# Multi-modal Intervention for Lactation Care (MILC) will be a mHealth platform to increase

> **NIH NIH R44** · BENTEN TECHNOLOGIES, INC. · 2021 · $313,508

## Abstract

PROJECT SUMMARY/ABSTRACT
The 2017 Centers for Disease Control and Prevention’s (CDC) Breastfeeding Report Card reported that
despite a high breastfeeding (BF) initiation of approximately 80% among the Hispanic population in the United
States (US), less than 25% of infants were exclusively breastfed (EBF) through 6 months, further perpetuating
ethnic disparities in chronic diseases such as diabetes, obesity, and hypertension. Hispanic women are more
likely to supplement feeding with formula, than non-Hispanic or African American (AA) mothers. Research has
reported that barriers such as insufficient BF education, lack of BF technical support (i.e. latching issues, sore
nipples), returning to work, easy access to free or discounted formula milk from Women Infants and Children
(WIC), lack of social support, perceived inconvenience, cultural belief that both formula and breastmilk (los-
dos) is best for the babies, perception that the infant is not satiated, and embarrassment associated with
breastfeeding result in premature weaning off BF among low-income Hispanic mothers. Therefore, increasing
the duration of EBF and continuous BF among low-income Hispanic women would require an innovative and
comprehensive approach that addresses the diverse range of barriers listed above. The proposed Fast-track
proposal titled Multi-modal Intervention for Lactation Care (MILC) will be a mHealth platform that consists of
the following innovative components: 1) Chat bot system to provide virtual peer counselor support; 2) Use of
escalating magnitude of incentives contingent on remotely observed breastfeeding; 3) Asynchronous and
synchronous communication tools to facilitate lactation and social support; and 4) Virtual peer mother to
mother support network. We propose the following aims for the Phase I:
1) Conduct formative research with a) low-income Hispanic mothers, b) Certified and international board-
certified lactation consultants (CLCs/IBCLCs) and c) in-depth Interviews (IDI)s with WIC staffs/primary care
providers (PCPs).
2) Conduct pilot testing of MILC prototype with 20 low-income Hispanic BF mothers who delivered their babies
at TUH and 5 CLC/IBCLCs working at TUH to demonstrate feasibility (usability and acceptance).
We propose the following aims for the Phase II:
1) Modify Phase I MILC prototype for commercialization and;
2) Conduct a randomized control trial (RCT) with 178 participants from TUH and Christiana Care Health
System (CCHS) and 20 CLCs/IBCLCs on MILC to assess MILC’s efficacy to significantly improve EBF rates at
6 months including increasing rates of any BF at month 1, month 3 and month 6.
In the long term, the impact of MILC will increase the rates of EBF up to 6 months along with increasing rates
of any BF up to 12 months.

## Key facts

- **NIH application ID:** 10401171
- **Project number:** 1R44MD017174-01
- **Recipient organization:** BENTEN TECHNOLOGIES, INC.
- **Principal Investigator:** Tony Xuyen Ma
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $313,508
- **Award type:** 1
- **Project period:** 2021-09-18 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10401171

## Citation

> US National Institutes of Health, RePORTER application 10401171, Multi-modal Intervention for Lactation Care (MILC) will be a mHealth platform to increase (1R44MD017174-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10401171. Licensed CC0.

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