A few months ago a story out of Australia caught my attention. A research study conducted at Queensland University of Technology showed that new mothers who received cell-phone based text-messaging support (also referred to as SMS, which stands for Short Message Service) were four times less likely to stop breastfeeding than those who did not. This collision of technology with nature’s perfect infant nutrition piqued my interest and I wanted to learn more (self disclosure – I’m a bit of a technophile). While details of the study have not yet been published, I was able to talk with an IBCLC who uses SMS, as well as hear the perspectives of several nursing mothers. This post is intended to share this story and also generate a conversation about what other practitioners have experienced using text-messaging to support breastfeeding moms. Please join in the discussion!
An IBCLC’s Perspective
Robin Kaplan, IBCLC and founder of San Diego Breastfeeding Center, LLC, offers mothers the option to communicate with her via SMS after she conducts an initial in-home consultation. She estimates that about 25% of her follow-up communication is through text-messaging, with some clients using it for 100% of their contacts. The nature of Robin’s texts are primarily responding to questions from new mothers (moms can include a photo with the question to help in diagnosing some problems), as well as checking in with mothers to see how they are doing. One of the benefits of text messaging is that it isn’t interruptive, like a phone call may be, and it can be managed from a time perspective (versus not knowing how long a phone call might last). This seems to be important for new mothers, as Robin gets more responses from texting than she does from phone calls. Texting is also conducive to the round-the-clock hours that nursing mothers keep. “They can leave me information any time they want,” says Robin. From a business perspective, she sees texting as time and cost-effective. “It makes a lot of sense!”
“When you have a sleeping baby, or you’re just too tired to get into a long conversation, texting is so convenient,” said texting mother, Tracy. “Robin was able to get straight to the point and offer quick responses to my questions, which were very helpful… Though some might think it’s impersonal, texting is still a conversation and a readily available one at that, I really appreciated the instant gratification.”
Adoptive mother, Danielle, said text-messaging support was a huge help in establishing her breastfeeding practice. “The reason texting worked for me is that my consultant, Robin, was always quick to reply… This [breastfeeding an adopted infant] is a new frontier and being able to text when your baby is asleep in your arms is so helpful… For me, texting as opposed to verbalizing sometimes kept me a bit calmer. I always know I can call if I need to. The ability to have both options, however, was great.”
According to Erin, “Because newborns require so much attention around the clock, texting was the easiest form of communicating with Robin. It allowed me to send her a quick message, an update or ask a question without regard to the hour or any of the long winded social niceties that a telephone conversation would require. By the same token, Robin was able to check in on my progress, offer much needed practical advice and soothe my worries with most welcome words of support.”
On the Bleeding Edge
How does text-messaging fit into healthcare privacy laws that might impact lactation consulting care? This will vary country by country, and many governments are still trying to figure this out. Robin said she is moving towards printing and then deleting text messaging conversations and adding them to patient records. She deletes photos immediately. Having a password lock on your phone is another measure of security. It’s always important to get a mother’s consent before you begin sending text messages.
What has your experience been with adding text-messaging support to your lactation practice? We’d love to hear your stories!
By Maryanne Perrin MBA, graduate student in Nutrition Science, and ILCA volunteer
I offer all my moms the option of calling me, e-mailing me, or texting me with questions after I have seen them. I think the e-mails & texting run about neck and neck with calling a distant third. Moms love the options, and I think we all find that texting and e-mailing is much less disruptive to our lives. One of the advantages of electronic communication is that I can send links to videos or articles that may be helpful in that mom’s particular situation. What an amazing change since I started practicing in 1985!!!
Jan Barger, RN, MA, IBCLC, FILCA
A great article (and I think I’ll let it inspire a blog post of my own to encourage my clients to use text messages to reach me). I, too, communicate frequently with clients through texting. I find (and ask at intake) that each mom has their own preferred method of communication and I really try to match my communication with them to what they want.
I, too, delete photos immediately and also have an email record of all texts I receive as my work phone is a Google Voice number (and texts go to that number as well).
We work with many moms returning to work while breastfeeding – texting is perfect for them, only a quick moment to send a note and they can receive our feedback, short and sweet, when it is convenient for them. Not a replacement for in person consultations but super for follow up.
Good to see that research is backing it up! We are using texting, email and Facebook to reach mothers in our WIC peer counseling program in Shasta County. I have seen success within out county. Phone calls still make up the bulk of our peer counseling but without email and texting there are mothers that we would never reach.
I am wanting to implement this at my local WIC clinic, however, we do not have a Peer counselor program and the work phones do not support SMS. If I wanted to follow up with a mom via text I would have to use my personal phone, which I am not willing to do at this point. I have used email to some extend successfully, but would really like to add SMS to our services. Have any other WIC clinics dealt with this challenge?
Sally, several WIC clinics are piloting SMS support for breastfeeding moms. We are working on a story for the Lactation Matters blog about this very subject, so please stay tuned!
My name is Jacquie ,I’m from Australia and have been trying to introduce SMS messaging to all my antenatal clients . I am interested in how you overcome the medico-legal aspects and anyother research documents or papers you have relating to this practice. I am,a midwife and childbirth educator and working towaerds IBLC this year.>looking forward to any responses
I, too, am interested in knowing more about the medico-legal aspects of SMS messaging in the USA. I provide both hospital and community-based antenatal and postnatal out-patient services to a high-tech population. Any info would be appreciated!
Diana Chisholm Estep, RN, IBCLC
I am a Midwife, IBCLC, Childbirth educator and due to complete my Maternal and Child Health Nursing in a few weeks. I’m from Australia and have my own private practice.
I encourage clients to SMS me for brief questions or to call me. If they send me long winded texts (usually super anxious mums) I give them a call. I delete the messages promptly. I am not surprised by the content of this article – I may send mums a quick “hope all is going well – call me if you need me” type SMS and I’ll often leave a little pic text of a flower or a smiley face. Mums love that touch and say that makes a huge difference.
I have just added Skype and FaceTime consults for quick Q&A’s and Assessments as I have advanced skills in oral motor function assessment. It is a bit of a watch this space. First trial – connection was terrible, when I worked out my software was outdated :-(. Have since sorted it out and yet to have such a consult. I know I’m not the only IBCLC who does this – does anyone else know if it is effective, can anyone think of any medico legal issues. We have Telehealth here in Australia where remote communities are able to access medical support and assessments via Skype! Any ideas? Comments?