UK Dev Lead and Partner at Femtech Startup LactApp Women’s Health
Christiane Gross is the UK Dev Lead and Partner at Femtech Startup LactApp Women’s Health, an app dedicated to women’s breastfeeding, where she focuses on international expansion. Having graduated from the Bocconi University Milan, she started her career in consumer marketing at two food multinationals before training as an NHS breastfeeding supporter and pursuing her role at LactApp.
Section 1: LactApp
1.1. What issues / challenges does the LactApp aim to solve?
LactApp is a mobile-based app that aims to resolve questions about breastfeeding and maternity for new mothers. LactApp gives the possibility for a new mother to download the app and set up her baby’s profile. This will include information such as the baby’s DOB and weight. Subsequently, the app will give you personalized answers based on the profile of the child and the mother.
It has also a tracking function, which means you can track, as a mother, “How long have I fed? I’ve fed the left breast. I’ve fed the right breast. For how long etc.” There are many competitors who provide similar types of tracking app, for example, there are food trackers. What we do differently is that we are giving personalized advice and information on what to do. For example, the mother asks, “I have two-day-old baby. I come back from the hospital, and I’m feeling pain in my breast, and the baby doesn’t latch.” We will then offer suggestions, solutions and ideas for these issues.
Everything of course is based on research. We have got expert lactation consultants in our team that have written this content. We have also got a midwife on our team and we calculated the other day, that all together we have 80 years of lactation support experience. We also constantly update and change the content. For example, we have a new section about COVID-19 which has been up since March. When COVID-19 came out, we immediately put in a section for “What should I do? I am breastfeeding, and I think I might have symptoms of coronavirus.” We put together the latest research-based evidence, and we provide this information to mothers.
1.2. Where does the app sit within the landscape of Femtech?
I think it would not be classed in the well-being app category. This is very difficult to say, because we are talking about breastfeeding and lactation. It’s not an illness, so it’s not treated by medicine, because it is a physiological process of our body, which is supposed to be a natural process. I think we are very focused on a more medical point of view, but I think lactation is a bit the forgotten and under-researched part of medicine. For example, if you see the GP curriculum, they actually have one hour where they talk about lactation and breastfeeding in the whole curriculum when they study. It’s an area that has been under researched a lot.
I would not say LactApp is a fertility app either although we do have parts of the app where we talk about fertility. For example, the part where mothers are asking us questions of, “I am breastfeeding. Can I get pregnant?” or “I am planning to have another baby, but I’m also breastfeeding. So, how would that work together?” Therefore, we do answer questions about fertility as well, but we are not a fertility tracker. There are lots of fertility trackers, for example, that track your period, but we are not like that. We are more focused on pregnant women that are interested in breastfeeding, and then postpartum, we are very much focused on helping after birth. I wouldn’t say that is a well-being issue. Obviously, there is a big component of mental health in there as well. We have got plenty of answers and a lot of content about mental health as well, which is part of the postnatal care package. Let me say that, it’s a very important part of it, because we know there are increasing rates of postnatal depression. We also have a psychologist in our team who works on the content.
I wouldn’t just call it a well-being app, and I wouldn’t just call it a medical app. It’s also not a medical app, because we are not there to manage a certain condition, because we are not about a health pathology. We’re about a natural, physiological part of motherhood, which has, until now, not been focused much on. If you want to see numbers, we know that over 80% of new mothers intend to breastfeed their children initially. So, we are not about convincing mothers to breastfeed. We aim to help mothers that say, “I want to breastfeed, but it doesn’t work,” or “I need help,” or “I don’t know how to do it.” That is where we come in. As I said, it’s over 80% of mothers already want to breastfeed, and we are coming to help this 80% of mothers with practical information on how it’s done.
In the US, it’s over an 80% breastfeeding rate, which means we are talking about three million new mothers a year, which is definitely not niche. I know in the UK, it’s around 600,000 mothers a year. Often breastfeeding and motherhood is something considered easy, natural, and something that everybody can do; but it’s not like this. Therefore, for us, it’s really difficult for investors and other people to see this angle, because they don’t think that there could be issues. However, we know that one of the top causes of abandoned breastfeeding is pain. Breastfeeding can be really painful, and it can cause serious injuries and serious nipple damage if the latch is not proper. If you don’t get help, there can actually be serious complications that often are not addressed.
Another health complication that can come up with breastfeeding mothers is mastitis, which means when you get a blocked breastfeeding duct and certain bacteria grow. This can become a very serious health condition if it’s not treated properly. We know mastitis affects many breastfeeding mothers. I don’t have exactly the medical numbers, but it must affect at least half of breastfeeding mothers. I wouldn’t say we are a medical, and I also wouldn’t say we are a well-being app. What we are is very focused on our target individual, which is the new mother that wants to breastfeed and looks for information for help with it.
1.3. How would you describe its success to date?
Now, we are not doctors. We are not prescribing medication, but we can suggest and say, “Based on this and this, what you have told me, the best course is to go to your doctor, your GP or to see your midwife.” Currently, we are solving around 90,000 questions a week. we also have around 40,000 unique monthly users. We are mainly based in the Spanish-speaking user group. Firstly, around 50% of our users are in Spain, but the next countries where we have users is America. We have a very strong base of Latino users who are using our app. We also have users in all other Spanish-speaking countries including Mexico, Colombia, Argentina and Chile.
Currently, we are looking to expand. We have an English version of the app as well. We are also looking to expand our communication channels to be better known in the English-speaking world. What is quite interesting to note is that we have grown completely through organic growth. We’ve never invested anything in marketing, we’ve only been referred. We’ve only been growing through referrals from mothers and from health care professionals. We also have a medical version of the app so if you are a midwife, a GP or any other health care professional, you can opt for a different medical profile, which means you can set up a lot of different baby profiles, depending on what your patient’s needs are. When we last checked, we have more than 4,000 health care professionals who are using our app for this purpose, to help them support postnatal mothers.
1.4 What does the future of LactApp look like?
We definitely have a vision of being an app used worldwide. At the moment, we are working on the English version, but it’s easily scalable. Therefore, with not that much investment, our app can be easily translated in all the languages of the world that you would like to. It could easily be translated next into German or Italian. I also read an article, the other day, that it could be translated tomorrow or within the next six months in Mandarin. There are millions of women struggling with breastfeeding in China at the moment, because they don’t get the right information about breastfeeding. If you don’t get the right information about breastfeeding, and you don’t know how it works, it’s very easy to quit, because formula companies are very aggressive on marketing, and it’s very easy to give up.
I see us everywhere where there is a high adoption of mobile phones and new technology usage. Here I would talk about Indonesia, China and India. It would definitely be markets with low breastfeeding rates. Overall, breastfeeding initiation rates are really high, but then, mothers quit very early. We know, for example, in the UK, that most mothers that quit breastfeeding in the first few weeks were not happy to do so. They were actually unhappy about abandoning breastfeeding so early and intended to feed for longer. That’s where we come in and help with information and the right support. I see this actually as a global movement, rather than just a local movement.
On another scope, breastfeeding is linked to all 17 or 18 sustainability goals by the United Nations. Obviously, if you feed your baby naturally, you are not using any resource. You are not using energy to warm bottles; you’re not using plastic to give bottles and you are not using milk. We know how much the dairy industry is a factor in climate change. We think that the millennial mother of tomorrow, let say the Greta Thunberg generation, will be more willing to breastfeed than any generation before, because they want to give their children the most natural food.
Section 2: FemTech Industry
2.1. What have been some of the major changes in the FemTech industry over the last 3-5 years?
A few years! Let me talk about the last few months. We already know there has been a lot of industry prognosis around the growth of this sector. We know that the FemTech industry, and it has already been corrected a few times, is estimated to grow to X billion. The figures have already been corrected multiple times, but I think what happened in the last few months is that coronavirus occurred and we see it in our target of new mothers, that the whole health care industry has changed completely and profoundly, I think forever.
In the last few months, people have had to focus much more on their health than previously, because suddenly, we have a really big health threat to everyone. I think everybody including investors, governments have had to put so much more focus on health than we have ever done before. Then the second element is that suddenly there is a risk to face-to-face interaction. All of a sudden, everything has moved digital. We have seen a boost in the use of our app, because a lot of people couldn’t go, in our case, to face-to-face breastfeeding support groups. They were all canceled because of coronavirus. What we have seen is our users have had to stay at home more and they are looking for solutions online and digitally; whereas before, they were solutions in the real world. Now they are pushed even more to look for solutions in the digital world. I think this gives the whole of FemTech, from our app perspective a huge increase in usership.
I spoke with a lady from a telemedicine app the other day, and they were selling diagnostics to send home. They also had a huge increase in this as well. Everything that is telehealth medicine and digital health care related, has had a huge growth during coronavirus. Rather than us seeing it going slower, it has just accelerated the whole movement of our digital sphere in the health sector. In FemTech, we’re not only talking about health, there are also other devices, but I think that the consumer has just moved so much more to using digital than before, that it has just given us a boost. Here I’m not even talking about the last three or four years. I’m just talking about the last few months, and we will only see this accelerate in the future.
We have seen that even GPs are now doing telephone call consultations. Everything is moving on remotely and digitally, more than before and I think this gives us an advantage, because we were already there in the digital space, so it has only given us a boost. I think investors will see that this is something that is here to change. We see these solutions are also more cost efficient to help people at home, rather than having everybody go into the office. Obviously, we’ll never replace it fully, but we have seen a huge boost in the whole of digital care.
In terms of females, I would like to add that maybe investors have understood now that, in female health, there is a lot still to solve. Female health problems are not solved yet and there is a lot of research to be done. For example, in our space of lactation, there has been a lot of research done on what is actually exactly inside breast milk, but very little research has been done on the actual feeding process. There’s so much more than can be done for example, we don’t know enough about mastitis or how to detect it earlier. We’ve just always been working on the assumption of the male body, and the female body is just a small version of the male body, but it’s so far from the truth.
I think investors will see that we have to do so much more on the female side. Females make 50% of the population, and if you see the numbers we are using its definitely not a niche area. We are actually quite a big population and with this, we’ll go even further over the next few years. Overall, I see the outlook as very bright, and our industry growing. I’m not saying, “it’s the next big thing,” but finally claiming the space it should have had before.
2.2. What are the current key growth areas in FemTech? Why these areas specifically?
I think all the areas such as fertility, menopause and menstrual are really important. I cannot see a single one standing out actually. All these areas are very important and haven’t been addressed before. There are obviously those companies who’ve been already doing really well, and they are showing already the way forward, and that there is demand, and that it is also a profitable business model.
Other areas could include research and medication of pharmaceutical companies that is especially female-focused. I’m thinking, for example, endometriosis is one illness that only affects a woman that is difficult to diagnose, and there is not much that cures it. There are several of those female-specific illnesses where there’s not enough medication out there yet. We’re also entering now in a sphere of biotechnology and also genetics. For example, there is now an argument that birth control should be matched to our genetics. We can do a lot there, because depending on what our genetic profile is, some birth control will give more side effects, and some will give fewer side effects. I think that’s a very interesting angle to do research into.
It’s difficult for me to see a particular area standing out. Obviously, in our area of maternity, especially focused on breastfeeding and lactation, there is a lot of potential, because women are not informed yet. It starts with teenagers, and they are not informed yet about their breasts. If you go to school, and you are taught biology, they will maybe not even tell you what the exact milk ducts are and the exact part of the breast and functioning. We all know the functioning of the heart and we all learn the functioning of the kidney, the guts or the bladder, but we don’t actually learn about the functioning of the breasts, which, during lactation is very advanced.
2.3. What are some of the challenges to user adoption in FemTech?
Certain issues might only affect a woman during a certain period of her life. I see that, but I think, in terms of us, for example, we still have not reached all the users that we could. There are so many millions of mothers, sitting at home, googling, “I have pain in my breast while breastfeeding,” and we haven’t reached them yet. Therefore, I’m not too worried about the fact that it’s only a limited time period in their life.
I think the limitations for the FemTech industry as a whole is access to investment. Many or most of us are female-founded companies, it’s been traditionally always more difficult for us. You imagine a female founder pitching in front of ten male investors explaining to them about vaginas, lactation and breasts. It’s very difficult for them to relate, because most investment decisions are mainly made by male investors or VCs. Therefore, it’s very difficult to get heard because they cannot relate as much. It’s very difficult for them to have the empathy to understand if this is even something that is needed. I think access to funds is the biggest component, and from there, I think there are a lot of things that depend on that, because the more funding you have, the more users you can reach and the more revenue you can make and the more profits you will make in the end.
However, I see a lot of hope and movement and there’s a lot of great mentors and female VCs as well. There’s a lot of investors who now have a focus in this area, because they are seeing the returns speak for themselves. Returns are in favor of female-founded companies, and they’re actually higher and more secure because we know that women are slightly less risk-taking than men.