<!–– The Quantified Baby ––>

Joshua C. Hollingsworth, Pharm.D, Ph.D.
Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University
Brent I. Fox, Pharm.D., Ph.D.,

Having a newborn is a truly miraculous time. (We speak from experience. We each have two children, all 4 years of age or younger. Josh’s youngest, Isla, is currently 8 weeks old.) It is a time of joy, love, and laughter, of new beginnings, newfound meaning, and togetherness. It is a time to be fully present, to capture everything in vivid memory, as it is a time that will be gone as quickly as it came. Oh, what a wonderful time it is. It can also be, well, utterly exhausting. It can be a true test of one’s mental and physical limits. It can be a time of no breaks, little sleep, and high anxiety, which can all too easily lead to a time of forgetfulness (Did I give her her medication?), miscommunication (I thought you already gave her her medication.), and errors in decision-making (Is that one tablespoon or teaspoon per kilogram?). And it is at this very time when these factors — accurate recall, communication, and shared decision-making between parents and other caregivers — are of the utmost importance.

Luckily, there are mobile apps available that can help address at least some of these issues. For lack of a better term, let’s call them baby-tracking apps. And track they do. They can be used to track or document nearly every aspect of baby’s life. This of course includes the basics — diaper changes, sleep time, wake time, and feedings. Tracking these parameters can be very useful and is generally recommended in the first days of life to ensure baby is having the appropriate number of wet diapers, is feeding often enough, and is getting an adequate amount of sleep. Baby-tracking apps can also be used to monitor many other parameters, such as mood, various activities, and milestones. Most baby-tracking apps also offer journaling and photo-capturing capabilities. Of course, you could just write all of this down with pen and paper, or capture it electronically. However, using an app specifically designed for this purpose is a more elegant solution.

Not only do baby-tracking apps make it easy to capture every aspects of baby’s life, they also make it extremely easy to share baby’s data with all caregivers. In fact, it is automatic. Once you set your first caregiver account on one of these apps, you can then invite and authorize additional caregivers. For instance, Josh uses Baby Connect. It costs $4.99, and works on both iPhone and Android. It also has a web app. After setting up his account, Josh sent his wife and their nanny an invite. Now, all three have access to Isla’s data, and any time one of them logs something, the new entry is automatically synced across all of their devices. This allows all three of them to always know exactly where they are in terms of Isla’s feed-wake-sleep cycle. There is no guessing. They find great value in this approach. An additional feature that these apps offer, and that is most germane here, is health tracking.

Most baby-tracking apps offer basic health-tracking capabilities. This includes weight, height, head size, temperature readings, allergies, medication administration, vaccinations, and doctor visit notes. Many include comparisons to growth charts (from the CDC or WHO) for the relevant parameters. Using these apps to log the timing and dosage of medications that have been administered is extremely valuable. As we know in healthcare, documentation is necessary for appropriate care, especially when there are multiple providers. The fact that, with these baby-tracking apps, the administration record is automatically synced to all caregivers’ devices decreases the risk of duplication of therapy and helps ensure that appropriate dosing intervals are being used. Despite the clear healthcare-related benefits of using these apps, we are left wanting more. Here are a few features we would like to see added in baby-tracking apps to increase their utility in healthcare. These features impact both the parents and the pharmacists who care for babies.

Medication Dosing Assistance

As we know, medication dosing for infants is weight based. Thus, it would be convenient to have baby-tracking apps that could help calculate the appropriate dose, based on baby’s most recently logged weight. This could also include information on proper selection of dosing instruments and unit conversions, as needed. Dose reminders and alerts for improper dosing intervals could also be incorporated.

Embedded Health and Medication Information

Patient medication information could be incorporated into the app, providing caregivers with valuable information regarding potential risks and benefits of medication usage. Information for appropriate over-the-counter medications could be initially included, and prescription medication information could be pushed from the filling pharmacy (see feature below). Similar information could be included for upcoming vaccines, based on the CDC’s recommended immunization schedule. General health and wellness information could also be included. Of course, the information would need to be of a health literacy level appropriate for the general population.

Connect to Providers

Ideally, these apps would be able to both push and pull data to and from medical providers and pharmacies. Thus, instead of caregivers having to manually enter new growth measurements and vaccinations, this information could be pulled in from the provider’s electronic health record. As previously mentioned, pharmacies could push prescription information to caregivers, including dosing assistance and interval reminders. Similarly, pertinent data entered by caregivers could be pushed to medical providers and pharmacies. This might include abnormally high temperatures, administration of medications, and other parameters. Further, rules could be set such that, when warranted based on tracked health parameters (e.g., high temperature), a provider message is automatically generated and sent to caregivers. Protocols such as Blue Button and Direct might be used for such implementation.

There are many baby-tracking apps available, and they can be valuable tools when caring for a newborn. This is especially true when multiple caregivers are involved. They provide a method of documenting baby’s activities, progress, and health-related information that is convenient and easily accessible. When using one of these apps, it’s important to ensure that all caregivers are consistently documenting pertinent data in a timely fashion and that the app is syncing properly across caregivers’ devices. Although we would like to see additional, more-interactive health features added to these apps from reputable sources, we have found them to be extremely useful as they currently exist.

How many babies does your practice provide care for? How many times a week are you presented a question related to a baby’s health and need information that one of these apps could be used to track? Even if the desired features were incorporated into a baby-tracking app, parents will still rely on trusted healthcare professionals for guidance. We see valuable potential in using these apps as tools to enable informed decision-making — by parents, other caregivers, and healthcare professionals.

We welcome your comments and questions. CT

Joshua C. Hollingsworth, Pharm.D., Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn Campus, and Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University. The authors can be reached at jhollingsworth@auburn.vcom.edu and foxbren@auburn.edu.