Why collaboration is key to advancing infant health: An engineer’s perspective on thermoregulation and innovation
By: Steven Falk, Chief Technology Officer, Maternal Infant Care, GE HealthCare
After more than 35 years working in maternal and infant care engineering, one truth has never changed: we cannot advance neonatal health without deep, meaningful collaboration between clinicians and engineers. Every improvement we make in thermoregulation, microenvironment design, or neonatal technology is born from the combination of two equally important perspectives, the physics of premature life and the lived reality of caring for fragile newborns.
I have spent decades thinking about something most people never consciously notice – energy balance and heat. How babies create it, how quickly they lose it, and how we can protect them from the risks that come with thermal instability. But none of that engineering work means anything unless it aligns with the needs, workflows, and observations of the clinicians who care for babies every day.
This is why collaboration must always be at the heart of innovation.
Seeing the newborn through an engineer’s eyes
When I look at a premature infant, I see a delicate control system, a small mass with a disproportionately large surface area that loses heat through conduction, convection, radiation, and evaporation. Their ability to generate heat through metabolism is limited, while their exposure to heat loss is amplified at the same time.
In a high-level view and overly simplistic, metabolic heat is proportional to body mass. Convective, radiant, and evaporative heat loss is proportional to body surface area. Generally, as gestational age decreases, the surface-area-to-mass ratio increases, which, in turn, increases the heat loss with lower metabolic heat. Couple that with thermoregulation immaturity in the very low birth weight (VLBW) and extremely low birth weight (ELBW) newborns, this energy/heat balance is critical to maintain.
Clinicians understand the impact of this physiological vulnerability. Engineers understand the mechanisms behind it. When clinicians describe what they observe at the bedside, and engineers turn those insights into predictable and controlled thermal systems, we make meaningful progress. Neither perspective is sufficient alone. Together, they create solutions that protect lives.
Why we redesigned the way incubators think
Early incubators responded directly to the baby’s temperature by simply activating or deactivating the heater. While functional, this approach caused temperature fluctuations that stressed fragile infants.
The “cascade algorithm” we created for the Giraffe OmniBed was shaped by thousands of clinician conversations. Clinicians told us that:
- Temperature swings were stressful for infants
- Stability mattered more than speed
- They needed tools that responded gently and consistently
Their feedback challenged us to rethink how an incubator should behave. Instead of reacting aggressively to temperature changes, we adjust the air temperature in small, controlled increments. This allows the infant to regulate at a natural pace while keeping their microenvironment steady.
This improvement exists because clinicians and engineers solved the problem together.
Designing for the real NICU instead of a laboratory
Clinicians must interrupt the microenvironment constantly to care for patients. Any opening of the incubator changes airflow, temperature, and environmental stability. Understanding this reality shaped several features of the Giraffe OmniBed.
Double wall construction
Warm air flowing between an outer wall and an inner wall keeps the inner wall warm and radiantly stable, even when room temperature fluctuates. This design came directly from clinical requests for a consistent environment during hands‑on care.
Tunneled portholes
These portholes were developed because clinicians frequently reach into bed. A gasketed design minimizes warm air from escaping and cold room air from entering.
Air Boost
A clinician once asked, “Can you help me keep the temperature steady when I open the door?”
This question inspired the Air Boost feature, which temporarily increases airflow, and redirects it slightly to bias into the infant compartment, to create an invisible barrier that protects the environment during procedures.
Every one of these features and benefits to the patient represents true collaboration, where clinical workflow meets engineering possibility.
The Golden Hour: A challenge that requires shared understanding
The first hour of life is an intense thermal transition. A baby leaves a warm intrauterine environment and enters a much cooler room while wet and vulnerable. Clinicians have led the charge in Golden Hour innovations such as delayed cord clamping, plastic wraps for extremely preterm infants, and improved stabilization practices.
Engineering supports this work by designing equipment that makes these interventions safer and more effective. When clinicians asked how delayed cord clamping affects thermoregulation, we worked together to understand the physics associated and identify new questions. When they sought smoother thermal transitions between delivery and the NICU, we began rethinking how to engineer that experience.
Collaboration makes these advancements possible.
Looking ahead: Innovation requires shared imagination
The future of neonatal care includes smarter sensors, improved microenvironment control, and research into artificial womb technology. Some concepts will become real solutions. Others will evolve into unexpected discoveries that shape viability and long‑term outcomes.
The most important part of this work is not the technology itself. It is the collaboration that drives it. Clinicians share their daily challenges and their wisdom from the bedside. Engineers bring system thinking and the ability to turn problems into possibilities.
Together, we create tools that will support the next generation of infants.
Why I am still here after three decades
People often ask why I have stayed in neonatal engineering for more than 30 years. The answer has always been the same.
It is the babies, and it is the people who care for them.
Clinicians bring extraordinary dedication and skill. Engineers bring the physics and design thinking needed to support them. When we combine these strengths, we make the world better for the smallest and most vulnerable patients.
Collaboration is not just helpful.
It is the reason we save lives.
It is the reason we innovate.
It is the reason infant health continues to advance.
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The material presented in this blog represents the opinion of the author(s) and not necessarily the views of Synova Associates. Synova Associates does not endorse any specific products or organizations but strives to connect its industry partners with leaders interested in product/educational innovation.
