Breastmilk Testing: Why Measure the Quality of Your Breastmilk? with @lactationlab Stephanie Canale, MD

Stephanie Canale (2m 3s):

For a lot of moms, it's just tweaking their diet. Do they really need the hundreds of dollars of supplements a month? No, a lot of times it's just different foods they need to eat and that can actually make up for whatever is potentially lacking. And sometimes there's nothing lacking.

Katie Ferraro (2m 18s):

Hey, there Im Katie Ferraro Registered Dietitian college nutrition, professor and mom of seven specializing in baby led weaning here on the baby led weaning made easy podcast. I help you strip out all of the noise and nonsense about feeding, leading you with the competence and knowledge. You need to give your baby a safe start to solid foods using baby led weaning. Hey guys, welcome back. And today we're talking about Breastmilk, but this is a different type of breastfeeding episode than you might have been expecting. We're going to be talking about the quality of your breastmilk and testing your Breastmilk. My guest today is Stephanie Canale.

Katie Ferraro (2m 58s):

She's a medical doctor, the founder of lactation lab. Now lactation lab analyzes Breastmilk for its nutrition content, and then provides dietary recommendations that allow moms to make the decisions for their bodies and their babies. I have to be fully honest with you guys. The first time I heard about the concept of Breastmilk Testing, I was like, oh my gosh, this is so bogus. Like, I'm sure you just send us a sample of your breastmilk and, and they send you back this whole panel of supplements that you need to take and convince you that your breast milk is inadequate to feed your baby. First of all, I was way off base because Dr. Kelly works with Registered Dietitian. Yes, she tests your Breastmilk and her team and the technology that she created does. And oftentimes they'll find some imbalances in the nutrient quality of the Breastmilk some changes that can be made in mom's diet, but she does not promote or sell supplements.

Katie Ferraro (3m 43s):

So if you guys know me, I always have other credentialed feeding or professional experts on the podcast to do a lot of research about this one, because this is certainly an emerging area in breastfeeding nutrition and breastfeeding as a field. But Dr. Canale again just blew me away. So she is a medical doctor. She got her undergraduate medical degrees from McGill university completed her residency training in family medicine at UCLA. She was part of the teaching faculty at UCLA for a while. She no longer teaches there, but again, her research is based out of there. She's a member of the American family of board medicine, and she's here today to chat with us in an episode that's called Breastmilk Testing. Why Measure the Quality of Your Breastmilk? And I want to say, thank you to Elena Facina.

Katie Ferraro (4m 25s):

Elena is a mom. Who's also a dietician she's breastfeeding. And she's the one that told me to check out Dr. Canale and to get her on the podcast. If you guys have a good idea for a podcast episode, I find my best ideas from you. If you could leave me a review on apple podcasts, I scan and read every single one of the reviews, drop your episode idea in that review. And hopefully we can interview the person that you're interested in talking to. So Elena, thank you so much for putting us in touch with Dr. Canale. I've got to let her tell her story. If you guys are even remotely interested in breastfeeding and personalized nutrition, I think you're really, really going to enjoy this episode again, it's Breastmilk Testing. Why Measure the Quality of Your Breastmilk with lactation labs?

Katie Ferraro (5m 5s):

Stephanie Canale.

Stephanie Canale (5m 10s):

Oh, it's so nice to be here. Thank you for having me

Katie Ferraro (5m 12s):

Before we dive into Breastmilk Testing. Can you tell me a little bit about your background and how you got into medicine and then how you came to specialize in this like very niche area of maternal health?

Stephanie Canale (5m 22s):

Well, I never thought I would be here. That's number one. So I'm a family medicine. It was my specialty. So I went to medical school in Canada, from Montreal, came to UCLA where I did my residency and I stayed on faculty for about 15 years. I'm a mother of two and I struggled so much with breastfeeding. So my patient struggled quite a bit. My practice really became geared about 50% pediatrics, mostly a lot of newborns. And it was through that my own personal struggle and watching my patients struggle that I was like, oh my gosh, what is going on here? We need to take the guesswork out of breastfeeding and that how lactation lab was born.

Katie Ferraro (5m 59s):

So tell me a little bit about what lactation lab

Stephanie Canale (6m 1s):

Does. So we're a Breastmilk Testing company to really take the guesswork out of this and to figure out what is in your milk and how your diet affects your milk. How this came about was I wanted to breastfeed. I wanted to be that mom that was like sort of the perfect mom instinct. You know, this is before Instagram, but you know, the mom that just had baby latch, new issues, enjoyed it. And I failed miserably with my son and the money I had my daughter. I had so much pressure that I put on myself to do that. Now she was failure to thrive. So she was falling off the growth chart, uniquely breastfed, and she started to have these issues where she'd have a bowel movement every 12 days she's losing weight. And it really, I mean, the only factor here was me and I had no issues with milk production.

Stephanie Canale (6m 43s):

I was one of those women that could pump two, six ounce bottles in five minutes. So volume wasn't the issue clearly what was in there, something was lacking. And it was really, really hard for me to figure this out because I would go and I want to know just like when a patient would come into my office and say, oh, I don't feel good. I'm tired. I'm this. We could run these tests. We could figure it out. I couldn't figure it out. I went to a very dark place. I was like, why can't I figure this out? Why is this so hard? Why doesn't anybody notice? And so this is how it all came about of like, why don't we know more about this? Like, why is Breastmilk this big, mysterious entity that we're just supposed to assume? It's just perfect for all of our children. The day I gave my child two ounces of formula, she was happy, less fussy poop.

Stephanie Canale (7m 27s):

So there was clearly test case scenario here, something missing.

Katie Ferraro (7m 30s):

You said two things about the anecdote of your own child that really jumped out at me is because we so often encounter moms who are like my breast milk isn't working and we of course want to support and encourage moms. And I know you're going to get to the part where you explain the benefits of breast milk and that not all moms have these issues, but when you tell me you had growth, faltering your child, falling off the growth curve and no bowel movement for 12 days. Like those are huge red nutritional flags. Most parents will come in and be like, I feel like my baby's not getting enough. And then we weigh them and we do all the anthropometrics and we're like, no, your baby's perfectly fine. Not like it's all in your head mom. But like the data is showing us that your baby is tracking the way they're supposed to on the growth curve. And if they're having regular bowel movement, every couple of days even would be normal, but 12 days certainly is not.

Katie Ferraro (8m 12s):

So your situation, if you don't mind just reiterating, that's not typical, correct?

Stephanie Canale (8m 18s):

It's not typical. About 15% of term babies are failure to thrive. And for whatever reason, you know, and it's not about like, first of all, what a horrible diagnosis, right? The term failure to thrive.

Katie Ferraro (8m 29s):

I don't even use the term failure to thrive actually nutrition anymore. We refer to it as growth faltering because there's such a negative connotation. It is you have not failed. You are faltering.

Stephanie Canale (8m 38s):

Well, right? I mean, my daughter's nine now. So our diagnosis was pretty clear back then it was failure to thrive. And you know, that just leads back to what is the factor here? It's me, my diet, that's it. It's not like she had, you know, this is when she was, you know, less than a month old. So it's not like she's getting any other food or whatever,

Katie Ferraro (8m 56s):

But didn't you worry? Like she had some, I would think like some underlying metabolic condition, like why are you not utilizing this perfect nutrition that I'm making? Because we've all been told that Breastmilk is perfect. And I think that's where your story comes in. Right? Cause it's not all Breastmilk is created the same. Is that a safe assumption?

Stephanie Canale (9m 10s):

And I think there's variability between moms that same mom, you know, it can vary. I mean, what we eat affects our milk period. And that's like my mission in life now is to take the guesswork out of this and stop the assumptions and stop assuming that it's just, we're not here to say like, oh my gosh, every child needs formula breastfeeding. We're not, I'm not going to be on any side of this. Both of my children would have died if formula did not exist.

Katie Ferraro (9m 37s):

Quadruplets and I sucked at breastfeeding. I struggled so bad with my oldest who was a Singleton. I pumped exclusively. She had terrible nerve damage at birth. She couldn't transfer. She would latch perfectly and not transfer. I'm like, what the heck is happening? Like every lactation, it sounds like you're doing a great job except you'd wear before and after a feed. And there was 0.0 milliliters of transfer. Like it was terrible. And if it weren't for a breast pump, she would have died. And then I had quadruplets and I was like, I'm not even going to try, like, I'm going to pump like crazy, but like, I'm not going to try to concurrently nurse four kids at once. And then I had twins after that and I tried and I sucked at tandem breastfeeding. So like, if it weren't for the breast pump, I feel like my kids would have died. And I always had to supply them with formula. And that you have parents have this feeling of shame about formula, but I was like, thank God for it.

Katie Ferraro (10m 17s):

Like it saved my kid's life.

Stephanie Canale (10m 19s):

I really wanted to exclusively breastfeed. And my kids did have a good amount of only Breastmilk but clearly needed something else. And what I didn't want another mom to go through was that feeling of shame and guilt and just overall frustration and failure of like, what am I not doing? What am I not eating? What am I not? Why is this not working for me? And I want to bring data driven answers here, right? So the same way that when we see patients and we can say, oh, well, your B12 level is this. You need to eat more of this or take a supplement, whatever it may be. I want to bring that same data and information to breastfeeding moms so that there's no more guessing.

Katie Ferraro (10m 60s):

Dr. Canale, can you talk to us a little bit about the field of Breastmilk Testing? Cause I have to be honest, when another dietitian wrote to me, who's a mom who listens and was like, Hey, you need to interview this founder of lactation lab, who is all about Breastmilk Testing. And I kind of like rolled my eyes. And I was like, what? Like then I saw you're a medical doctor. And I was like, well, hold up. Maybe there's some legitimacy to this and then looked more into it. But like, to be honest, my first instinct was like, Hey, I've always been taught. Breast is best. Nobody wants to denigrate breast milk. That even like when you study it, for example, I teach nutrition throughout the life cycle. And whenever we're teaching about undernutrition and malnutrition, the party line is even if mom is malnourished or undernourished, the quality of her breast milk does not suffer.

Katie Ferraro (11m 41s):

The quantity might at which point it would be insufficient for the baby. But the quality is always perfect. Is that not true? Is what you're saying.

Stephanie Canale (11m 50s):

Absolutely not true. You cannot take a mom living in a developing country. Who's unbelievably poor and malnourished. I think that this goes to a bigger women's health issue here right now where women, you know, it's, they're a group of people who believe that it's innately stressful to say what I just said. I'm glad

Katie Ferraro (12m 8s):

You said it. To be honest if I said that on my own, without a lactation background, like people come after you. I think we all acknowledge that for a neuro-typical baby and a healthy mom. Breastfeeding is wonderful and Breastmilk is great, but there are certainly situations and thankfully there's experts like yourself to be, listen, that's not always the case. And if this is happening to you, like it happened to you, you can do something about it.

Stephanie Canale (12m 29s):

That's exactly it. I mean, it's more about, it's not just about empowerment. It's about data and information and making the best decisions. And you know, for a lot of moms, it's just tweaking their diet, you know, do they really need the hundreds of dollars of supplements a month? No, a lot of times it's just different foods they need to eat and that can actually make up for whatever is potentially lacking. And sometimes there's nothing lacking, right? So it's just figuring out what it is. But the reality is the differences vary significantly from mother to mother, there are so many other benefits of Breastmilk, right? You've got all these immune cells, stem cells, so many other benefits, including like skin to skin, contact and psychological and social emotional.

Stephanie Canale (13m 10s):

But what we're getting down to is just basic nutrition. A baby is eating the same thing every day. There's no very diet, right? For ideally for the first six months of life. That's what the recommendations say for the first six months of life. It's mostly Breastmilk, that's what it should be. So this idea that it's magical and it's just perfect. And even if a mom is malnourished, well, her body's going to figure out a way to just get extra calcium and get that extra B12 source. I mean, it just doesn't even make sense physiologically. But secondly, what it does is it really sends the message then that, okay, so what do you then tell them? We're just

Katie Ferraro (13m 44s):

Not trying hard enough. You're not trying

Stephanie Canale (13m 46s):

Hard enough. You failed. Your baby just needs more. So I had an example of a mom who had her second child thirty-five weeker was in the NICU for a very short period of time was their second child. She had no issues breastfeeding with the first daughter thrive Singleton. Second Singleton, born 35 weeks pumping. I mean just a ton of milk, huge stash donated milk. And the baby, actually, you know, when you come in for well-child visits, you check weight, height and head circumference. So it was just getting bigger and bigger and bigger. And again, you're not testing the baby for anything. You're not doing a blood test on the baby. You doing a well-check right? It's like exactly. So we noticed the head was getting a little bit bigger.

Stephanie Canale (14m 27s):

It turns out that they went to cranial facial. They saw these specialists, iron deficiency anemia was the cause. So yes, every breastfeeding mom should be giving their child an iron supplement and vitamin D supplement, but most, a lot don't because it causes an upset stomach. It causes gas and fussiness. And this mom did, she did when she remembered. But the reality is is that we picked this at six months of age, which you don't even routinely test for until a year of age. So what is the message you want to tell that mom then that, oh, she wasn't depleted enough. She saw her OB at six weeks. She had her blood test. What else is she supposed to do?

Katie Ferraro (15m 5s):

Did the baby of encephalopathy related to iron deficiency

Stephanie Canale (15m 9s):

From iron deficiency? Anemia, the head was growing actually quite big. Yeah. So we corrected the iron deficiency anemia and the head stopped the growth velocity. And

Katie Ferraro (15m 18s):

Then the mom was already supplementing. So how do you

Stephanie Canale (15m 20s):

Correct it? We supplemented with a much higher dose and much more frequently than what was

Katie Ferraro (15m 26s):

recommended. And I just want to stress here to everyone listening. Like the key there. It's okay to supplement if there's underlying diagnosed micronutrient deficiency, but we just don't go Willy nilly, spraying the baby with a bunch of supplements because we think they're not doing well. Like this is all under the care of a medical doctor.

Stephanie Canale (15m 41s):

I also want to stress too, that a lot of moms just go and take a lot of supplements. One thing that we've done on the side too, is we've tested for heavy metals in breast milk because we've had a lot of requests for that. And we've had a lot of cases of arsenic and lead in milk and the underlying source, are supplements.

Katie Ferraro (15m 58s):

Interesting. It's not environmental it's supplements. Yeah. And I think that's important to know parents think because they can buy something over the counter in the United States of America, that there's all these quality controls and there's absolutely not. Like you have to prove that the product is unsafe in order to have the supplement removed from the shelves. You do not have to prove that it even does what it says it does. And there's certainly, you know, you're the one that private company going and testing. This is not being done. You know, before that product goes to the market, for many types of brands are certainly big brands that have more scrupulous practices and more thorough controls. But I think parents are oftentimes really surprised to hear that supplements aren't as amazing as they once thought they are and that they could actually even be dangerous as you've indicated. Can we talk about the technology?

Katie Ferraro (16m 40s):

So what sort of technology existed or did you have to develop if you're a mom, you yourself, Dr. Canale . And you're like, well, I'm breastfeeding and my kid's eating a lot and yet there's something going wrong. Cause they're not thriving. Where did you go first to discover that it might've been in the breast milk? Or did you have to go invent the technology? We invented

Stephanie Canale (16m 56s):

The technology because I knew it was the breast milk because it was just one of those things. It was definitely

Katie Ferraro (16m 59s):

An intake. It's all the baby's getting. Right? Yeah. It's like the control. Exactly.

Stephanie Canale (17m 2s):

All my daughter was getting the moment I introduced formula all of the issues subsided. So it was really, I wanted to know what was in my milk. Why couldn't I get a nutrition label for my milk, like I had on the side of formula. So chromatic crit is something that a lot of hospitals still use nowadays it's D was developed in 1978. It's basically like taking a capillary tube, which is like the inner tube of a ballpoint pen, filling it with Breastmilk. So you can imagine just a couple of drops of milk, spinning it down. You can imagine how accurate this is 1978 technology, and then measuring the fatty layer from the watery layer, using a ruler to guess how many calories are in it. We needed to step it up. And that's really why we've been doing this over a couple of years.

Stephanie Canale (17m 43s):

So our lab is actually on campus at UCLA we're at the Nanosystems Institute where we actually use state-of-the-art multimillion dollar equipment to develop methods that are, you know, to be able to test for this and back to the supplement issue that the testing is expensive. That's why other companies don't necessarily see

Katie Ferraro (17m 60s):

Required either. Why would you potentially point out the heavy metals in your supplement capsules? If you don't have to

Stephanie Canale (18m 5s):

Our own methods of which we have patents pending on of how to test and measure these analytes in milk.

Katie Ferraro (18m 13s):

Okay. What's an analyte

Stephanie Canale (18m 14s):

Story like vitamins minerals milk is a complex fluid, you know, a lot of sugars in there, a lot of fat and the fat is quite variable from mother to mother. So really figuring out how we can extract and then test these samples consistently and develop our reference ranges. So our reference ranges of what is normal what's out of normal is basically from the literature we pulled every published study of data, no women in Kenya, from women to Canada at all over I'm looking at what were published values of, let's say B12, vitamin C, vitamin a calcium iron things that a mom's diet will affect her milk. And this is all based on literature.

Katie Ferraro (18m 53s):

This is so fascinating because you know, from a nutrition standpoint, so much of the quote unquote nutrition messaging around Breastmilk is subjective. It's perfect for baby. You trust your body. You will make enough. And yet, you know, formal kind milk. Like if we can talk about that, it makes sense that the composition of the milk changes throughout the feed. But to what degree, like, so you really can study that, right? Like the milk at the beginning of the feed versus the milk at the end, and having more fat at the end cause fat is a more satiating. Nutrient is internally telling the baby to slow down and stop eating because they're about to get full because there's more fat at the end, is that true or not

Stephanie Canale (19m 33s):

High milk for milk and high milk. It's just a timing issue.

Katie Ferraro (19m 36s):

Exactly. It's the same milk it's coming out of the same duct. Like,

Stephanie Canale (19m 38s):

But the first milk that looks more watery and less fatty by appearance actually contains more free fatty acids and amino acids, which is essential. You know, it doesn't make sense biologically, why a mom would produce a formula. You would imagine that the first milk that comes out is the most important. And it kind of is because it's the free fatty acids. It's stem cells with life. It's all good. Don't get me wrong. I mean, we just published another paper that basically said, look, any milk a mom can give is great because the bacteria in human milk, we did MRNs studies. It's just amazing. What's in there. I mean, when I first saw the data, I was like, okay, this got cross-contaminated with God knows what in the lab, but we tested over and over.

Stephanie Canale (20m 21s):

And it's amazing. I mean, there's listeria, salmonella, pseudomonas, this crazy amounts of bacteria, which are protective and beneficial for baby. So if a mom pumps one ounce and the baby gets one ounce of milk in a 24 hour period, great, they need that. That's fantastic. What I'm trying to say is like, if you need something else to really just support the overall growth and development of your child, that's fine. And let's stop shaming. People who need that. And instead support them to make those decisions. Whether it be based on their own intake, their diet, what they need to do, or if they want to go straight to whatever it may be. Like, what I'm saying is let's bring data to validate these decisions.

Katie Ferraro (21m 1s):

The other, I think old wives tale that gets passed around a lot. And I want to ask your opinion. I'm calling it an old wives tale is that mom's hydration. Status has no effect on Breastmilk composition. That can not be true if you are not taking in enough fluid and Breastmilk is a high water content food of course would affect the composition of the breast milk. Like I personally hate water and I was like, yes, I don't have to drink a lot of water. It's still pumped. Perfect. Breastmilk

Stephanie Canale (21m 25s):

It would be true. It's ridiculous to think that Breastmilk has made up of at least 75% water and hydration is number one. It is so critically important to milk production, but we're also learning is that, and this was our original study that we had done was we looked at moms in their third trimester and with MRN and gene expression, we're like, wait a second. Can we start predicting? Who's going to have issues with milk supply. They do this in cows, right? Cause they start breeding out the ones that don't work very well. So I'm like, wait a second. Could this overlap to humans? Some of our genome genes get expressed, whatever hormone under hormonal control.

Stephanie Canale (22m 5s):

And could we start predicting the over producers and under producers? Because that message then says, it's not you you're genetically programmed to do ABC. Now 50 years ago, a hundred years ago, what would happen? We'd sit in a group together. We'd be raising all of our babies together. There'd be one. Mom had produced a ton of milk. Guess what? She feed the other babies that needed a little bit more. It doesn't work like that nowadays. Right? And especially with COVID, everyone's even more isolated. Now we tried to do, and we did find it. Our sample size. Wasn't big enough for this study to show that the data's there, but there is some information to show, wait a second, there's a genetic predisposition to milk production. So again, every mom is different.

Stephanie Canale (22m 45s):

Every person is different, but beyond, and on top of that, you've got a genetic code. Let's say that at the time of delivery is driven by hormonal changes to determine who may have issues. And that message I want to get across to moms is it's not your fault. It's not try harder. It's not drink more water. If not go buy the $200 supplement, it's not drink this milkshake and everything's going to magically improve. It's not necessarily going to work. And you know what? Like let's stop pretending because that mom,

Katie Ferraro (23m 20s):

Yes, please let's stop. Pretending that buying a fancy cookie is going to make you produce more milk. I mean, honestly, I see so many parents falling victim to it's the same exact kind of marketing scams as a lot of the supplements. You know, there's a little bit of data to show that a few supplements might help a very small percentage of the moms, but don't feel bad if it's not, you understand the underlying data, which is what I love about your message. Could you tell us a little bit about the process? So lactation lab, the private side, that you are the founder of, what do you do and what services do you offer to moms? What does the process or the procedure look like?

Stephanie Canale (23m 53s):

So right now, what we have is our kits where a mom buys a kit, collects your milk at home. We have her pump throughout a 24 hour period. So collect a little bit of milk from each sample. And that's been in the published data collected for 24 hours, freeze it, send it into our lab and she gets an analysis. Now what we are getting ready to launch, which I'm super excited about is our macronutrient tester, which will be done in the comfort of a mom's home. So when you're thinking, when you go to the doctor and you're told, oh, your kid's not gaining enough weight, go supplement with this formula. Now you have data. Now you can go home, test your milk. It takes five minutes on a test chip. It's read through our app and you'll know exactly how many calories, how much total fat, how much total protein and carbohydrate are in your sample.

Stephanie Canale (24m 40s):

So you can make those decisions again. So trying to, and again, this is a tough one trying to eliminate the guilt that mom will feel from supplementing with her milk is let's say it's 13 calories per ounce, but then also helping her healthcare team when her milk is 26 calories per ounce. And she's told to supplement, wait a second, maybe you don't need to supplement. Maybe there is something going on with the baby

Katie Ferraro (25m 4s):

You're taking the guesswork out of it because of the range of calories per mil of Breastmilk is so vast and wide. It doesn't always work out that it works perfectly for every baby. It's like how we supplement breastfeed for premature babies, how we supplement formula. Sometimes even neuro-typical babies will need that because mom's variability is going to be a wide range, right?

Stephanie Canale (25m 23s):

The key here is hydration and also stress. I mean, I can imagine with quadruplets, I can't imagine how you're thinking of.

Katie Ferraro (25m 31s):

Can I ask you one thing? This would really suck when I was pumping for my quads, I made exactly half. So I made enough breast milk, always half the bottle was breast milk and half it was formula. And if the one baby was sick, then they got a whole breastmilk bottle. The other one got a whole formula. And I was always like, well, at least when I have twins, I know I can make enough milk for twins. And then when I had twins, you know what, I didn't make enough milk for twins, but it was probably because I had prick and for 18 month olds on top of newborn twins and a one and a half year old, so super stressed, like maybe that's why I didn't make enough.

Stephanie Canale (25m 59s):

I'm kind of surprised you made any mill point, just hearing

Katie Ferraro (26m 3s):

I needed an excuse to go pump. I literally called pumping like my vacation. It would be like, I need to go pump into my brother-in-law was like, you're the only person I know who goes to pump like every hour. I was like, dude, I have this many kids. Like I gotta get out of here. So I, it was like my lifeline. And to this day, my kids are older now they're seven, five and three. And my brother-in-law he's like, where are you going? He's like, I'm going to go pump. He's like, okay, I'll watch the kids. And he's like, wait a minute. You're not doing that stuff anymore. It's like, I know I just need a break. It's like built into my day to day.

Stephanie Canale (26m 25s):

I love it. I love that. But again, like the pressure to do so is so high, right? I mean, let's just, again, you know, help moms make the decision because I can't imagine, you know, we're, I'm talking singletons my experiences with two singletons and I failed miserably.

Katie Ferraro (26m 39s):

So tell me what your company is working on now. Like, it sounds like you have a lot of exciting projects in the, you guys are doing a lot of research, but you're also offering consumer based products, which I think is so cool because consumers are interested in this, right? Like if I can swab the inside of my mouth and figure out my genetic history, that's cool. If I can send you a sample of my Breastmilk and see what's really in there, that's really cool. Like what other avenues are you guys working on to kind of open this up to the public? If we don't, you know, work at UCLA or know how to work in a lab or interpret all this, like high-level published data.

Stephanie Canale (27m 7s):

Well, the other thing that we've launched is an at-home mastitis test step. And again, the guests were trying to take the guesswork out if, if a mom has mastitis or engorgement, because what would normally happen? It hurts and it's painful and it's red and feel all this stuff, which could just be in . But what happens? A mom calls her doctor I've been on the receiving end of those calls to am, right? You're like a mom thinks she has mastitis. What are you going to say? No, wait a couple hours. You know what I mean? The standard of care really is that a mom gets antibiotics and the kind of addicts are typically anywhere from seven to 14 days. And we know that that affects the baby. Now don't get me wrong. There are cases where a mother needs antibiotics because it is a true infection.

Stephanie Canale (27m 50s):

But again, we want to take the guessing out of that inflammatory phase here where it's not. So we developed a test strip that actually measures an enzyme in milk called L LDH, which is all of our bodies and it's first sign of infection. And basically we, a mom can then track it over time to see like, are you going in that direction where things are getting a little bit worse? You know, again, emptying the breasts, making sure you have a good latch, all of this stuff. And really then kind of knowing when you need to kind of make that decision and when the antibiotics. So we just don't want to see antibiotic overuse with momt

Katie Ferraro (28m 25s):

Certainly I think the more kids you breastfeed and longer, you do it. If you have mastitis and it's recurrent, you know exactly when it's coming on, but the first time it happens to you, if you don't know what to expect, or you don't know what to anticipate, and that's the thing that makes you stop breastfeeding, if that were preventable with a test at home, because you could've gotten the treatment earlier and you would have been able to continue breastfeeding, like that's a huge development for the world of breastfeeding and breastfeeding retention.

Stephanie Canale (28m 46s):

I find it interesting, you know, the 50% of moms stop breastfeeding. And this is again, report in literature, not something I'm making up. 50% of moms stopped because they think their milk isn't good enough. I,

Katie Ferraro (28m 57s):

I read that study. We cite it all the time and we're usually teaching moms like you should trust in your body, in your body's ability. And I know that you're working with the ends of the bell curve where maybe that's not the case, but I think that's so scary because I think that just speaks to like, we don't even believe in our own bodies, but sometimes your body doesn't work the way it's supposed to. And I want the test and the objective data to know. I don't just want to guess.

Stephanie Canale (29m 18s):

It's the same way that like someone wears glasses, you know, or someone needs fertility treatments. It's not their fault, right? That their eyes don't work perfectly. And that's really what I want to bring to, you know, this particular women's health issue is that breastfeeding is not necessarily somebody's fault. If it doesn't work out for some, it's a choice, great, all the power to you, but just like some people need glasses because their aren't perfect. Some people need help because their breasts don't perfect. If that makes sense. You know,

Katie Ferraro (29m 47s):

I feel like there's a lot of crossover between our respective areas of expertise. Like there is so much judgment in breastfeeding. There is so much a judgment in baby led weaning. And a lot of is like, let's look at the underlying data. Let's acknowledge that what works for one person doesn't work for all people let's acknowledge that there's not one right way to do everything, but the importance of having the data driven evidence to develop these technologies and these products and these modalities is so important. So what I'm interested in is like, if I'm a mom, I come to your services, I'm going to get my Breastmilk Testing. We get the results. What is, I don't say it like a normal result, but if my breast milk came back slightly abnormal, what is the next intervention step? What are you then doing for me?

Katie Ferraro (30m 28s):

And who's giving the nutrition advice.

Stephanie Canale (30m 30s):

I would argue that all of it is sort of normal. And that's the point I'm trying to make is that normal is not the sliver that we've been taught. That is perfectly magical. And the same for everybody, it's all going to be normal. Some moms will have very low caloric value of their milk. Some moms will have ridiculously high where we're like, this is insane. But the bottom line is that a lot of times it's just dietary recommendations. So we have a panel of dietitians and doctors, and we have one functional medicine, doctor, three MDs, who I've known forever. We all have traditional training, but basically we all kind of had our own journey to the same place where it was like, wait a second.

Stephanie Canale (31m 11s):

You know, in medical school, we didn't have all of this education about diet and nutrition. And now we're sort of like, wait, this does matter. This does matter. This doesn't make a difference. And so, and I think it's also frustration that we see a lot of moms just go down these rabbit holes and they're taking this supplement that supplement that cookie, the shape, the bar the way. And again, some of them are fine and it's not harmful, but some can actually be more harmful. And a lot of it is just making different food choices and that's all they need. So I would say 90% of the moms who test their milk with us, they just get dietary recommendations.

Katie Ferraro (31m 46s):

And when you say dietary recommendations, are we talking about food or you providing like a supplement recipe?

Stephanie Canale (31m 51s):

Food!

Katie Ferraro (31m 51s):

Okay, good. My concern was like, no, this entire world, like, honestly, if it's run by someone who's not a scrupulous medical practitioner like yourself, all this is, is a huge ploy to sell supplements. And I think I'm not telling you how to do your job, but like staying laser focused on the food and helping parents use food to fix problems instead of expensive, questionable supplements is so key. That's why I'm so excited to hear that you have dietitians giving real food advice instead of VCs who are like, this is an awesome way to sell more supplements.

Stephanie Canale (32m 20s):

Dietary advice for me is food. Like I said, I was spoke to, to Congress. That's how strongly I feel about supplements. What not in supplements, the lack of regulation. I mean, they're concerned about lead and baby food. I'm concerned about lead in the supplements that cause

Katie Ferraro (32m 34s):

Then baby food has been around for a very, very long, has been a known issue for decades that they've done nothing about the supplements issue. I agree, especially because of the concentration is certainly more concerning because there's less regulation like in food it's supposed to be regulated. There's zero regulation in supplements. Like you're super screwed.

Stephanie Canale (32m 49s):

We actually worked with a private company and one of our investors actually did a it's interesting. They tested over 240 brands of over the counter prenatal and postnatal supplements. And over 243 brands for clean. When I say clean, I mean, no pesticides, mercury lead, arsenic, plastics, you name it.

Katie Ferraro (33m 9s):

Dr. Canale. Where can our audience go to learn more about Breastmilk Testing and the work that you and your company are doing?

Stephanie Canale (33m 18s):

Visit our website lactationlab.com. And we also sell our test kits on Amazon.

Katie Ferraro (33m 21s):

Thank you so much for joining us. This is a fascinating conversation. I'd love to have you back to talk more about toxicity in baby foods as well.

Stephanie Canale (33m 28s):

I would love that. That would be great. Thank you for having me.

Katie Ferraro (33m 30s):

Well, I hope you guys enjoyed that episode with Dr. Stephanie Canale she's the founder of lactation lab. I'm going to put a link to a number of the different research studies that you was talking about in the interview. That'll go on the show notes for this episode, which you can find at blwpodcast.com forward slash 188. I hope it came across in the interview, but I can't tell you how refreshing the conversation and interview with Dr. Canale is I feel like so much of the breastfeeding world is just repeating statements that maybe aren't always evidence-based. And so I really appreciate the research that her team is doing and acknowledging the individual differences that may exist in everyone's breast milk, and that hopefully your breast milk works for your baby, but if it doesn't, maybe there are some simple dietary tweaks that you can make.

Katie Ferraro (34m 20s):

So again, she's online at lactation lab on social at lactation lab, all of her resources will be linked up on the show notes. BLW podcast.com forward slash 1 8 8. If you guys get your breast milk tested and you find out anything interesting, I'd love to hear more. It's one of those things that I'm like, I'm done having babies, but at the end of the interview, I was like, God, I wish I was breastfeeding because I would love to get my breast milk tested and see what it says about us. So thank you again to Dr. Canale for this fabulous interview. Thank you to you guys for listening and I'll see you next time. Bye now.