Year/Course: 2010-2011, Easter 2011

Contact: Stephen Gerrard, Chemical Engineering & Biotechnology & Arron Rodrigues, Engineering World Health Cambridge
Other information: JustMilk

Originally based on an idea from a conference at MIT where a team of students were challenged to reduce mother to child HIV transmission, Stephen, Arron and their team are working to develop nipple shields designed to deliver anti-retrovirals to babies while they are breastfeeding (nursing).

The idea is that by delivering the drugs during a normal milk feed, babies will be more likely to swallow and absorb them without spitting them out. Secondly the drugs can be administered at home by the mother, rather than needing a visit to the nearest clinic, which greatly increases the likelihood of continuing the course of treatment.

An initial acceptability study has been conducted in Kenya with the NGO PATH. This used sample nipple shields and drug inserts but no real drugs. Shields were shown to various stakeholders in the village and the concept explained to them and their feedback recorded. For example, mothers were worried about the stigma of using the shields outside the home and therefore being identifiable as mothers with HIV. If the drug used only required one dose a day then this could be overcome by giving a single feed with the shield, leading to a second concern which still needs to be researched, as to whether the baby will accept some feeds with a nipple shield and some without.

The team firstly looked at delivering compounds which killed the HIV virus in the milk, which would need to be delivered in every feed to be effective. New WHO guidelines now recommend anti retro-viral drugs instead, so the focus of the research has moved to look at these.

The challenge for the i-Team is to work with Stephen and Engineering World Health Cambridge (a student society) to investigate the potential routes to market and sources of funding for the product. They will do this by discussing the nipple shield product with a wide range of industry experts and potential partners and funders. For example, would the nipple shields be purchased by local governments or by NGOs? How would they reach the women who need to use them? Should JustMilk partner with an existing nipple shield manufacturer, with an existing nutrition company or drugs company? Which funders are interested in the area and might provide commercial, charitable or research funding for the project?

The i-Team will also be invited to the regular Design Progress meetings with EWH Cambridge and their partners, to better understand the context of their work. The research is supported by the Gates Foundation and by the charity Family Health International.