A new study evaluating the impact of virtual lactation support found it boosted maternal health and breastfeeding success outcomes.
The study evaluated SimpliFed, a virtual baby-feeding platform led by UMass Chan Medical School. Participants who completed three or more telelactation visits breastfed for nearly 16 weeks longer than those who did not engage with any visits. The impact was even more drastic for moms with mental health conditions, where average feeding duration increased by 24 weeks. The study, presented as a poster, is not yet published online.
The researchers recruited a group of 200 participants from prenatal through postpartum. All were offered unlimited access to the SimpliFed platform for 12 months. Utilization was evenly split: a third did not complete any visits; a third completed one to two; and a third completed three or more.
Dropping breastfeeding rates over time were common, mirroring national trends. Most participants, regardless of whether they engaged with SimpliFed, breastfed at one week postpartum; three-quarters did by six months; and about half did at 12 months. However, completing three or more SimpliFed visits led to longer duration of breastfeeding compared to others in the cohort.
Another positive impact, for women with mental health diagnoses in particular: those who engaged in more virtual visits experienced greater reductions in symptoms of anxiety and depression over time, as measured by GAD-7 and PHQ-9 assessments.
The American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding for the first six months to support positive health outcomes. While lactation support can be available in the hospital setting, it drops off when a new parent goes home with their baby. At discharge, breastfeeding may not yet be established and a family could benefit from ongoing support. Yet between rushed pediatric visits, competing priorities and limited community resources, parents often struggle to get support, SimpliFed executives argue.
“There's great support in the hospital, but your milk hasn’t often come in yet,” SimpliFed founder and CEO Andrea Ippolito said. “After you leave is when the resources are sparse … and that’s actually when your milk comes in.”
"There's a lot of additional support that families would benefit from,” echoed Nisha Fahey, D.O., assistant professor of pediatrics at UMass Chan who worked on the study. “This near-real-time intervention is incredible.”
Acknowledging the “Fed is Best” movement, which started in 2015 in response to the “Breast is Best” concept historically promoted by WHO and others, Fahey said that breastfeeding is not the path for every parent.
“There are medical benefits that have been established in the literature about breastfeeding benefits for both mothers and infants. However, I do also strongly believe that breastfeeding has to align with the intentions and goals of that pregnant person and that person,” Fahey said, adding at the end of the day, “I believe a fed baby is best.”
The Fed is Best Foundation says on its site that it represents families whose babies were malnourished due to insufficient breastfeeding under current guidelines and who were shamed for feeding babies with infant formula. This may be for a variety of reasons, including social determinants or having insufficient breast milk. Some critics of the exclusive breastfeeding idea claim “fed is best” does not deny the benefits of breastfeeding, but rather encourages the idea that formula is also safe. To that end, SimpliFed bills itself as an agnostic breast- and baby-feeding support platform.
The UMass study was a pilot, and additional research is needed to understand how best to reach all patients equitably, per Fahey. For example, while the study recruited a relatively representative sample, patients with higher levels of education and on commercial insurance had statistically significant higher levels of engagement. This is not entirely unexpected and exists across other research, Fahey said.
SimpliFed offers on-demand messaging and virtual visits within two hours on average, with board-certified lactation consultants and other providers. Appointments are available every day of the week from early morning to late evening. SimpliFed also offers maternal mental health screenings and care navigation. It is covered by major commercial payers, some Medicaid plans and TRICARE, with generally up to six visits covered. Marketplace plans and other plans are required to offer breastfeeding support. It is a grade B U.S. Preventive Services Task Force recommendation, meaning relevant plans must cover it.
“We just see overall that people don’t know that they have access to this type of support,” Ippolito said.
SimpliFed, founded in 2019, closed its $10 million series A funding round earlier this year. This year, it will get referrals representing 5% of all pregnancies in the U.S., according to Ippolito. The company’s referral partners include health systems, OBGYN practices, federally qualified health centers and nonprofits.
Together with its partners, SimpliFed designs custom safety and escalation protocols to ensure patients who need in-person support get it in a timely manner. This doesn’t only apply to lactation support, but also mental health and other health conditions that it catches early, like anemia. SimpliFed hopes to show with the latest data that by reaching parents early, they can improve health outcomes and save downstream costs.
“When you identify issues early, you can prevent them from escalating,” Ippolito said.