Decentralized human milk banking with ODK sensors

Abstract

Developing countries are faced with the daunting challenge of lowering their neonate and child mortality rates. Studies have indicated that up to 13% of the deaths of children under the age of five could be prevented by breastfeeding alone. One key barrier is the availability of breast milk for vulnerable infants (those born pre-term, with low birth-weight, to HIV-positive mothers, or orphaned at birth). One strategy to increase availability of breast milk is establishing human milk banks that process donor milk. However, it has been difficult to provide safe, pasteurized donor breast milk to infants in developing countries due to cost and lack of infrastructure. Low-cost pasteurization methods require rigorous temperature monitoring and quality assurance processes for adoption at scale. In this paper, we present an affordable system to monitor breast milk pasteurization. It leverages mobile and sensing technologies to enhance an existing, low-cost pasteurization method called flash heat pasteurization. A mobile application, running on an Android phone that is connected to a temperature probe, monitors milk temperatures during pasteurization, and provides audiovisual feedback to guide users performing the procedure. At the end of the procedure, users are able to print a pasteurization report, and labels for pasteurized milk jars from the mobile application. The pasteurization temperature curve is also uploaded to a server that enables supervisors to remotely review procedures and perform audits to ensure that procedures are being performed correctly. We discuss the lessons learned from ongoing deployments at two locations in Durban, South Africa. To date they have processed microbial assays for 40 donor milk samples in which 31 samples showed microbial activity pre-pasteurization, while none of the post-pasteurized samples show any microbial growth. We are currently working with the Human Milk Banking Association of South Africa to scale up the use of the system to more sites.