Every year, more than 1 in 10 babies are born pre-term. Of those, one million children die from related complications. According to mOm Incubators, 75% of those deaths could be prevented with simple interventions, such as keeping babies warm. The company’s Essential Incubator was inspired as one such intervention, to address the lack of flexible neonatal care available to support medics in challenging environments.
On seeing a documentary that highlighted this issue, James Roberts, mOm’s CEO and Co-Founder, realised that “[in lacking] this piece of medical equipment, namely, neonatal incubators, you’re effectively losing entire generations of kids … I thought that was a strange thing to still be happening because when you research it, you find out that the real face of good neonatal care is thermal regulation.” As a newborn, James’s mum was in one of the first incubators in the UK. “Without one, I wouldn’t be here.”
The optimistic engineers
James studied design at Loughborough University. His entry into this world was a childhood passion for building things. “My parents would probably say a passion for destroying things. I was good at taking things apart, and sometimes I was good at putting it together. But the two didn't always match up.”
He thinks this came partly from his mum’s side of the family: his grandfather invented one of the original cooling systems for nuclear rods – making him part of “a lineage of tinkerers”. James is careful to stress that he’s not a true engineer. “I call myself an optimistic engineer. Designers and engineers are usually quite different [sorts of] people … or have different ways of looking at the world.”
Gemma Singer, mOm’s lead engineer, politely disagrees. “It takes a lot of optimism to see a problem that you don't know how to solve and think, if I work at it, I’ll be able to do it. Maybe it's a different sort of optimism, but you need to have that resilience to work through a problem and see it through to a solution.”
She arrived at her mechanical engineering degree at Imperial College London by combining her strengths in maths and the sciences, with craftier hobbies like sewing. Like James, tinkering comes naturally to her. “My friends [are like], ‘I can’t believe you tried to just take apart the sink!’ I assume that’s normal, but maybe it’s not!”
Ups, downs, and ups
Having become aware of the problems with conventional incubators, James came up with an idea for a more accessible, portable incubator during his degree. He built an inflatable prototype for his degree show, which culminated in him winning the prestigious Dyson Award in 2014, aged just 23.
“Life kind of changed for a little bit. I think I got too much attention, too young,” he says. “The one thing I wish I did was not put a massive milestone on myself at the very beginning. [After winning the Dyson Award] I said OK, right, the next thing now is to get it working and clinically used, not realising that was going to take five to six years of my life.”
Taking this burden on his shoulders, James started the company in 2016, taking in the ups and downs of the startup world along the way. He has been a member of the Royal Academy of Engineering’s Enterprise Hub since winning the 2015 Launchpad competition, with a prize of £15,000. In 2019 he joined the six-month SME Leaders Programme for coaching, business mentorship and leadership training. "The Academy has been very, very supportive,” says James.
Besides fundraising, the team also had to overcome the challenge of product development in a pandemic. Gemma describes “doing late night Zoom calls and James has a video camera on a largely transparent medical device, and we're trying to conceptualise how to solve a problem. It's very tricky when you can't all get round the product itself and physically show your thoughts.”
But what the team has produced is unlike conventional incubators, in that it can operate anywhere. Not only does this allow it to support transitional care, as demonstrated in its first pilot for the NHS; it can also support rural and remote births. The compact and lightweight incubator can be packed up to half of its size, while being able to operate off inconsistent voltage supplies, or a backup battery.
In November 2021, mOm achieved its first clinical use in the UK. St Peter’s Hospital in Chertsey was the first NHS hospital to use the incubator to keep a baby warm. The collapsible, portable incubator filled a niche that traditionally immobile incubators are unable to. “When babies get cold and need transitional care, having to go to NICU needlessly and stressing out the parents – we can save a lot of time, energy, and effort,” says James.
Of the experience, he says: “I don't have the vocabulary to properly explain it… Every 18-hour day, every problem, every little thing just melted away.” Since then, as part of the NHS pilot, 27 babies have now been monitored and kept warm inside the incubator.
The team also had to overcome the arduous regulation process required in the medical device industry for the incubator to receive a CE mark – meaning the incubator can be sold commercially in the EU. “To give an idea, our technical file submission was six or seven times longer than War and Peace,” says James.
A global problem
The company has its sights set on the global picture. “I think two-thirds of medical devices are sold to the US, Japan, Germany and France alone… [As] you can imagine, most are designed for this very small portion of the market,” says Gemma. “They are just not designed for places with diverse infrastructures. You might not have consistent power, or the ambient temperature might be different, and cause a whole bunch of alarms to go off – whereas it's never an issue in an air-conditioned NICU in many parts of the world. There is a bias, for sure.”
As a result, many such devices end up unused. This also chimes with another starkly evident inequality. While most babies born before 32 weeks of pregnancy in high-income countries survive, in low-income settings, half of preterm babies die because of a lack of access to practical care, which includes warmth, among other factors. Shocking figures such as these are precisely why more attention needs to be bought to this problem.
Saving lives in Ukraine and promoting circularity
As challenging environments go, few are more challenging than regions experiencing conflict. In May, the company sent 51 of its incubators to Ukraine (In brief, Ingenia 91) to help support the country’s fractured medical system, where the stress on citizens since the Russian invasion has caused a spike in premature births.
Looking to the future, James says mOm isn’t just about the incubator. “So many devices are stuck in the 1980s… they haven’t been looked at for 40 years. Medical devices is a bit of a dirty industry when you get into it – just the amount of waste. I understand the sterilisation needs, but maybe things need to be thought about a bit differently.”
For mOm, aside from battling the medical equipment graveyard, James is also hinting at a business model that promotes circularity and an economic model that rewards building things to last. “Otherwise, it just gets boring, right? You’ve got to challenge yourself,” he laughs.