of care and education for these populations, though she acknowledges the infrastructural constraints in place: MyChart, which is owned by Epic, has only been developed for the English and Spanish languages. 

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

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

She briefly entertained a day where the Epic corporation acknowledges the merits of TrackMyMilk and integrates it into their software as a ubiquitous, permanent fixture — but also recognizes the difficulty of getting even just one staff group to implement a new system. 

Even as she takes small steps forward, Myers already feels gratified hearing her patients’ narratives of taking ownership of their breastfeeding. 

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

Bridgeport Hospital was founded in 1878.

Samantha Liu covers Community Health & Policy for the SciTech desk and serves as co-chair for the Diversity, Equity & Inclusion Committee. As a Global Health Scholar, she studies English and Molecular Biology.