Daniel John slips his arms through the straps of his inflated baby carrier, adjusts the harness to his chest and places a newborn-sized doll behind the smoky-blue tinted window with Velcro embedded in the fabric. He checks the fit and smiles, confident that his medical sling will help turn a long-stuck idea into something tangible – and wearable – for parents who lack access to care for a common, easily reversible illness early in life.
Known as BiliRoo, this lightweight support is designed to treat neonatal jaundicea disease that affects approximately 60 percent of newborns and 80 percent of premature babies. This happens when bilirubin – a yellow pigment in the blood – builds up faster than the baby’s body can eliminate it. In about 5 to 10 percent of cases, levels rise high enough that, without treatment, bilirubin can enter the brain and cause permanent damage. Globally, severe jaundice is estimated to cause more than 100,000 deaths each year, as well as many more cases of long-term disability.
In modern hospitals, jaundice is usually a temporary nuisance: babies are placed under electric blue lamps which help the body eliminate excess bilirubin, so the levels drop and the problem disappears. However, in many parts of the world, phototherapy devices are rare, forcing families to rely instead on sunlight. Yet even though the sun’s blue wavelengths can trigger the same bilirubin-destroying response, its ultraviolet rays can also damage sensitive skin and eyes, raising the specter of cancer.
It’s a risky compromise, one that John hopes caregivers won’t have to make. He described his patent-pending device and its first performance data on January 14 in Pediatric research.
At the heart of BiliRoo’s design is a transparent panel, placed on the baby’s back, that blocks ultraviolet rays while allowing therapeutic blue light to pass through, mimicking hospital phototherapy. “It’s inexpensive, easy to use, simple and non-electric,” says John, a first-year medical student at the University of Michigan in Ann Arbor, who founded a company, also called BiliRoo, to commercialize the concept.
As an added bonus, the treatment takes place in the parent’s arms rather than in a plastic crib. This eases the monitoring burden on overworked hospital staff, while allowing caregivers to go about their daily lives. It also promotes the type of skin-to-skin contact, known as kangaroo care, which strengthens the bond, regulates temperature and alleviates infant stress.
For John, the desire to build BiliRoo is deeply personal. He spent his childhood in the Midwest of Nepal, in the foothills of the Himalayas, where his father worked as a pediatrician and his mother as an industrial engineer. Power outages were commonplace, frequently knocking out equipment at the local hospital.
When John moved to the United States and began studying mechanical engineering, he set out to design technologies that could work in low-resource environments like the one he experienced growing up, places without stable electricity or modern infrastructure. “I knew I wanted to work in health care access,” he says. “And I saw the need for low-cost medical devices.”
John asked doctors in Nepal and sub-Saharan Africa which problems most urgently needed better solutions. One answer kept coming back: neonatal jaundice. To John, filtered sunlight therapy seemed like an underutilized workaround.
In Nigeria, studies by developmental pediatrician Bolajoko Olusanya and others have shown that the approach works: newborns treated in tents with filtered sunlight and makeshift greenhouses. fare as well as those who receive standard phototherapywith bilirubin levels decreasing safely in moderately jaundiced babies. But with little buy-in from government health officials and substantial training of community health workers still needed to ensure safe and consistent use, the approach “has not been rolled out yet,” says Olusanya, executive director of the Center for Healthy Start Initiative in Lagos, who was not involved in the study.
John’s goal is to avoid the need for dedicated sunlight filtering rooms by putting the therapy directly into parents’ hands – or rather, hanging it on their bodies.
To build his first prototype, John methodically took apart commercial baby carriers, studying their straps, seams and supporting structure, before finally sewing sheets of optical filter film into scraps of fabric. His older brother Stephen, also a doctor in training – and a new father – became the first user of the test.
A practical challenge remains, however: unlike the types of structures Olusanya studied, a parent carrying a baby constantly changes position. To be viable, the device would need to provide therapeutic light from different angles, not just ideal, direct sunlight.
John tested this idea in a college courtyard and found that even with the stand tilted at awkward angles, the harness consistently captured enough blue light to meet phototherapy standards, while blocking more than 99% of harmful ultraviolet rays.
Even with encouraging early testing, key questions remain about the device’s reliability in everyday use. In the real world, sunlight is intermittent — clouds roll in, caregivers move indoors — raising uncertainty about whether BiliRoos’ babies will consistently receive enough therapeutic light. And although filters block ultraviolet radiation, prolonged exposure to hot sun could put vulnerable infants at risk of overheating or dehydration.
These are exactly the kinds of questions John now hopes to explore in clinical studies of his patent-pending device, which will soon include an additional filter section that can be placed on the baby’s head. The first small batch of BiliRoos is being manufactured in Nepal, and John’s first trial with new parents and their young is expected to begin later this year in Ogbomoso, a town in southwest Nigeria.
“I think it will be a good device,” says Tina Slusher, a pediatric critical care specialist at the University of Minnesota in Minneapolis, who led the first trials of filtered sunlight therapy in Nigeria and is collaborating with John to test the BiliRoo. “There won’t be enough babies exposed to treat very serious jaundice.” But for mild to moderate cases, she adds: “I think it’s a really good idea.” »
