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Innovator Spotlight – Betty Kuo

Betty Kuo,
Inpatient Neonatal Physical Therapist, CHOC

You recently came up with an innovative solution to help patients being treated for omphalocele. Can you share more about this with us?

Omphalocele is a birth defect where the abdominal organs protrude outside of the body due to a defect of the abdominal wall. Babies with this defect are limited in positioning and often times cannot be positioned prone until the sac is epithelialized. This doesn’t allow the baby to have any “tummy time”. Prone positioning is challenging for a patient with an omphalocele but there are also many studies supporting the benefits of tummy time including
improving gross motor skill development, preventing positional defects and improving cardio and respiratory function.

I wanted to see if there was a way to allow for tummy time for these babies, a position that they have never been able to experience. My concept was to create a cushioned foam surrounding with a “hammock” to support the protective shell covering the infant’s abdominal defect. My prior experience in wound care, particularly in the NICU setting, underscored the importance of meticulous care in protecting vulnerable areas. This knowledge became a primary focus in the design of the solution, as I understood the intricate needs of this specific patient population. The significance of safeguarding not just the immediate physical well-being but also the long-term developmental aspects cannot be overstated. With these factors in mind, I created a simple prototype, which was very encouraging and exciting, as I was seeing my idea come to life. It wasn’t easy, and I had to really think through the design and the materials, trying multiple solutions until I arrived at my current design. Soon after this, I met with the Mi4 team, sharing the problem statement and potential solution. It was so great to speak with Mi4 about my concept, as we talked through options for next steps. What struck me as particularly crucial was the collaborative effort involving not just physical therapists but a multidisciplinary team, including physicians, nurse scientists, biomedical engineers, and more, focused on ensures a comprehensive understanding of the unique challenges for our patients and families. It takes more than a single person to make something like this come to life. One of our meetings even included a physician that was visiting from a children’s hospital in the UK, and Mi4 is reached out to several other children’s hospitals who are very interested in collaborating to help make this a reality.

The innovation process takes time and resilience. What keeps you moving forward?

I was approved to share my design with one family and trial it. Their baby was fussy and having trouble sleeping due to the prolonged positioning on his side. They were excited to see that I had taken the initiative to find a way to make their baby more comfortable. Since then, I keep thinking about the baby and the parents, and all of the other families like them. The relief that they showed with the possibility of their baby being more comfortable and having the opportunity for tummy time. It is also great to think about how the clinical team reacted, seeing the effort that went into finding a way for our patients and their families to have a better experience. The reactions all around are what keep me going. I am looking forward to moving this forward; refining it and being able to test it and measure results through a clinical study. I am confident that we will find much more than comfort as the outcome of this, based on the scientific research that has been done on the multiple developmental benefits of tummy time. I know that our entire team will want to be involved, the doctors, nurses, respiratory therapists, and of course our amazing families. That’s one of the things I love most about CHOC. The desire and team approach to always improving the care and experience for our patients and families. The innovation process is a journey, both challenging and rewarding. I’m excited for the next steps in the process.