Pain Points and Triumphs: 3 Ideas for Innovating the Breastfeeding Experience
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Nipple shields.
Lanolin.
Pump. Feed. Repeat.
Mastitis.
APNO (All-Purpose-Nipple-Ointment).
Lecithin.
Antibiotics.
An abscess the size of a kiwi.
The first three months of my son’s life seemed to revolve around my breasts in a cascade of events my husband described as a “parade of maladies.” In my day job as an innovation consultant, I spend a lot of time thinking about the proverbial pain points, yet I did not expect the physical and emotional labor associated with feeding my baby, something I had assumed would come easily and “naturally.”
My son, Nikolai, arrived three weeks ahead of schedule, just on the cusp of being considered full term. He struggled with jaundice and slow weight gain. We spent the first few weeks shuttling between pediatrician and lactation consultant appointments, attempting to assess the “efficiency” of his feeding and the severity of a potential tongue-tie, which was causing me considerable breastfeeding pain. Watching the scale, seemingly frozen at 7 pounds 2 ounces, I worried about my milk supply due to a confluence of factors: an endocrine condition, my son’s jaundice, and nightly, insatiable cluster-feeds. My lactation consultant recommended pumping to increase supply. My midwife suggested APNO to heal lacerations and prevent infections. My pediatrician gave me permission to supplement with formula. To process and supplement abundant advice, I spent many nighttime hours online, learning about power pumping and fenugreek.
Mastitis, colloquially known as the “boob flu,” was quick to follow. Overnight, I developed a 103°F fever, chills, dizziness, and what felt like an anvil in my right breast. It was the first time since Niko’s birth that I did not bother getting dressed for the day and sobbed openly on the couch. Thus began a daily pattern of taking fist-fulls of medications and supplements: antibiotics for the infection, topical APNO, lecithin to prevent further clots, fenugreek to defend milk supply, and various vitamins and probiotics to round out the cocktail.
The fever and pain abated, yet the lump persisted. Since it was no longer symptomatic, I ignored it, joking that Niko’s feedings now included both milk and cheese. Yet it continued to grow and harden. Again, I sought advice from lactation consultants, pediatricians, and online forums. I tried everything — cold cabbage leaves; hot showers and warm compresses; pumping; an electric toothbrush and a wide-tooth comb; breastfeeding positions fit for an acrobat; an iodine grid around the lump; garlic… If it was mentioned or written anywhere, in English or Russian, I tried it. Nothing worked.
Meanwhile, the mass in my breast matured to the size of a kiwi, becoming red with visible anger. The inflamed, broken skin horrified both my lactation consultant and my midwife, who immediately referred me to the hospital breast center for an ultrasound and a secondary round of antibiotics. Unfortunately, I developed an allergic reaction, debilitating myalgia and joint pain. My nurse found a second antibiotic compatible with breastfeeding but could not diagnose or resolve the pain. My family’s life revolved around my breast. I was either feeding, pumping, massaging out the lump, or going to the hospital to hear that nothing had changed.
After several weeks and two ultrasounds, I developed an abscess that would make aspiration worth-while. I worried that the needle might puncture a milk duct and necessitate weaning, but the doctor informed me this risk was low and that at this stage, I really had no choice. Fortunately, the procedures went well. The first one produced 30 ml of infected, green milk. The second yielded 10 ml. The specialists agreed that I did not need the third. Three months after my son’s birth, I was finally free to truly enjoy feeding.
Through the illness, self-doubt, emotional exhaustion, and postpartum lack of sleep, I was fortunate to have the support of my partner, who offered water, medication, and levity by writing poetry about breastfeeding struggles and triumphs; my employer, who provided generous family leave and a second, travel-sized pump; and family and friends, who visited to help change diapers and cook hot meals. Nonetheless, my breastfeeding experience, and the experience of many women who receive fragmented care and incomplete information, is ripe for innovation.
The question healthcare providers, device manufacturers, and insurers should be asking centers around a mother’s (aka the “customer’s”) experience: “How might we support a mother’s confidence in her ability to breastfeed?”
I would like to offer three ideas for consideration.
1. Curate a supportive community centered around the mother. The healthcare system is fragmented, resulting in inefficient, inadequate outcomes for sleep-deprived, time-poor parents. I saw no fewer than six different providers for breastfeeding and postpartum support. Each time, I had to recount my symptoms, medications, and recommendations from other providers. Unlike many parents, I was fortunate to have extended family leave and a partner who could care for our son through my many appointments, but not everyone has this flexibility. Home visits from a dedicated nurse or midwife might have diagnosed our challenges early and accelerated recovery.
To supplement the information I was receiving from my providers, I cobbled together a range of online resources with forums for new-mother support: the app GlowBaby; a local moms Facebook group; KellyMom.com; and MommaStrong. These communities offered advice, reassurance, and a sense of camaraderie. Providers and device manufacturers could consider curating similar groups, aligned to the baby’s age or device purchase location, or directing new parents to existing resources, such as ZipMilk or La Leche League, to enhance and extend the experience beyond the pump.
2. Anticipate the milestones with tailored programs. A mother’s experience with the breast pump has many milestones: first introduction to pumping (How to assemble and clean the pump? How to store milk?); potential challenges with breastfeeding (How often and how long to pump to maintain supply?); return to work (What to wear to pump more easily? How to clean pump parts away from home? How to keep milk cool during the commute?); to eventual weaning (How to prevent clogged ducts or mastitis?).
Healthcare providers and device manufacturers could consider anticipating these milestones along the “mother’s journey.” For example, a pre-birth survey could begin to customize resources and continue to be refined over time. How long does the mother plan to breastfeed? Will she pump exclusively? An app or an email campaign could anticipate key moments and provide resources. A health avatar or chatbot could answer common questions and provide just-in-time information, directing a mother to an online lactation consultant, as needed.
Ideally, these resources should be set up well before delivery and reinforced by providers soon after the baby’s birth. As I write this six months postpartum, I realize that Medela does offer some support through an app (to my knowledge, Spectra does not). I am sure the app must have been featured on an insert we promptly stacked with the rest of the hospital paperwork to read after a few hours of sleep… and let’s be honest: if a nurse, a lactation consultant, or a friend does not encourage a new mother to download the app early on, by six months in, it is already too late.
3. Think outside the (pump) box to enhance the initial pumping experience. New parents have many questions, ranging from how to use and clean the pump to how to store and heat breast milk. I skimmed the manuals in those critical early days and did not realize that designs of my Spectra S2 and the Medela Freestyle differed in fundamental ways. Consequently, I used the Spectra incorrectly for weeks before realizing I need to activate the let-down cycle manually (the Medela does this automatically after 2 minutes of pumping).
Both Spectra and Medela provide instructions to support a mother’s confidence to breastfeed and pump, yet they could do more to create a positive — and dare I say it? — luxurious first experience. For example, they could consider partnering with others to offer cross-promotions, packaging delightful surprises together with the breast pump to pamper a tired new mother: an eye mask, soft, cozy socks, a packet of tea, samples of lanolin, a bar of chocolate. They might even enhance the digital experience by offering a relaxing playlist or an inspiring documentary. These items would position pumping as a mini-retreat and a quiet sanctuary, rather than a chore tightly squeezed amidst chaos.
First interactions with a product, service, or a brand are critically important to “customer experience.” My breastfeeding and pumping journey got off to a rocky start due to a range of factors, and I consider myself fortunate to have been able to persevere in feeding my son. While I cannot single out one weakest link, the breastfeeding ecosystem could have been better designed to offer more coordinated resources to enable success earlier in my journey.
