When Seattle Children's went to Africa in 2007, it was to train the local surgeons how to fix cleft palates, a birth defect where the roof of the mouth hasn't fused together to seal off the nose.
"But on our very first trip there, we realized that we had ignored something that was very obvious," said Dr. Michael Cunningham.
These children aren't able to feed properly. "They get a lot of air and they don't get as much milk as they need," he said.
Malnutrition is a significant issue and a life-threatening one.
"We needed to come up with a way we could use a modified cup system that would be useful to them and long-lasting and be able to be cleaned and be used probably for the first year of life," said Dr. Cunningham.
It also had to be low cost. That inspiration led to a partnership with Seattle's global health innovator PATH, which has been working on prototypes for the last few years.
"Oftentimes simple, affordable technology is the best solution for that setting," said Trish Coffey with PATH.
Along the way, the team, which also includes Christy McKinney of UW Dental Public Health Sciences, realized this system could also help preemies in developing countries.
"If they're born below about 35 weeks of age, they don't have a suck swallow breath mechanism and they don't have the maturity to successfully breastfeed. So, they need a tool to help them transition from feeding without the breast to feed with the breast," she said.
The current design features a small reservoir at the feeding end.
"This reservoir is really important because what it allows the infant to do is pace their feeding themselves," Coffey said.
The team will be taking the cup to Ethiopia sometime next year to see how it works in practice before they finalize the design. They have been nominated for a $250,000 award to continue the research.
The Neonatal Intuitive Feeding Technology or NIFTY cup may also have applications in the U.S. for preemies to serve as a bridge until they can breastfeed directly.