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UD students, Nemours create chair for babies with fragile bones

University of Delaware students and Nemours doctors have designed a chair to help keep babies with brittle bone structure safe. 




Babies with Osteogenesis Imperfecta, more commonly known as Brittle Bone Disease, have to be handled more carefully than other infants because they’re prone to spontaneous bone fractures.  


Several UD biomedical engineering students who enrolled in a clinical immersion course partnered with Nemours Alfred I. duPont Hospital for Children in Wilmington to build a chair that protects a baby’s skeleton while allowing them to do things other babies do, like playing with toys and eating.


Sarah Rooney, a biomedical engineering professor, said the way parents try to safely carry their babies around now doesn’t always work. 


“Parents will kind of scoop them up in their arms and prop them on pillows so that they’re situated properly,” Rooney said. “However, that’s not necessarily giving them the support that they need, nor are they able to interact with the world around them.”  


Parents buckle their baby into the chair, which has a soft memory foam cushion to absorb any pressure that could damage their skeletons. Doctors work with the parents to find comfortable positions for their child, and they use the chair to shift the infant’s position from sitting upright to laying back. The chair is designed for patients with the most severe forms of Brittle Bone Disease.


According to the Osteogenesis Imperfecta Foundation, OI, or Brittle Bone Disease is “a genetic bone disorder characterized by fragile bones that break easily.” 


Dr. Michael Bober, the director of the Skeletal Dysplasia Program at Nemours, said one in 20,000 babies across the world are recognized to have Brittle Bone Disease at birth. But there are some cases that go unrecognized at birth - found after a baby turns more than a year old and breaks a bone.


“Cognitively, these children are typical. They have average intelligence,” Bober said. “But they have very weak, fragile skeletons. So we want them to be engaged with the world, engaged with their environment, and that means, really, we have to bring the environment to them.”


Babies with severe Brittle Bone Disease are typically diagnosed on an ultrasound before birth. After birth, doctors assess the baby’s skeleton and any fractures they may show at birth, Bober said. They look at how they’re breathing or if they broke any ribs. They might prescribe medicines to improve bone strength.


And Bober said because muscles naturally pull on bones when a person moves around, a contraction in the muscle could cause a fracture in a patient with brittle bones. As a result, these children have delays in motor development and parents need to be able to assist them to do most things, for example, sitting up, Bober said.


“The bones of the spine are fragile and I believe if we get these children upright too quickly, the gravity force through the spine can actually lead to additional fractures and compromise the spine,” Bober said.


Nemours and UD initially partnered on this project in the Fall 2016 semester, and built a prototype of the chair. This past semester, they worked with mechanical engineering students on understanding the clinical significance of the design. The worked on a second-generation prototype of the chair and developed a survey for OI patients and families to understand the needs of these infants. 


Eventually, if they identify that enough babies in nearby areas could use this type of chair, Rooney said they could put the chair on the market.


Rooney said she expects infants to use the chair for a year or two before they outgrow it.