# The Impact of Telelactation Services on Breastfeeding Outcomes among Minority Mothers: Siteless Tele-MILC Trial

> **NIH NIH R01** · RAND CORPORATION · 2020 · $510,317

## Abstract

Project Summary
Breastfeeding offers many medical and neurodevelopmental advantages for mothers and infants; however, the
majority of mothers stop breastfeeding before it is recommended, with less than half of infants receiving breast
milk at six months of age. Professional lactation support by International Board Certified Lactation
Consultants (IBCLCs) increases breastfeeding duration and exclusivity (i.e., proportion of breast milk in an
infant’s diet); however, many communities lack access to IBCLCs. Racial and ethnic minority mothers have
lower breastfeeding rates, and limited access to professional lactation support may contribute to this disparity.
Virtual “telelactation” consults that use two-way video have the potential to increase access to IBCLCs among
underserved populations. Telelactation is convenient because it does not require a new mother to travel with
her infant and can be provided on demand. Telelactation is also less costly than an in-person visit. Since 2015,
several companies have begun to offer telelactation through a direct-to-consumer (DTC) model, where women
initiate video calls with providers using their personal devices (e.g., mobile phones); however, no published
research has linked telelactation with breastfeeding outcomes. To address this evidence gap, we will expand on
a successful pilot study that demonstrated the feasibility and perceived value of telelactation in a rural
community, and conduct an innovative “siteless” randomized controlled trial to evaluate the impact of DTC
telelactation on breastfeeding outcomes. We will recruit 2400 primiparous pregnant women age >18 who plan
to breastfeed and live in the 17 states most underserved by IBCLCs. Recruitment will occur via Ovia, a popular
pregnancy tracker mobile phone application. Women will be randomized to: 1) on-demand telelactation video
calls on personal devices or 2) usual care. Quantitative data on breastfeeding rates, as well as qualitative data
on experiences with telelactation, will be captured via surveys and in-depth interviews and compared across
racial and ethnic groups. The specific aims are: 1) Assess the impact of DTC telelactation breastfeeding
duration and exclusivity, compare effectiveness by race/ethnicity and rural/urban location, and explore
whether self-efficacy serves as an explanatory mechanism; 2) Explore how acceptability of and experiences
with telelactation vary across subpopulations of mothers. This research aims to improve children’s health and
reduce disparities in key maternal and child health outcomes. It will also inform the design and execution of
future siteless trials among pregnant and postpartum women to enhance minority participation in research
and reduce the time and resources required to surface evidence on the impacts of new eHealth interventions.
Study results will inform policy debates about reimbursement of telelactation and will identify strategies to
further tailor these services to meet the needs and preferenc...

## Key facts

- **NIH application ID:** 10048706
- **Project number:** 1R01NR018837-01A1
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Lori Uscher-Pines
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $510,317
- **Award type:** 1
- **Project period:** 2020-09-15 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10048706

## Citation

> US National Institutes of Health, RePORTER application 10048706, The Impact of Telelactation Services on Breastfeeding Outcomes among Minority Mothers: Siteless Tele-MILC Trial (1R01NR018837-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10048706. Licensed CC0.

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