Development of the Breathing Operator for BaBY (BOBBY): an automated tactile stimulation device to facilitate breathing in preterm infants

Objective Preterm infants have difficulty breathing unassisted because their lungs and respiratory control systems are immature, resulting in frequent respiratory pauses. Manual tactile stimulation provided by the nurse is effective but also selective and comes with response delays. This prompted us to develop a purpose-built automated tactile stimulation device (ATSD) to address these challenges by providing a reliable and direct response. Methods The development process followed an iterative design approach incorporating five phases. The discovery phase consisted of various studies to gain a deeper understanding of the challenges and context of the problem. The knowledge gained was integrated into user needs and requirements in the define phase, which in turn provided input for the ideate phase. Ideas, concepts and prototypes were generated and built during multiple cocreation sessions. Iterative evaluation took place to select the most promising concepts. Results Insights from all phases guided the development of Breathing Operator for BaBY (BOBBY), the first purpose-built ATSD for preterm infants. In the design, we prioritised safety and efficacy, ensuring separation of electronic components from the infant. We have employed an apparent tactile motion technique that simulates the stimulation performed by the nurse when responding to cardiorespiratory monitor alarms, to enhance neural excitation while minimising irritation or damage to the skin. Conclusion BOBBY can potentially advance neonatal care using automation and address the challenges associated with breathing pauses in preterm infants. Clinical trials are warranted to validate its safety, efficacy and added value in the neonatal intensive care unit.