User talk:Airmax617

Supplemental nursing system
Hi Airmax617. Welcome to Wikipedia! Unfortunately I've had to revert your first contribution to Supplemental nursing system as it's an announcement about a very new product that hasn't been the subject of much discussion yet in independent reliable sources. We really try to avoid having Wikipedia articles fill up with product announcements, or else product descriptions would quickly overwhelm everything else. If the Laally becomes reviewed in reputable medical journals, we would be able to include a brief mention. If you would like to make other contributions to articles about breastfeeding, please do! We need more editors in this area. Cheers, Clayoquot (talk &#124; contribs) 19:56, 3 September 2019 (UTC)

Responding to feedback on edits for SNS entry
Hi! Thanks for reviewing so quickly. The current article isn’t entirely correct since it talks about supplemental nursing systems, but doesn’t include the options that are out there. The Medela SNS, Lact-aid and Laally Bridge are the three products on the market for this purpose. They aren’t necessarily medical products so there are no medical journals or studies on them, but these are the supplemental nursing systems and methods out there. The current article introduces tubing and tape option only, which is not correct.

Also, Laally Bridge was discussed by Cornell and by Forbes. We are relying on information sources like Wikipedia to spread the Laally Bridge message and improve global breastfeeding rates. Is there a way to introduce the devices in these articles without a product announcement?

Our goal is to educate moms that at breast supplementation resolves all kinds of BF issues and that there are devices out there that are readily available and make it easy. With the Bridge being the easiest :)

Thanks for the work you do! Airmax617 (talk) 21:29, 3 September 2019 (UTC)


 * Hi again Airmax617. The main questions in my mind are, "Does this product have the same indications, at least the same benefits, and no additional risks when compared to existing supplemental nursing systems?" The Cornell and Forbes articles don't try to answer these questions. From looking at the Laally Bridge website, it looks like it would have a very different benefit/risk profile than traditional systems. Some of the defining characteristics of an SNS are that the baby latches directly onto the breast, and that the baby controls how much fluid they get. The Bridge does not have those characteristics.


 * If you'd like to get a second opinion from other Wikipedia health editors, I have no problem with that. You can ask for this by adding a section to the Talk page of WikiProject Medicine, or I can ask for you if you like. Take care, Clayoquot (talk &#124; contribs) 05:14, 4 September 2019 (UTC)


 * And by the way, medical journals do cover supplemental nursing systems. Clayoquot (talk &#124; contribs) 05:21, 4 September 2019 (UTC)


 * 1. What risks are you imagining for someone that would use the Bridge?
 * 2. The defining characteristic of an at-breast supplementation tool (SNS and Supplementary Nursing System are trademarked terms by Medela) is to allow parent to deliver supplement at the breast instead of via an alternate method (e.g., syringe, spoon, bottle). The main reasons behind at-breast supplementation can be: a. to get baby that is not interested in breast to latch; b. to keep the baby on longer so that mom increases supply; c. provide full-time supplementation for moms that can't naturally BF due to IGT, breast surgery, or another medical reason; d. provide skin-to-skin time if parent can't/won't breastfeed
 * 3. The Bridge takes a very different approach to at-breast supplementation; its primary purpose is to provide a tool for moms to resolve breastfeeding issues -- which are mainly latch or supply driven. Its ideal use case is to be used for a very short period of time to incentivize baby to latch and to bridge the moms until her supply comes in/starts. The Medela SNS, according to Medela's own materials, is primarily designed for long-term supplementation.
 * 4. The Bridge is novel because it makes at-breast supplementation easy for parents. If you take a look at all reviews for Medela SNS, the tubing, tape and container are difficult to use -- so parents don't end up using the device. The other lactation consultant "SNSs" that are made from various parts are usually only used with LCs and in an office setting. Parents who are lucky enough and have access to an LC that can show them a makeshift SNS, still end up overwhelmed and stop using such devices at home. The Bridge fixes that.
 * 5. If you can share the research on supplemental feeding systems, I'd appreciate it. Airmax617 (talk) 05:51, 4 September 2019 (UTC)airmax617


 * Re #1, since the Bridge includes a nipple shield, research would need to assess whether the device introduces the same risks as nipple shields, e.g. depression of milk supply and perpetuation of latching problems.


 * Re #2, can you point to somewhere that says SNS and Supplementary Nursing System are trademarked terms?


 * Re # 2 - 4, I'm not the person you need to convince that the Bridge has these benefits. Wikipedia is a tertiary source that summarizes what has already been published elsewhere in reliable sources. There is nothing Wikipedia editors can do to get the Bridge story out until it gets properly covered in reliable sources.


 * Re #5, do a Google search for "Pubmed supplementary nursing system" without quotes.


 * Please note that if you are working for Laally, Wikipedia's Terms of Use require that you disclose this fact. Cheers, Clayoquot (talk &#124; contribs) 22:32, 4 September 2019 (UTC)

RE: Re #1: The Bridge is not a nipple shield -- a nipple shield is used to protect a damaged nipple. The Bridge (or an supplementary device) is a device for moms that will otherwise go to a bottle, it's a device that gets babies keep the baby at the breast or gets the baby back to the breast. This is why it's important that the education about a device like this is correct -- depression of milk supply has been noted in studies but the studies did not control for the stage where mom is at in her BF journey. For moms that are successful at breastfeeding, of course, putting in an artificial barrier will impact milk transfer. However, moms that are forced to use a nipple shield (or otherwise stop breastfeeding) results of nipple shield are positive. This is from clinical experience and not a study, since I am not aware of a study that test the intervention with a nipple shield vs. no intervention when mom is about to stop due to cracked nipples, pain, inverted nipples, etc. The two studies that mentioned lower milk transfer rates did not control for anything other than shield vs. no shield. Regarding latching problems, I am not aware of any study controlled properly or not that proved that nipple shields reduce latching issues. But this all doesn't matter since the Bridge is not a nipple shield.

RE: Re #2: "SNS and Supplemental Nursing System are trademarks of Medela, Inc. Medela is a registered trademark of Medela Holding AG." --- from https://www.medelabreastfeedingus.com/attachment/download/479

RE: Re #2-4: It sounds like you are the person I need to convince since I made the edits and your reverted them based on your authority. The Bridge has been discussed in articles, used by over 500 customers in 11 countries, reviewed by experts, and ordered/used by many lactation consultants.

RE: Re #5: aware of the research on the topic, and interestingly enough the first hit on PubMed is research study analyzing prior work. Here's the summary: "Very limited research exists on the use of SFTDs as a method of supplementation for breastfed infants; however, existing research suggests that an SFTD may be useful as a supplementation method for breastfed infants. High-quality research is needed to evaluate the efficacy of using an SFTD for supporting exclusive and all breastfeeding rates."

I never said I wasn't affiliated with Laally, and disclose it whenever asked. My wife is an IBCLC and PA, and is the inventor of the Bridge. Kate and I are just trying to educate people on the value of at-breast supplementation as a means of resolving breastfeeding issues. U.S. breastfeeding rates are at 25%, moms come to Kate crying not to be judged and out of options. It's all because we don't have the right tools, support and education to help these moms. There is an article on Wikipedia on Supplemental Nursing Systems -- it's missing a huge innovation in the space. We tried to edit and got rejected, that's why it hurts. We don't have to mention Laally or the Bridge, but we do have to educate people about the options that exist.


 * Wikipedia does not report about "huge innovations" until they have received enough coverage in reliable sources for us to describe those innovations with a neutral point of view. This is especially important in the healthcare space because of the potential for causing harm, of which you are dismissive when it comes to your product. If you wish to contribute further, please first read the following important guidelines: WP:COI and WP:MEDRS. Clayoquot (talk &#124; contribs) 16:13, 5 September 2019 (UTC)

You have a very condescending tone for no reason. We certainly think our invention is a huge innovation. Like I mentioned before, we think the coverage we've received does come from reliable sources. The product is on the market - it's been covered by press, it's been used by lactation consultants, it's been used by parents. We're not asking to have Wikipedia verify efficacy or post any claims. We're asking for the relevant Wikipedia article to state the fact that such a product and method exist.

"Wikipedia's purpose is to benefit readers by acting as an encyclopedia, a comprehensive written compendium that contains information on all branches of knowledge." At-breast supplementation to resolve breastfeeding issues is knowledge, and educating the public on the options of at breast supplementation tools is valuable knowledge that is complementary. The Bridge is an iteration of an at-breast supplementation system.

We can debate for a while and I don't think it will get us anywhere. Let's get to actionable terms: what do we need to do to get the Laally Bridge concept introduced in the at-breast supplementation section of Wikipedia? If the answer is "enough coverage" -- what does that mean? Please remember we are not a medical device and don't make medical claims -- latching a baby is not a medical claim and helping moms keep the baby at the breast is also not a medical claim.

Welcome!
Hello, Airmax617, and welcome to Wikipedia! Thank you for your contributions. I hope you like the place and decide to stay. Here are a few links to pages you might find helpful:


 * Introduction and Getting started
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Please remember to sign your messages on talk pages by typing four tildes ( ~ ); this will automatically insert your username and the date. If you need help, check out Questions, ask me on my talk page, or, and a volunteer should respond shortly. Again, welcome! Clayoquot (talk &#124; contribs) 05:28, 4 September 2019 (UTC)

There is currently a discussion at Administrators' noticeboard/Incidents regarding an issue with which you may have been involved. Clayoquot (talk &#124; contribs) 18:10, 5 September 2019 (UTC)

Supplemental nursing system: what to do next
Greetings! I am C.Fred, an administrator here on the English Wikipedia. I have responded to the thread that was opened about you at the administrators' noticeboard for incidents. I want to open up a direct dialogue with you on your talk page. You can respond here; I have this page on my watchlist and will see when you reply.

First, at the base level, I share your concerns about the state of the Supplemental nursing system article. The sourcing is awful. The article needs to pull in citation from reliable sources—ideally, journals and other secondary sources written from a neutral point-of-view.

Second, I think you can contribute to the article. you are certainly passionate about it, and you appear to be knowledgeable.

The problem is that you have a conflict of interest with the article, because you are involved with producing a system. The general rule of thumb is that editors with a COI should not edit articles where they have a conflict; instead, they should request edits via the article's talk page.

That's what I recommend you do: as you find sources to add to the article, use the Request edit template on Talk:Supplemental nursing system to request the changes and cite the source(s) that support the change. Then, independent editors can assist you in making the changes.

Finally, I have added the article and its talk page to my watchlist, so I will see the activity there. I will also be able to assist with edits in the future—although, because I am involved in this issue currently as an administrator, I need to be careful about what edits I make to the article! Once the situation calms down, I'll be able to act more as an editor on the article and can help with the improvement. I hope I'll have the opportunity to work with you on improving the article in the weeks and months to come. —C.Fred (talk) 19:29, 5 September 2019 (UTC)


 * sorry i was too slow on my response on the admin thread, and it's now closed =)
 * thank you for both of your replies on the public page and here -- you are very structured and logical. Kate and I will go ahead and ask the lactation consultant community to provide their input on the articles -- they are the best (and independent) resources to comment about the topic. We will also provide our POV on the talk page only. Regarding your above point on this being a medical product, the expert here is the FDA and lists the Medela SNS as an 510K exempt product, while others aren't even registered with the FDA (e.g., Lact-Aid which is featured on the video on the SNS wiki page). These supplementation devices are more consumer products, closer related to bottles, pacifiers, and nipple shields rather than medical devices. But I agree, this can be seen as a gray line.
 * Regarding the talk conversation on the SNS page, I maintain that the response was rude and condescending --- particularly the point made about quoting my huge innovation point and inaccurate argument on potential harm. We spent the last two years full time and several hundred thousand dollars of savings to bring this to market, without outside investment so we don't have to compromise on our social impact goals and values. Having someone, especially a moderator in position of power on this site, question our intentions and unjustly attack in a public forum is unnecessary.


 * Wikipedia's rules are weird. Lactation consultants do not get any extra clout in discussion because of their status as lactation consultants. (I don't get any extra weight in an article about accounting because I'm a CPA.) They are just as bound as anybody else in citing published reliable sources. That said, they may have a better idea where to find the resources. (I know how to cite journal articles written about accounting concepts—and where to find such publications.)
 * WP:MEDRS does have a little broader scope than medicine proper: it applies across everything from traditional medicine to alternative treatments. So, even if SNS aren't medical products by strict definition, they may fall within the bounds of medicine when broadly construed.
 * There is no history at the article's talk page (Talk:Supplemental nursing system); you'll have a clean start, as it were, when you start a thread there (or join in one somebody else creates).
 * One last note, it's easier to follow a discussion if every participant signs their messages at the end. You can have the system do this by typing four tilde characters at the end of your message. This is recommended for all talk pages and discussion boards. —C.Fred (talk) 20:22, 5 September 2019 (UTC)