With increasing workloads, growing staff shortages and all the challenges facing the Dutch healthcare sector now and in the future, a great deal of time and money is being invested in solutions designed to help keep healthcare manageable and affordable. Robotics is one of the areas in which great expectations are placed. In the operating theatre, robots have become almost indispensable, whilst cleaning and social robots have long since become familiar sights in our hospitals and care institutions. A remarkable example of a robot that can ease the workload of nurses can be found in the Neonatology Department at the Erasmus MC Sophia Children’s Hospital. Paediatrician and neonatologist Tom Ouwehand is working there, alongside researchers and technicians, on a breast milk robot. This robot, the third prototype of which is currently being tested, can prepare breast milk automatically and with extreme precision.
In the Neonatology Department at the Erasmus MC Sophia Children’s Hospital, healthcare professionals work daily with the most vulnerable patients: seriously ill and premature babies. It is precisely here that time can make the difference between complications and recovery. This is one of the reasons behind the idea for a robot that can take over (part of) the work involved in preparing breast milk from nurses. Ultimately, the breast milk robot will not only reduce the workload but also minimise the risk of errors and improve the quality of feeding.
Nursing shortage
According to Ouwehand, the growing shortage of nurses is one of the biggest challenges facing the healthcare sector today. In neonatology, this has direct consequences. When there are insufficient staff available, beds may remain empty and vulnerable newborns sometimes have to be transferred to other academic centres, far from their parents and social environment.
He believes that technology can help alleviate this pressure. This shifts the focus from exclusively patient-centred care to a broader approach that also places the healthcare professional at the centre. “Many of the tasks carried out by nurses are essential, but do not always form part of their core duties,” says Ouwehand. “By automating repetitive and labour-intensive processes, more time is freed up for the care that only people can provide.”
Labour-intensive
One such process is the preparation of breast milk for premature and seriously ill babies. As these children are often not yet able to feed independently, they are fed via a feeding tube. Breast milk from the baby’s own mother is preferred, as it is better tolerated and reduces the risk of infection. When insufficient breast milk is available, donor milk is used.
However, accurately measuring, fortifying and dispensing this feed is very time-consuming. Every day on the ward, several nurses spend hours preparing portions in syringes and bottles. This sometimes requires precision down to the millilitre, and the addition of protein fortifiers. Although healthcare professionals take the utmost care, the risk of errors remains. Incorrect amounts of formula can affect a baby’s growth or cause digestive problems. Mixing up breast milk can also pose medical risks and undermine parents’ trust.
Collaboration between healthcare and technology
To develop a solution to this, the NEOPERFECT project was launched within the Convergence partnership. This project brings together Erasmus MC, Erasmus University Rotterdam and RoboHouse at Delft University of Technology. Each partner contributes their own expertise. Whilst healthcare professionals provide insight into daily practice and the challenges faced on the ward, robotics specialists contribute technical knowledge and social scientists investigate the needs of nurses and parents.
This multidisciplinary approach has now led to the development of several prototypes. The development process takes the wishes of all those involved into account. For example, the robot must operate with extreme precision, produce virtually no noise, and allow users to see what is happening inside the system. That is why the design incorporates transparent components.
Automatic preparation
In the intended procedure, a mother places her own expressed milk into the system after pumping. The robot then automatically processes the prescribed quantities, adds supplements if necessary, and prepares the feed for the baby in question. As soon as the feed is ready, the nurse receives a notification. According to the researchers, as handover points are largely eliminated, the risk of mix-ups is also reduced. Furthermore, the quality of the breast milk is better preserved as unnecessary temperature fluctuations and manual warming processes are minimised.
The current prototype can prepare feeds for ten patients simultaneously over a 48-hour period. According to the project team, full implementation across various wards within the hospital could result in savings equivalent to around eight full-time positions in preparatory work.
Still in development
Although the breast milk robot is still in development, expectations are high. If the validation and implementation processes go according to plan, the technology could be put into use around 2028 or 2029. For Ouwehand, one goal is central to this: giving nurses more time for direct patient care. “This robot does not replace healthcare providers,” he emphasises. “Rather, it supports them by taking over time-consuming processes. Ultimately, that means more attention for babies and their parents at times when that attention is needed most.”
The breast milk robot thus demonstrates how robotics and healthcare innovation can come together to improve both the quality of care and the workability of healthcare practice. The video below shows a demonstration of the breast milk robot.
Smart nursing pad
Last year, American researchers developed a smart nursing pad that can analyse the quality of breast milk in real time. The portable device, which is still in the testing phase, combines the function of a traditional breastfeeding pad with sensor technology that automatically analyses collected breast milk. The smart nursing pads contain sensors that can analyse breast milk for the presence of acetaminophen, the active ingredient in paracetamol, amongst other medicines. This allows mothers to gain insight into the amount of drug residues that may be passed on to their baby via breast milk.
The development was prompted by the fact that certain medicines, although generally safe when used normally, can pose health risks if there is excessive exposure. Acetaminophen, for example, has been linked to acute liver failure in children. The researchers expect that the smart breast pad could, in future, contribute to safer breastfeeding and personalised monitoring of breast milk, without the need for laboratory tests. The technology thus offers an accessible way to monitor the quality of breast milk at home.
