UdeM nursing student develops hammock for preemies

In 2021, Université de Montréal graduate student Adèle Saives asked to fast-track into the doctoral program in nursing specifically to work on an ambitious project: a device to support the development of prematurely newborn babies.

This was a major undertaking, probably a first for a doctorate in nursing, according to her supervisors, Faculty of Nursing professor Marjolaine Héon and Marilyn Aita, a professor and researcher at the Azrieli Research Centre of the UdeM-affiliated CHU Sainte-Justine.

Saives had come across a study of a handmade neonatal hammock used in Brazil. After some research, she concluded that nothing similar existed in North America or Europe, and there was no standardized model on the market.

She called her project Prémac — and the hammock has come a long way since. It underwent initial testing in the neonatal unit at CHU Sainte-Justine and then received funding under a pilot program there to clinically validate new healthcare technologies in a real-world environment.

The project is jointly supported by the CHU Sainte-Justine Research Centre, Quebec’s Ministry of Economy, Innovation and Energy, and Axelys, a non-profit that supports the transfer of innovations produced by research to promote sustainable prosperity for Quebec.

Developed by a research team led by Adèle Saives who is supported by a CIHR doctoral training scholarship, and used in the neonatal unit at CHU Sainte-Justine, the hammock is already generating significant interest. Since a patent application for it is still under review, however, images of it are not being circulated.

After delivery, a premature baby is flung into a blindingly different environment.

“In neonatal units, we want to optimize neurological development,” said Saives, who has also worked as a neonatal nurse at CHU Sainte-Justine since 2020. “So we try to provide the same sensory stimulation as during pregnancy.”

In the womb, it's darker and quieter than outside, but the foetus is also free to move. “That provides important stimuli for brain development, promoting everything from coordination to sleep,” Saives said.

In an incubator, however, premature babies have little opportunity to move in ways that engage their vestibular system. Saives wanted to create a hammock that would allow more movement, activated simply by the baby’s breathing, while at the same time enveloping the baby.

“This is the closest we can get to in utero movement,” she said. “We think it could have positive effects on the stability of physiological parameters and also on sleep, which is very important for the development of premature newborns.”

Saives drew extensively on her experience and practical knowledge as a nurse.

“Adèle did it all,” said Aita and Héon. “She didn’t just come up with the idea, she created the design using software, chose the materials, sewed the prototype and recruited the hospital’s seamstresses to produce the final models.”

Saives was also concerned with getting her idea accepted. “It was important to make my project compatible with the care routine in a clinical setting,” she said. The response at the hospital was enthusiastic from day one, she added.

Saives consulted people from a variety of disciplines: neonatologists, physiotherapists, occupational therapists, respiratory therapists. She then worked on the first sketches with Sophie Labat, then a doctoral student in biomedical engineering at Polytechnique Montréal.

Then she sewed the prototype. To design a fastener that would work on the new-model incubator used in the neonatal unit at CHU Sainte-Justine, she sought the expertise of Julie Lévesque, an engineer at the Centre de métallurgie du Québec.

While the project spans several disciplines, Saives’ experience gave her a holistic vision. “Her university training in nursing equipped her to consider many aspects of the device in terms of developmental care,” said Aita.

Every detail was carefully analyzed, from the choice of the material that gently envelops the babies to the seams, which must not damage their fragile skin. The hammock can also be quickly laid flat for an emergency intervention and can be easily disinfected.

After confirming the safety of the technology, Saives is now conducting a randomized clinical trial involving premature babies in the neonatal unit at CHU Sainte-Justine who were born at between 26 and 35 weeks.

“I want to evaluate the effects of the hammock compared with babies lying on their backs in an incubator,” she explained.

In addition to the funding agencies and Axelys, Saives has received assistance from other organizations including the Canadian Institutes of Health Research, UdeM’s Bureau Recherche-Développement-Valorisation (BRDV) and the CHU Sainte-Justine’s Bureau de l’innovation.

“This was a new process for us,” said Saives. “We really appreciated the step-by-step support.”

If the results of the clinical trial are positive, Saives hopes to patent the Prémac and see widespread use of the device. But whatever the results, the project has been formative and rich in both intellectual and human discoveries, she said.