Authors:
Juan Li, Hemin Du, Junfeng Wang
Breast milk is the most natural source of nutrition for infants, and breastfeeding plays a vital role in the physiological and psychological health of mothers and infants. Smooth breastfeeding is a key factor in establishing a positive emotional bond between mothers and infants. Desley Hegney et al. [1] reported that about half of mothers see breastfeeding as a way to establish contact with their babies, and that difficult breastfeeding is emotionally challenging. Koa Whittingham and Amy Mitchell [2] concluded that negative breastfeeding experiences had an impact on the mother-infant relationship. They emphasized the importance of breastfeeding support, which is conducive to mother-infant coordination. Many infants, however, face difficulties in breastfeeding due to health conditions that result in absent or inadequate sucking and swallowing ability. These conditions include cleft lip and/or palate [3], prematurity [4], Down syndrome and other trisomies [5], neurological disorders [6], and Pierre Robin syndrome [7]. Infants with these conditions are collectively referred to herein as infants with disabilities. Our focus is on addressing the breastfeeding difficulties of these infants, providing breastfeeding support, and reestablishing the intimate emotional connection with their mothers is the focus of our attention. This article discusses the challenges and solutions of breastfeeding aids for infants with disabilities. In addition to the basic functions of the products, we focus on the psychological functions of breastfeeding aids for these infants—emotional interaction—and provide ideas and suggestions for future designs.
Insights
→ Breastfeeding is a challenge for infants with disabilities who have inadequate sucking and swallowing ability.
→ Replacing suction and controlling flow rate is an idea that should be further explored in the design of devices for these infants.
→ The importance of emotional interaction between mothers and babies should also be a guiding principle in the design.
Challenge 1: Sucking and Swallowing Absence or Deficiency
Lack of or inadequate sucking and swallowing are two major challenges infants with disabilities face when breastfeeding. Insufficient sucking ability prevents these infants from effectively drawing milk, leading to inadequate nutrient intake. Similarly, a lack of or weak swallowing ability causes infants to feed at a very slow pace. On the other hand, if the flow rate of breast milk exceeds the infant's ability to swallow, it can easily result in choking, which in severe cases can lead to middle-ear infection (otitis media) and pose a serious threat to the infant's health.
Potential solution: Replace suction power and control the flow rate. We conducted research on existing breastfeeding methods for infants with disabilities. The main methods include using spoons, droppers, gastric tubes, and breastfeeding devices. The latter are designed to allow infants to easily drink breast milk by replacing the need for suction. These devices also control the flow rate, which addresses the issue of insufficient sucking and swallowing ability.
The Medela SpecialNeeds Feeder and the Kelaifu bottle for infants with cleft lip and palate (Figure 1) use pressure instead of suction. The Medela features an isolation valve that opens when a baby gently presses against it, allowing them to feed on the milk. The valve closes when the baby pauses, helping them easily manage the flow of expressed breast milk. The nipple is equipped with three graduation lines: zero, medium, and maximum flow. By selecting the corresponding line on the nipple to point to the baby's nose, the flow rate of the feeder can be controlled. A one-way valve is situated between the bottle and the nipple, which can help control the milk flow rate and prevent air from entering the bottle.
 | Figure 1. The Medela SpecialNeeds Feeder (left) and the Kelaifu bottle (right). |
The Kelaifu bottle includes a soft body, a nipple, and an anti-backflow plug. The nipple features a sucking part that extends into the baby's mouth and a base part that attaches to the bottle. One side of the sucking part is thinner than the rest of the nipple. The anti-backflow plug is inserted into the inner side of the nipple's base. By thinning one side of the sucking part and incorporating an anti-backflow plug, a relatively closed space is formed at the front end of the nipple. To feed, the baby simply presses their tongue against the thinner part of the nipple, which allows the liquid in the bottle to enter the baby's mouth. When the pressure on the nipple is released, the liquid automatically refills from the bottle into the nipple. The design provides better feeding care for infants with cleft lip and palate. The base part of the nipple adheres to standard-size common nipples, making it compatible with most standard bottles and caps on the market, increasing its applicability and widespread use.
To complement these approaches, we designed a breastfeeding device for infants with disabilities (Figure 2). To solve the problem of insufficient sucking ability, the product integrates sucking and feeding functions. It uses electricity to simulate suction, allowing infants to feed without relying on their own sucking ability (Figure 3). The breast-suction mechanism uses the principle of a breast pump. A brushed direct-current (DC) motor air pump works together with an air-release valve to create negative pressure in the breast-suction chamber at a specific frequency, gently squeezing the breast to extract milk. The milk then flows into the reservoir through the milk outlet pipe. At the feeding end, the air pump, in collaboration with the air-release valve, connects to the milk storage device via a duckbill valve, ensuring stable and safe air pressure. The pressure moves the milk from the reservoir into the nipple, allowing the baby to easily drink by gently pressing the nipple.
 | Figure 2. Breastfeeding device for infants with disabilities designed by the authors. |
 | Figure 3. Replacement of suction power in the breastfeeding device designed by the authors. |
To address the challenges faced by infants with disabilities, the product incorporates a human-computer-coordinated intelligent speed-control system. The brushed DC motor air pump and air-release valve maintain stable pressure, guiding milk into the nipple (Figure 4). The nipple's design—thicker at the top and thinner at the bottom, with a Y-shaped opening—enables the baby to control the milk flow using tongue pressure. When the tongue presses upward, pressure increases and the flow rate rises. When the tongue presses downward, pressure decreases and the flow rate lowers. The feeder is equipped with a one-way valve that regulates the milk flow rate and prevents air from entering the reservoir.
 | Figure 4. Human-computer-coordinated intelligent speed control in the breastfeeding device designed by the authors. |
Challenge 2: Lack of Emotional Interaction
Breastfeeding for infants with disabilities not only allows them to drink breast milk but also promotes emotional interactions with their mothers. Existing breastfeeding devices for infants with disabilities have been developed in the form of bottles or bottle-like devices, with special milk-dispensing methods and nipples that replace suction and control the flow rate. These devices help infants with limited sucking and swallowing abilities safely consume breast milk, thus addressing their feeding challenges. They do not, however, allow for the same emotional interactions as breastfeeding, and both mothers and infants miss out on the joy of the experience. The lack of emotional connection can pose a serious threat to the mothers' psychological well-being, particularly for those who are unable to achieve the self-efficacy of breastfeeding, and to their bond with their babies.
Potential solution: Simulate breastfeeding. Breastfeeding is an intimate act. The close skin contact and nurturing interaction foster a deep emotional bond, which helps the baby develop a sense of security and trust, positively affecting the psychological well-being of both mother and child. Therefore, specialized infant breastfeeders should aim to closely simulate naturally occurring breastfeeding to meet the emotional needs of both mothers and babies.
We explored existing products in this area and found a patent developed in China. It includes a suction cup, breast cushion, connectors, grip, sealing ring, nipple, hose, and control valve. The suction cup connects to one end of the grip section via connectors; the other end of the grip section is connected to the nipple by the sealing ring. The breast cushion is placed inside the suction cup to simulate breastfeeding. The control valve generates pressure on the breast cushion, allowing milk to be expressed through the nipple and directly fed to the baby. This design enables babies with limited suction ability to drink fresh breast milk, allowing both mother and baby to enjoy the breastfeeding experience.
While this product represents a preliminary exploration of simulated breastfeeding, it is lacking in appearance. To address this, we designed our breastfeeding device for infants with disabilities (Figure 2) with a bionic form that resembles a mother's breast, offering a more natural feel. The device integrates sucking and feeding functions, with an air pump that mimics the frequency of a baby's natural suckling, simultaneously delivering breast milk to the baby's mouth. The feeding mode replicates naturally occurring breastfeeding.
Challenge 3: Breastfeeding is Inconvenient
The inability to breastfeed is already a significant emotional challenge for mothers of infants with disabilities, and a complicated feeding process can lead to even more stress. Therefore, the design of feeding devices should aim to simplify breastfeeding, provide a positive experience for mothers, and reduce their stress.
Most breastfeeding devices for infants with disabilities require mothers to pump breast milk and then transfer it to the device before feeding the milk to the infant. This adds steps to the process, increasing the emotional and physical burden on mothers. While the patent developed in China that we described earlier eliminates the above steps, it still requires the mother to hold the feeder and manually control the valve, which does not allow her hands to be free and adds significant inconvenience to the process.
Potential solution: Integrate sucking and feeding to use with a bra. We designed the breastfeeding device to integrate sucking and feeding, eliminating the need for a traditional breast pump to collect milk and transfer it to a bottle. With smart suction and a compact design, the product can be used with an integrated bra, freeing up the mother's hands (Figure 5).
 | Figure 5. A bra integrated with a breastfeeding device designed by the authors. |
Conclusion
Breastfeeding plays an irreplaceable role not only in the physical growth and development of infants but also in establishing a strong emotional bond between mothers and their babies. The challenges in breastfeeding faced by infants with disabilities need to be addressed, with the primary concern being inadequate sucking and swallowing.
We propose a solution that focuses on replacing the suction force and controlling the flow rate. In addition, it underscores the importance of emotional interaction in breastfeeding aids for infants with disabilities. Existing aids are designed as bottles or bottle-like products, which do not allow mothers and their infants to experience the joy and emotional interaction that breastfeeding affords.
Simulated breastfeeding may be one solution. The breastfeeding device for infants with disabilities designed by the authors imitates the shape of a breast and integrates sucking and feeding functions. However, further innovation is required to achieve a greater degree of similarity with naturally occurring breastfeeding.
References
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2. Whittingham, K. and Mitchell, A.E. Birth, breastfeeding, psychological flexibility and self-compassion as predictors of mother-infant emotional availability in a cross-sectional study. Infant Mental Health Journal 42, 5 (2021), 718–30.
3. Reilly, S. et al. ABM Clinical Protocol #17: Guidelines for breastfeeding infants with cleft lip, cleft palate, or cleft lip and palate, revised 2013. Breastfeeding Medicine 8, 4 (2013), 349–53.
4. Wang, Y., Briere, C.-E., Xu, W., and Cong, X. Factors affecting breastfeeding outcomes at six months in preterm infants. Journal of Human Lactation 35, 1 (2019), 80–89.
5. Thomas, J., Marinelli, K.A., and the Academy of Breastfeeding Medicine. ABM Clinical Protocol #16: Breastfeeding the hypotonic infant, revised 2016. Breastfeeding Medicine 11, 6 (2016), 271–76.
6. Wilson, E.M. and Hustad, K.C. Early feeding abilities in children with cerebral palsy: A parental report study. Journal of Medical Speech-Language Pathology (2009), nihpa57357.
7. Nassar, E., Marques, I.L., Trindade, A.S., Jr., and Bettiol, H. Feeding-facilitating techniques for the nursing infant with Robin sequence. Cleft Palate-Craniofacial Journal 43, 1 (2006), 55–60.
Authors
Juan Li is a graduate student at Shenzhen Technology University. She has a strong research interest in HCI. [email protected]
Hemin Du is a professor in the School of Design and Innovation at Shenzhen Technology University. He teaches a wide range of courses in industrial design and related fields. [email protected]
Junfeng Wang is a professor in the School of Design and Innovation at Shenzhen Technology University. He teaches several courses in UX and related fields. [email protected]
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