#474 - 🚀 [Tech Tuesday] - mOm Incubators Returns, Now FDA Cleared and in Eight Countries

Hello friends 👋

James Roberts, co-founder and CEO of mOm Incubators, returns to Tech Tuesday almost four years after his first appearance, when the device was still in development. A lot has changed. The mOm Essentials is now CE marked and FDA cleared, in use across eight countries, and has reached roughly 18,500 patients, from NHS maternity wards to air raid shelters in Ukraine.

Daphna and James talk through what makes the system different: a bassinet sized footprint, one button operation, battery power that keeps warming through transport, and the ability to sit over a mother's bed. They discuss which babies are now staying with their parents instead of going to the NICU, the hypothermia admissions it is preventing, and how floor nurses have responded. James also shares the personal story behind the company and what mOm is building next.

mOm is now looking for US partners. Details at momincubators.com.

Link to episode on youtube: https://youtu.be/L069z-J6tuQ

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The transcript of today's episode can be found below 👇

Daphna Yasova Barbeau, MD (00:06.467)

Hi everybody, we are back for another Tech Tuesday, with a repeat Tech Tuesday guest. James, how are you doing? Welcome back.

James Roberts (00:16.726)

I'm good. It's great to be back, Daphna. I'm really glad to be back on this.

Daphna Yasova Barbeau, MD (00:18.949)

I've got with me today James Roberts, the co-founder and CEO of mOm Incubators. We're going to get into how neat, exciting, and unique mOm Incubators is, but first I wanted to mention that you were one of our very first handful of Tech Tuesday episodes. Your first episode aired as episode 91 of the show, in 2022. It's been that long, almost four years. At that time, you were really still in the development phase of mOm Incubators, so it was exciting to be a little part of seeing how mOm was going to grow.

Before we get started, tell us a little bit about the mOm incubator compared to the conventional incubators we use in high-level NICUs (neonatal intensive care units). Then we'll talk about all the uses for the mOm incubator. But first, tell us a little about the equipment itself.

James Roberts (01:34.743)

Of course. I can't believe it's been that long. That's crazy. I'm just trying to think back to where we were at that time. Everyone knows what neonatal incubators are. They've been around for a long time. They're these massive, bulky, heavy pieces of equipment that are difficult to use, maintain, clean, and get to where you need them to be. They've always been very solid, static systems that sit in one area of a hospital, which has always been the NICU. We saw this problem where people wanted or could use this type of device everywhere, but couldn't with the equipment they had. So we came up with the mOm system, where we basically took an incubator back down to its very essence and built it back up again, with the help of a lot of clinicians, obviously.

It's something very easy to move, very portable. It can literally go anywhere around a hospital and sit over a mother's bed. It offers warming as good as a conventional system, but it can be used anywhere you want. We describe it as NICU-grade warming anywhere, and when we say anywhere, we mean anywhere. It's being used in UK NHS (National Health Service) hospitals in maternity, labor and delivery, and transitional care, but also in crisis zones at the moment. In Ukraine, they're taking it from the NICU, and if there's an air raid siren going off, they take it down to an air raid shelter so they can give the same type of care anywhere. So it's being used in all these different types of settings.

Daphna Yasova Barbeau, MD (03:09.509)

And that's why you've called it the mOm Essentials. You've taken these big, bulky incubators and pared them down to be effective but much more mobile. For people who aren't watching on video, you've got one right over your shoulder there. What are the measurements? You probably know them offhand.

James Roberts (03:28.929)

I do. One of the things we really noticed when talking to clinicians is that you just don't have time to do anything. You're trying to save lives. I'm a designer by training, and design is really a study of how people use products and interact with things in the world. I saw nurses, doctors, midwives, whoever, struggling with systems all the time: remembering where all the buttons are, how to actually use the piece of equipment, having to ask other people, wasting time while the patient deteriorates, all that type of stuff. All the smart stuff in the mOm system happens under here. It's probably one of the most technically advanced systems out there, if not the most, but we've tried to get it down to literally one button. You push it to turn it on, it goes through all the testing parameters, and that's pretty much all you need to do. There are some temperature settings on the front you can change, obviously. Everything else we've tried to automate as much as possible, so it's super easy. There are lots of features that make it quite different from a conventional system, but even little things, like you can take out the main power and it goes straight onto battery. It's been clinically proven to be easy to clean and very easy to maintain. We've tried to make it as foolproof as possible, so that these just go in, they work, and they're trusted.

Daphna Yasova Barbeau, MD (05:00.101)

Love that. So from my visual viewpoint here, the system itself is about the size of a bassinet. We still use bassinets in the NICU, and we're definitely using them in the nursery. And I think one of the most impressive features is this: on our incubators, when you unplug them, they turn off and reset. So we're losing temperature during transport, even within the hospital. But your incubators can run on battery for some time. Tell us a little about that.

James Roberts (05:44.065)

It is small in how it looks, but the internal dimensions are actually big enough for quite a large baby. The way I explain our world, and it's a bit different in the US, is that it's like a triangle without the bottom edge. You start in maternity, where the baby is born. If there's a problem, you go up to the NICU. And when you're coming toward the end of your NICU stay, you come down into transitional care, where you're being transitioned out to discharge.

Obviously incubators are used a lot in the NICU; that's where they've traditionally been. But where clinicians are most excited about our devices being used is in maternity, the nursery, and transitional care, spaces where they haven't had this type of equipment before. They can suddenly put this system over a mother's bed, keep mother and baby close together, and minimize separation. They're increasing NICU capacity and saving that space for the sickest babies. A lot of this goes into the patient experience as well. A lot of mothers and fathers don't want to be separated from their baby at that time, and that's what we're seeing a lot in the UK. Then there are the costs associated with separation, which can be substantial in a lot of cases.

In the UK at the moment, they're being used for intrahospital transport. You can see it's easy to move with one hand. They're also used in maternity, even for those lower-risk patients who just need a bit of extra help staying stable in the thermoneutral zone. That works a lot better than a radiant warmer, where you have to stay next to it for hours, it gets very hot, and babies dry out. They're used in operating rooms after C-sections, and postnatally for phototherapy. I think I already mentioned interhospital transport, but basically everywhere a baby might deteriorate or their temperature might drop, we're being used, and we're stopping those hypothermia admissions to the NICU. It's also showing some reduction in respiratory distress, though we haven't proved it yet. Keeping a baby in its thermoneutral zone, with that energy triangle of warmth, breathing, and feeding, seems to stop them from going into early-stage respiratory distress. At least that's what we think we're seeing. So that's been interesting for us.

Daphna Yasova Barbeau, MD (07:57.7)

We get those calls from the nursery all the time: baby won't eat. You check on the baby, and they're cold. They were a small baby who was big enough to stay in the nursery, but still small. Then they come to the NICU, probably because they couldn't eat after getting cold, and when we warm them up, they do just fine. I think that's really neat. You've already been using these in some maternity wards. What has the response been like, and which types of babies who would have gone to the NICU are now staying with their moms and dads?

James Roberts (08:37.294)

The overall response has been really positive. I'll tell you one challenge we have, which is actually the word "incubator." People hear the name and suddenly picture these big behemoth pieces of kit that are really difficult to use. Then they see this system and say, "That looks really approachable." The parents like it as well.

Daphna Yasova Barbeau, MD (09:04.611)

Less intimidating, for sure.

James Roberts (09:08.12)

Exactly. What we're seeing at the moment is that people aren't calling them incubators; they're calling them mOms, which has been great. We're trying to move into a new category, and we're working on the education to define it at the moment, so there's definitely an education piece to this. In terms of babies who would have gone to the NICU without this, it's your 34- and 35-weekers and above, who just need a bit of extra help. Before, they might have gone to the NICU for one or two days. Instead, they go into one of these systems and are potentially discharged a lot quicker, used alongside kangaroo mother care, of course. It makes sure they get that extra help at the very beginning of their life, which helps them thrive going forward.

Daphna Yasova Barbeau, MD (10:00.026)

I love that. We were just reviewing an article, and we know that here in the US, 34- and 35-weekers make up a big proportion of NICU admissions. Wouldn't it be remarkable if the babies who don't need respiratory support or continuous IV (intravenous) fluids could stay with their parents and family for bonding? I think it would revolutionize the way we do NICU care.

James Roberts (10:31.606)

That's what we're hoping for, and seeing. Imagine if you could extend a NICU without extending its walls. That's NICU-grade warming anywhere: putting these in nurseries, giving that type of care, and making it available to all. That's really what we're trying to do at mOm, especially in the UK and US use cases.

Daphna Yasova Barbeau, MD (10:57.593)

Let me ask you something, because I know some of our bedside nurses will be listening. Maybe the system is different in the UK, but let's talk this out. Somebody will say, "You're keeping this baby with mom and dad on labor and delivery or the postpartum unit. How is that affecting the nursing flow?" Have you had any pushback, along the lines of, "This baby would have been cared for by a NICU nurse, and now they're being cared for by a floor nurse"? Has anything like that been a barrier?

James Roberts (11:39.191)

Sometimes, initially, there is. You've got to get over that education piece. But if you think about what a floor nurse is doing, they're already checking those measurements and making the decision to send the baby to the NICU anyway. This system is very simple to use, and we've got temperature probes and all that, so you can monitor the baby very effectively. They get used to it very quickly once you put it in front of them. So far, it's been seen positively. Of course, every hospital has its own protocols and different ways it wants to use the mOm system. Some centers start more conservatively and then expand into other patient groups. But in general, it's been received fairly well.

Daphna Yasova Barbeau, MD (12:27.226)

I love that. People must be wondering why you got into designing these thermoregulation units. Why was this such a passionate area for you?

James Roberts (12:35.266)

Why did I get into this? I'll give you a bit of my background. As I said, I trained in product design. It was always my first love. I had the choice of doing biomedical sciences or design at university, chose design, and was very lucky to go to one of the best universities in Europe for it. I grew up playing with cars, motorbikes, Lego, the kind of nerdy stuff that creates people like me. In our final year of study, we were given the brief: design something that solves a problem. Very blue sky, and it worries a lot of students, because it's a massive part of the degree.

The day after receiving that brief, I happened to sit down in front of my TV in my student flat, and a documentary came on explaining that, because they lacked what seems like a simple medical device, an incubator, generations of children are being lost globally. It showed the issues in the UK and US with access to maternity and neonatal care, but also other areas of the world where these devices are lying broken in equipment graveyards. It's quite an emotive type of product, and it's sad to see these things not being used effectively. I thought, if these devices haven't really been rethought since the 1970s or 80s, which is where I see the last innovations coming from, wouldn't that be an interesting thing to spend a year on? Something that could actually impact people around the world. University is one of those times you can do that. As long as you follow a process, you've got the freedom to do what you want, and the university I went to, Loughborough, really allowed that. It was great. So I decided, why not do this?

That's where it got a bit strange, because I told my mum what I was doing, and she said, "That's weird." I asked why, and she sent me this picture. For listeners, it's a picture of my mum in one of the early incubators in London in the 1960s. It almost looks like an old oxygen chamber. Suddenly it went from an interesting problem to solve to something personal. I literally wouldn't be here without one.

Daphna Yasova Barbeau, MD (14:59.972)

So cool. And to your point, those of us in high-resource countries and high-tech units are thinking about this as an opportunity to keep babies out of the NICU. But you're right, thermoregulation, and we did a great mini-series on it, is a worldwide cause of mortality. There are babies who could survive and thrive if they could just be kept warm, and this might provide that opportunity for some babies in more resource-poor areas of the world.

James Roberts (15:45.955)

Definitely. It's the very base of neonatal care. For some reason I like talking in triangles, but if you imagine the base of that triangle, it's thermoregulation. There are some great kangaroo mother care programs in the world at the moment that have saved a lot of babies, but there are limits to them. It's hard keeping a baby on someone's chest 24 hours a day, and some babies need extra care beyond that. That's where incubators come in, and that's why in the UK and US we use a combination of the two. That's where the mOm system fits. It's a really robust system and can be used around the world. We're in about eight countries now, and being used in so many different areas really proves the flexibility and accessibility of the system. It's CE marked, and we recently got FDA (Food and Drug Administration) clearance. We think we've impacted around 18,500 patients now, which has been really exciting. That's the North Star for the entire team.

Daphna Yasova Barbeau, MD (16:41.914)

Very exciting. Amazing. That was really my next question: since we recorded four years ago, you have grown exponentially. What do you envision the future of the mOm Essentials will look like?

James Roberts (17:03.374)

For the mOm Essentials, we want to get it into as many places as we can. We started in our home market, the UK, getting these into NHS sites, which I'm sure some of your listeners will know is quite difficult at the best of times. But they've been great to work with in general, with really talented clinicians at a lot of NHS sites. Now we're looking to go into the US as well; we're very early on there. And then getting these out into difficult regions globally. We work with a few NGOs (nongovernmental organizations) who really value this system as well and are using them everywhere, which speaks to the robustness of the device.

Daphna Yasova Barbeau, MD (17:47.876)

I know you've been incredibly busy, but I know you've got a mind that's always working. You don't have to give us all the details, but is there something else on the horizon for the company as a whole?

James Roberts (17:58.829)

The interesting thing about mOm is that the incubator is our flag in the ground. It's our first demonstration of what we can do. We've taken a device that hasn't really been rethought for a long time, built it from the ground up, and shown that with some human factors design work, you can make these very robust, very easy to use, and able to go literally anywhere. There are so many pieces of equipment like that, especially in the NICU, things that probably haven't really changed since you started training, that should be made more flexible and usable in different parts of the hospital with the right supervision and training. That's what we want to do at mOm, sticking within that energy triangle of feeding, breathing, and warmth, and looking at how we can minimize separation of parent and baby. That's where we want to go with mOm in the future.

Daphna Yasova Barbeau, MD (19:02.534)

If people are listening and thinking, "We could use this," what's the best way to reach you? I know you're always looking for collaborators and partners.

James Roberts (19:12.014)

We've got an inquiries page on our website, and there's also my email and LinkedIn. It would be great if you could put my email in the show notes. I'm happy to share that, or an inquiries address.

Daphna Yasova Barbeau, MD (19:24.046)

Absolutely. You've got a really easy-to-use website with videos for people to look at, at momincubators.com, and they can contact you there under Contact. James...

James Roberts (19:40.719)

Definitely. I'll just do a quick call to action on what we're looking for. We're at the start of our US journey, and we're looking for partners who can help get our device into their clinicians' hands: places with nurseries, maternity units, places that sometimes see cold babies. Some people have described nurseries to me as chaos, and these systems really help there. Also lower-level NICUs, level ones and level twos, that potentially have to transfer babies unnecessarily. That's where we're really looking to go, and we're starting to talk to people. Those are who we'd be really interested in speaking with at the moment.

Daphna Yasova Barbeau, MD (20:24.996)

For our hospital system, I can imagine some areas of definite need in addition to the ones you've highlighted. We get a lot of babies from outlying ERs (emergency rooms) who come in unexpectedly or deliver unexpectedly, and we struggle with thermoregulation. Even if they come in some sort of unit, in the ambulance, or with mom, they're always, always cold. So I can imagine what this would mean for outlying ERs and rural communities. Wow, I think it would make such a difference for major regional centers bringing babies in from all over the countryside. So I'm excited, and I'm hopeful that lots of people will get in touch with you about new opportunities.

James Roberts (21:19.19)

Maybe you'll see a mOm near you soon.

Daphna Yasova Barbeau, MD (21:22.19)

That's right. I love that. James, we love having you on, we love chatting with you, and we love seeing mOm Incubators grow. I hope everybody will check out your website and think about how they can incorporate mOm incubators into their flow of caring for babies. Thank you so much for joining us again.

James Roberts (21:44.248)

Thank you so much for having me. It's been a lot of fun.

Daphna Yasova Barbeau, MD (21:46.855)

My pleasure.