Science & Research

Real-Time Visualization of Milk Transfer During Breastfeeding: Prospective 12-Month Clinical Outcomes

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Data collected in 2023. Analyzed in 2026 by Hilla Lev-Ran Hotam and Naama Schwartz.

Main Clinical Outcomes

70.6%

Of participants utilized Flow selectively rather than at every session

93.8%

Still breastfeeding at 6 months vs. 50–75% US benchmark

75.8%

Mothers gained confidence within first month of use

Data collected in 2023. Analyzed in 2026 by Hilla Lev-Ran Hotam and Naama Schwartz.

Background

Breastfeeding provides major maternal and infant health benefits. Continuation often declines during the first postpartum year. Perceived low milk supply and reduced maternal confidence are common barriers.

Aim

To evaluate whether the use of a novel breastfeeding aid providing real-time visualization of milk Flow during feeding was associated with sustained exclusive and any breastfeeding through 12 months postpartum.

Methods

Study Design: IRB-approved prospective longitudinal study. Population: 825 enrolled; 260 participants in the final analytic cohort. Device Use: Investigational device (Flow01) initiated at mature milk production and used according to maternal preference. Measures: Monthly follow-up assessments for breastfeeding status, exclusivity, and confidence levels using Flow01.

Kaplan-Meier survival curve: any breastfeeding rate 93.8% at 6 months, 85.8% at 12 months — Breastfeeding throughout the follow-up
Kaplan-Meier curve

Kaplan-Meier survival curve: exclusive breastfeeding rate 34% at 6 months — Exclusive breastfeeding throughout the follow-up
Kaplan-Meier curve

Results

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Supportive aid

The device functions as a supportive aid rather than a crutch; by the first month postpartum, 70.6% of participants utilized it selectively rather than at every session, demonstrating a transition to independent breastfeeding.

Confidence during first month

During the first month postpartum, 75.8% of mothers indicated an increase in confidence due to the use of Flow01.

6 months breastfeeding goals

98.9% of women reporting increased confidence from Flow01 at the first month met their breastfeeding goals at 6 months, compared to 79.2% in the no-increased-confidence group.

Increased confidence

Increased confidence from real-time visualization was significantly associated with a 27.96 times higher adjusted odds of meeting breastfeeding goals, and participants were 3 times more likely to actually exceed their personal breastfeeding goals.

Breastfeeding at 6 months

93.8% of participants were breastfeeding at 6 months and 85.8% at 12 months, exceeding US national benchmarks (~50–75%).

Exclusive breastfeeding

Exclusive breastfeeding at 6 months reached 34%, more than triple the previously reported US average of ~10%.

Conclusion

Real-time visualization of milk transfer extends the duration of both any and exclusive breastfeeding beyond national standards. By providing objective confirmation during the critical first month, this technology helps mothers build the confidence necessary to meet and exceed breastfeeding goals. Flow01 represents a substantial advancement in evidence-based lactation support.

Flow Use Cases

Here are the use cases we found Flow is most useful with.
We recommend trying it yourself.

Behavioral Transitions to direct breastfeeding

The mother is supplementing with bottles due to uncertainty about her milk supply.
The mother is exclusively pumping and finding it challenging to transition to direct breastfeeding.

Environmental Support

The mother is influenced by a non-supportive environment, and there is a need to demonstrate to her and those around her that she is producing milk.

Increase lactation self-efficacy

The mother has sufficient milk supply but doubts whether her baby is receiving enough milk.
The baby is having difficulty latching, despite the presence of adequate milk, and you would like to support and strengthen the mother’s confidence.
She experiences certain times during the day or during the week when she feels her milk supply is insufficient.

Educational tool for visual learners

Visual aid to help you explain essential breastfeeding concepts, including:

The impact of right positioning
Distinguishing between nutritive and non-nutritive sucking
Explaining flow rate and swallowing patterns
Educating about milk color variations

Lactation Consultant Case Study

From pumping to direct breastfeeding

Patient Profile

Mother: 29 years old, healthy. Spontaneous, normal pregnancy. History of hypothyroidism during pregnancy (balanced with medication). No history of breast surgery; currently not taking medications.
Infant: Born at 37+3 weeks via normal vaginal delivery. Birth weight: 2885g/6 lbs 6 oz; weight at six weeks: 3800g/8 lbs 6 oz.
Assessment: Appropriate weight gain, normal appearance and tone, no facial asymmetry, and no tongue-tie. Developing well and meeting milestones.

History & Clinical Presentation

The infant breastfed immediately after birth. However, after three days, nipple wounds developed, leading the mother to begin pumping.

At the time of consultation, the mother was breastfeeding approximately three times a day (morning, noon, and evening), with all other feeds given via bottle due to significant pain. The pain occurred primarily toward the end of feedings. Despite seeing two prior lactation consultants, the mother had not experienced improvement.

Clinical Session & Intervention

Initial Observation: We began with direct breastfeeding. Post-feeding, the nipple appeared compressed.

Flow Nipple Shield (Size Large – 24 mm)

The baby latched immediately using a cross cradle hold.

With the Large size, the baby opened her mouth much wider, and the latch improved significantly. Milk transfer became optimal with continuous flow visible in the tube.

Maternal Feedback: The mother reported zero pain during the session.

Guidance Provided

Use the Flow as a bridge to transition back to pain-free breastfeeding.
Utilize the shield occasionally or for parts of feedings rather than every feed.
Monitor for pain improvement and infant satiety.

Follow-ups

The following day

The mother reported a highly positive experience the following day:

“Yesterday I breastfed once with the nipple, and the experience was really good. It didn’t hurt at all, and being able to see when and how much she was eating was really nice. It seems the nipple really helps her latch better… The position you taught me and the adjustments you gave me helped me so much! The pain has significantly decreased even when I’m not using the nipple. I didn’t believe breastfeeding could be painless.”

One-month later Follow-up

The mother now reports that her use of the Flow is minimal, as she has successfully transitioned to nearly exclusive breastfeeding. She has significantly reduced bottle use to only once during the day and once at night (and occasionally less).

Clinical Outcome

The most significant result is the resolution of physical trauma; the mother reports she “almost no longer feels pain.” The Flow served its purpose as a temporary bridge, allowing the mother to correct her positioning and regain confidence. By providing a painless “reset” for her nipples, she was able to return to direct breastfeeding, achieving her goal of a nearly exclusive breastfeeding relationship.