International Journal of Grid and Distributed Computing

Vol. 14, No. 1, (2021), pp. 2117-2127

Real Time Monitoring and Control of Neonatal Incubator using IOT

Abstract

The care of new born babies are the most important and sensitive part of bio-medical domain. Some
new born babies have a higher risk of mortality due to their gestational age or their birth weight. Most
of the premature babies born on 32-37 weeks of gestation and are deceased due to their unmet need for
warmth. The neonatal incubator is a device used to nourish the premature babies by providing a
controlled and closed environment. This incubator provides the babies with optimum temperature,
relative humidity, optimum light and appropriate level of oxygen which are same as that in the womb.
But babies in the incubators have a risk of losing those babies lives due to the improper monitoring of
the it which causes accidents like gas leakage and short circuits due to overheating which leads to
bursting of incubators. Thus, the objective of this paper is to overcome the drawbacks of an unmonitored
incubator and develops an affordable and safe device for real-time monitoring of the neonatal incubator.
a low cost yet effective apparatus for monitoring the important parameters like pulse rate, temperature,
humidity, gas and light of the premature baby inside an incubator. The sensed data are passed to the
doctors or nurses wirelessly by the Arduino UNO via Internet of Things (IoT) so as to take necessary
actions at times to maintain an appropriate environment for the safety of the lives of premature babies.

Keywords: Neonatal Incubator, Premature Babies, IoT;

1. Main text

According to a study, the major reason for the 370,000 neonatal deaths in India at 2015 are the low-
birth weight and premature birth. It is also found that the neonatal deaths due to the above-mentioned
reasons are around 12.3/1000 births in 2000 to 14.3/1000 births in 2015. The rise in the deaths of
premature babies and low weight at birth is ununiform across India. It means that the death rate is high
in rural areas and less in urban areas. Furthermore, these babies needed more investments for incubators
and Intensive Care Units (ICU) for getting proper neonatal care. It is found by a study that more than
20 million new born babies are premature or low-birth weight out of which 450 of them are deceased
each hour. In addition to this, these babies may die due to the technical fault caused by the improper
monitoring and control of the incubators.
The recent advancement in technology leads to enhancement of the medical industry and hence the
mortality rate of premature babies is also controlled. This is due to the employment of incubators in the
treatment of premature newborn babies. Eventhough the incubators play a vital role in the lives of
premature babies, it requires instrument-health caregiver interactions due to its environmental and
working conditions. Due to the ratio of number of caregivers to the number of patients is not matching
i.e., more patients and less caregivers, the work load of the instrument-health caregiver is high, which
leads to improper monitoring of the incubators [1]. For the sustainment of the premature babies, oxygen
and nutrition are the must. In addition to this, there should be an appropriate thermal environment.
Traditional incubators are reported for resulting in severe hypothermia in premature babies inside it.
The thermal environment impacts the intrauterine conditions of the premature infants. The rectal
temperature should be targeted to 37 to 37.5°C and also a comfort temperature is suggested. Some of

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the premature babies in the comfort temperature shows the rectal temperature at around 39°C.
Researches are carried out to find the core temperature of the body like rectal and nasopharyngeal
temperatures. The brain temperature at mild to moderate increase develops the risk of neurological
damage and the mild to moderate hypothermia is considered as neuroprotective if the premature baby
as hypoxia. Hence it is important to focus on the rectal and nasopharyngeal temperature in premature
newborns to govern the capacity to handle the intended changes in the temperature of the incubator [2].
In Intensive Care Units (ICU), the use of central monitoring system is essential and more convenient.
This helps the caretakers to monitor the patients in real-time. But this system is missing in the infant’s
ICU. The caretakers should go around each incubator for checking it. This makes a way to the
development of web-based monitoring system after some decades [4]. A recent study shown that over
20 million new born babies are premature babies or babies with low birth weight for every year. And
among them around 450 are estimated as deceased for each hour. The death of these premature or low
birth weight babies can be prevented by using the neonatal incubator. The neonatal incubators are the
life saving devices for many these babies by providing them with appropriate environmental and thermal
conditions, so that the baby can get the normal weight and adequate nourishment by taking the available
resources from the incubators [7].
The need for continuous monitoring of patients is vital in clinical environment. This must to done
effectively with low cost that can solve the problem of the availability of human resources and also
leaves a positive impact the life of the patients [3]. The remote healthcare monitoring is very much
important for improving the quality of life of a person. The IOT makes it possible. Even the patient’s
personal details and which patient occupies a particular bed (Smart Beds) are also to be analyzed along
with their medical and psychological details which makes the entire unit as a smart home medication
dispenser and also alerts whenever the medicines are not taken in time [5]. The use of smart phones in
now rapidly increasing all over the world. In addition to this, the ISP based wireless technologies with
affordable cost leads to the development of many mobile applications. In 2015, it is proved that more
than ¼ of population world-wide are using smart phones. The mobile applications are of social media,
sports, games, news, business, healthcare and even shopping. The growth of bio-medical sensors, the
need for patients and the expense of healthcare induces the developers to create an m-health application.
Some of those applications are based on the staff level like sophisticated monitoring, database handling,
clinical advices, diagnostic data etc. and some applications are based on the patient monitoring for vital
signals, fitness, online medical advices and drugs prescriptions. The monitoring applications are divided
into flat-tier and multi-tier architectures. The flat-tier architecture makes use of mobiles to collect the
vital signals and passes it to the server. In Multi-tier architecture, mobiles along with a data collector
are used between the sensor and the server [6].
Information technology (IT) field is developing more in the instance of sensors, nano-technology and
bio-industries. The e-healthcare system is much useful in hospitals for gaining information from the
patients. But these are a wired process based on the network protocol and database. Now-a-days the
wireless communication is going on increasing in the healthcare field due to the advanced and new
technologies built in smart devices with the help of wireless sensor nodes [8]. The use of wearable
sensors is today in the next level in the field of medical diagnosis so as to help in preventing the diseases
like stroke, heart attack, and so on. The need for these devices in patient’s life is not only for saving the
additional expenses for healthcare but also for saving the life and to enhance the life style of the patients.
The major issue faced in the usage of wearable sensors are the power source. A wearable sensor should
have the characteristic of long battery life. So, the development of self-powered sensors based on the
body heat are proposed [9]. The wireless remote healthcare system and monitoring is usually achieved
by using the wearable sensors. These devices can collect the required programmed data from the patients
anywhere and these collected data are then transferred to the central storage with the help of the

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advanced technologies like GSM or SMS to the target mobile or computing systems of the doctor or
nurse or the caretaker [11].
The use of the incubator is to maintain the adequate environment for the premature new-born babies.
This is because the premature infants have limited immunity and limited thermoregulation. They are
more sensitive to the environmental conditions. Even a small change in the surrounding can cause
adverse effect in them. Hence, there is a need for some artificial device to make those infants sustain in
the world. It is reported that around 1.49 million oof premature babies with low birth-weight are born
in 2010 all over the world. Moreover, the distance of the hospitals are almost 8 kilometers away from
the patient’s residency even in the developing countries [10]. In bio-medical field, the most complicated
part to be focused is the premature infants. Some of the premature infants are at a higher risk than the
average risk, due to the gestational age or the birth weight that risks the life of those babies from diseases
or death. The infants in Neonatal Intensive Care Unit (NICU) are mostly preterm and the risk associated
with them is due to the prematurity. A statistical analysis from Iran in 1980 reported that, 13% of
newborns were preterm and in 2006 it rises to more than 30%. The environment of the preterm babies
should be the same as that in the womb so as to survive for them. The recent studies showed that each
preterm baby has a microenvironment which is based on the gestational age and medical condition of
them. Hence the incubator is used here, as it can fulfil the need for the microenvironment in the way of
stable temperature, humidity, oxygen and light conditions so as to protect those infants from getting
infected by the surroundings and also to sustain in the physical environment until they are completely
cured to be survived. The air temperature should be 35ºC [12]. All over the world, around 1 million of
preterm babies or low birth weight babies die on the first day itself and 4 million of them die in the first
month. Almost a minimum of 25% neonatal deaths are associated directly or indirectly with the preterm
birth and the infants with low birth weight are at high risks. Around 1.8 million infants die every year
due to improper maintenance of the temperature in their body [13].
The World Health Organization (WHO) reported that, globally more than 1 of 10 pregnancies results
in preterm birth, which means a birth that happens after the pregnancy but not more than 37 weeks, as
the normal pregnancy should be of 40 weeks. the preterm birth can be classified into 3 stages based on
their gestational age. They are the (1) Late preterm ie., 32-37 weeks, (2) Very Preterm ie., 28-32 weeks
and (3) extremely preterm ie., < 28 weeks. The preterm birth is the major reason for the death of the
children below 5 years and the mortality rate of them increase every year in underdeveloped
environments. The preterm birth can be prevented by providing steroid injections or antibiotics and
essential care for the newborns. But the use of incubators reduces the risk of premature babies by 24%,
as the incubator can provide the essential environmental conditions for the newborns to be survived
[14]. The incubator makes the body temperature of the infant to be stable inside a controlled and sterile
environment. In case of infant mortality rate, the incubator is a precious device for the infants with
prematurity. For example, the Malawi is the highest of the rate of preterm births worldwide. In addition
to this, the incubators are more expensive which cannot be affordable for countries under development.
Also, the power needed for the incubators are also high. Moreover, there will be a difficulty in the
transportation of such a complex machine across the rural areas. Hence the need for a portable, yet
durable and alternative powered incubators are much essential for the developing countries [15]. The
Ballistocardiograph (BCGs) is a device that captures the heart’s mechanical activities. The researches
related to the BCG are going on due to its benefits in recording unobtrusive psychological
measurements. The BCG can also monitor the bio-signals of infants without any physical confinement
[16].
The wired communications of biological data are to be replace with the wireless sensors so as to make
the work of the healthcare professionals to be easier. This method is to needed to be applied for the
wireless and automated monitoring for the infant’s heart rate, body temperature and movement every
minute for the early diagnosis of the risk of being affected with cardiac problem, abnormal boy

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temperature and body movement, hypothermia and hyperthermia and act accordingly for early recovery
and survival of the infants [17]. The screening of infant health is an essential part of the public health
that comprises of neonatal screening, monitoring the nutritional status and diagnosis of infectious
disease. But it is more complex for the caretaker due to the crude nature and the need for manual inputs
of the machines and the lack of training for the duty staffs that leads to error and falsification in the
results [18]. The premature babies below 37 weeks of gestation age has a low body weight and are
categorized as (1) Low Birth Weight < 2500g and (2) Very Low Birth Weight < 1500g. Also, their body
parts or organs are not yet developed completely. So, these babies are needed to be taken care more
seriously to survive by making an intensive care within the incubator immediately for neonatal
assessment. In 2010, Indonesia is one of the highest among the countries with premature birth rates. It
is found that premature birth is more common in the rural area that are with less healthcare facilities and
in the families with less income. The NICU is the place where the premature infants are treated with the
incubator. But the NICU is available only in the hospitals in big-cities also it is more expensive that
cannot be affordable for low-income families and families in rural areas [19]. The thermo-regulation is
a key issue in the premature babies that is to be taken care of the most. Often, they are kept inside the
incubators with convective heating. The air temperature in the incubator is sensed which is then used
for controlling the flow of heat or the skin temperature is sensed which is used in closed loop control.
But the skin temperature often results in huge fluctuation in the air temperature inside the incubator and
the air temperature causes fluctuations in the skin temperature. So, it is a big question mark whether the
air temperature and the skin temperature can be controlled simultaneously [20].

2. Related Works

An incubator with a wireless transmission of alerts to the neonatal nursing station was developed.
This system can minimize the workload of the caregiver. This system is categorized into 4, namely the
incubator temperature monitor and control unit, body temperature monitoring unit bed wet monitoring
unit and alarm transmission. The temperature is measured by using the LM35 temperature sensor that
is fixed within the incubator and then this signal is read by using the USB4704 and controlled by
LabVIEW. The control signals are generated by using the ON-OFF control logic was used and these
signals are generated via the USB4704. Also, the body temperature was read using the same USB4704.
The detection of bed wet was done by a 5V power supply-based circuit. Finally, the alarm signal for
sensing any unfair condition of these circuits is transmitted to the remote nursing station [1]. The
premature babies are investigated for their ability to cope with the temperature change with their rectal
and nasopharyngeal temperatures heat flux in several site and heart rate by either increasing or
decreasing the temperature of the incubator to 1°C. these values are to be recorded for every 6 hours.
After that it is found from the investigation that the rectal, nasopharyngeal and skin temperatures are
significantly increased when the temperature of the incubator is increased to 1°C when compared with
the 1°C decrease in temperature. Hence it is evident that the premature infants have less capability to
cope with the temperature increase in the nasopharyngeal and rectal temperatures [2].
A prototype of a low-cost modular monitoring system design that aims to support the mobile devices
to provide a better and yet fast medical interference in emergency situations is introduced. This system
is developed by using the low-power sensor arrays for EKG, SpO2, temperature and movement which
are interfaced based on IoT. The control unit uses RESTful web interface for safe and flexible
integration of the objects [3]. The remote healthcare technology reduces the need for managing the
chronic diseases regularly with the patient’s intervention also it enhances the quality of those people.
But due to the emergence of the Internet of Things and the low-cost sensors, the offline maintenance of
all the details needed in the monitoring during the runtime by engineers can be drastically reduced.
Hence, a system for ad-hoc based healthcare monitoring with low-cost wireless sensors with the IoT

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technology was built. This prototype of a basic remote healthcare monitoring system monitors the
patients real-time and alerts the patient’s caretakers or doctors whenever the system experiences an
unusual condition that requires any medical consultation [5].
The incubator which can be operated, managed and monitored in real-time for inspecting the
humidity and temperature of the incubator by a web-based system with the help of the Intranet and this
type of system is installed into the Intensive Care Unit (ICU). A pilot system is developed with the
temperature and humidity sensor and a module for measuring it in each of the incubator that are
connected into the web-server through Rs485 port. This model transfers the signal via the standard
TCP/IP protocol so as to accessed by any of the users with the computers with internet inside of the
healthcare center. This signal provides us with the humidity and temperature values of the incubator
measured by the modules through RS485 port on the web server to create a web-based document with
those gathered data. This system allows the hospital staffs, a centralized monitoring of all the incubator
conditions inside of the ICU with a computer. Also, this system alerts the staffs by giving an alarm
signal when the incubator experiences an unusual behavior when exposed to the light or sound with the
help of the measuring module integrated with each incubator. If this centralized supervisory monitoring
station is integrated with many of the incubators, then this system can be much convenient for the staffs
in the ICU for better intervention of the incidents happening in the incubators inside the ICU [4]. There
are a greater number of preterm babies and is increasing all over the world. M-health is a application
that plays an important role in the monitoring of bio-medical parameters with the help of internet in the
mobile devices. Hence, a Distributed Neonatal Incubator Monitoring System (NIMS) was developed
for the monitoring of premature infants. This system is built by using distributed software agents inside
the data hub of the incubator, medical server and the mobile terminal of medicals staffs and parents
with the help of Constraint Application Protocol (CoAP). The agents of CoAP and the URL for Data
ID are used for to enable integrating the NIMS and data collections to IoT, and this system was tested
in North Lebanon hospital [6]. A cost-worthy and real-time monitoring system for the premature infants
inside an incubator was investigated and designed based on the embedded system. This system focuses
on the diagnosis of the life-threatening actions in the earlier stage for maintaining a safer environment
needed for the babies. Both of the small and medium companies based on medical technology mostly
doesn’t adopt the existing best technologies, since they are all most expensive. Though, the big medical
companies can afford it, common man can’t. Thus, a cost-effective yet eco-friendly monitoring system
that can be easily affordable by a common man is proposed in [7].
RFID (Radio Frequency Identification), WSN (Wireless Sensor Nodes), etc. are used for the
identification and information processing of any devices. The Body Area Network (BAN) is implanted
into the body. Today’s e-healthcare applications are connected with the smart phones, tablets or
computers for the transmission of the data collected from the patients related to their health. Hence, a
smart phone based patient health care monitoring for transmitting the patient’s health related data to the
medical staffs through IoT. This system monitors the patient’s health parameters regularly and
compares it with the pre-defined parameters and whenever the real-time data varies from the pre-defined
data, then it passes an alert signal to the medical staffs to take proper actions. The (Wireless Body Area
Network) WBAN when associated with the smart phones, develops vast practicality. Hence this system
is supposed to be more capable worldwide for e-healthcare [8]. The wearable healthcare sensors are
expected to have the capability of changing the healthcare system in today’s world. There are many
advanced technologies being introduced with enhanced performance, but the major concern still to be
taken care of, is the battery runtime for the use in practical life. The runtime of a battery is limited to
the size of the battery, and it is the next major concern in practicality and acceptance from the customer.
Hence, a new system Ultra Low Power Sensor Evaluation Kit (ULPSEK) was introduced for evaluating
the sensors and the application (http://ulpsek.com). This system consists of multi-parameter sensor for
the measurement and processing of ECG, motion, temperature, respiration and PPG

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(Photoplethysmography). The ULPSEK system can be powered by the body heat harvester instead of
using a battery for power. An average of about 171 μW power is harvested from the ULPSEK that is
enough for the power supply of sensors used at an ambient temperature of less than 25°C. By keeping
in mind, the security issues arise from the self-powered sensors, a hybrid solution was suggested by
using a battery charged by the harvester [9]. By the guidelines provided from WHO and Engineering
World Health (EWH), a prototype was designed which modifies the existing HVAC system for the
optimization of the essential components such as the Humidity Control and Sensing, Heating System
and the Quantitive Thermal Optimization and tested it and obtained a safe and efficient design for using
wherever needed. In this redesign, the aluminum piping was replaced by the polyethylene for efficient
flow of air with the help of the computer fans. This replacement is done because, the polyethylene
provides a better modularity and can be obtained non-corrugated, so that the resistance to airflow can
be reduced and also the bacterial growth from trapped moisture can be reduced [10].
A prototype was designed based on wireless healthcare monitoring by sending SMS of the healthcare
paramaters to the caretakers. This design process is categorized into 3 phases. the data acquisition phase,
the data processing phase and the communication phase. In the phase of data acquisition, the
temperature and pulse rate sensors are used to monitor the temperature and the pulse rate of the patient.
This output is then converted into digital format and is passed to the Basic Stamp microcontroller for
processing before sending it to the data processing software called Visual BasicTM via a serial port. A
GUI form related to patient’s data was created using the Visual Basic for assisting the data processing
step. In this step, some values can be pre-set for the essential parameters of medical sensor data.
Whenever the system finds the exceed in the pre-set values, immediately a communication will be
initiated by sending an SMS to the uploaded mobile number. When unknown values are detected by the
sensors, then the communication will be by sending the SMS to the doctor’s mobile phone through the
GSM or SMS gateway, simultaneously the database from the hospital will also be updated periodically.
Several different designs are made and chosen the best from them. The data acquisition and accuracy
of the sensors are somewhat compromised by using some available sensors instead of bio-medical
sensor, so as to reduce the additional cost and for the availability factor [11]. A closed-loop control
system was designed and is implemented for regulating the humidity, temperature to maintain the
optimum temperature of the body and the incubator and the intensity of light for preventing from
jaundice and oxygen within the incubator. When the sensors combined with the actuators, a closed loop
control system will be formed. They are operated synchronously for giving a stable thermal
environment within the incubator. The implementation of this system was done by using the
microcontroller and PID controller [12]. An incubator monitoring system with a single-chip
microcontroller was integrated with the traditional incubator monitoring system. A temperature sensor
for sensing the temperature in the incubator, a humidity sensor for reading the humidity value in the
incubator and a respiration sensor for reading the respiration rate of the infant in the incubator, pressure
sensor, cooling fan, LCD and SIM SMS MODEM are connected to the proposed model of incubator
monitoring system. This single-chip microcontroller reads and frames the parameters like surrounding
humidity, temperature and respiration in addition to the sensors in the incubator. These recorded values
are displayed in the LCD. A small variation in the sensed data when compared to the pre-set values,
immediately an alert will be sent to the parents of the infant inside the incubator automatically with the
help of the single-chip microcontroller [13].
A premature infant’s birth is indirectly connected to some serious care that are to be taken for the
survival of those infants by monitoring the movement, weight gain, etc. of the infant. Along with these,
other parameters like the temperature and humidity of the incubator environment are also to be
monitored to prevent loss of heat in the infants. Hence, a modern incubator with temperature and
humidity sensor and weight sensor was demonstrated. This incubator is then connected to a central
network based on Long Range Networks (LoRa) which is used for storing the medical data in a

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database. Also, in this system, a Near Field Communication (NFC) interface was introduced which can
be used to identify the doctor who is giving the treatment, the patient’s evolution and if any updates in
the database done by the doctor. At last, this system is subjected to a laboratory test for verifying its
functioning [14]. A structural design of an incubator focusses on the durability and the portability. The
base of this incubator is made of the luggage that is converted based on the requirement. The vestibule
is made of a pop-up tent design which can be collapsible and this cover was made of a clear and
washable plastic which can support 2 DC heaters that was powered by the main-line power or by a solar
rechargeable battery. These heaters can maintain a steady temperature ranges from 34°C to 37°C inside
the incubator. This model was expected to be improve the lives of the premature infants and reduces
the mortality rates [15]. A psychological signal monitoring bed which is based on load-cells was
designed and described. An algorithm is subjected to extract the breathing rate and the heart rate of the
patient by the signals obtained from the load-cells. An experiment was carried out to test this system by
using 13 infants. The ECG and the respiration signals are also monitored by commercial devices for
comparing with the generated signal for accuracy. Optimal respiration and heart beat sensors are
connected to this algorithm. The results obtained form the load-cell sensor shows an average error or
2.55% in heart beat and 2.66% in respiration performances. Also, in this experiment, the positive
feasibility of the BCG-based measurements is verified in the babies [16]. An automatic neonatal
monitoring system was designed by using the sensor mobile cloud computing which is based on the
wireless sensor network and the mobile cloud computing. This system consists of a temperature sensor
for monitoring the temperature of the neonate, an acceleration sensor for monitoring the acceleration
caused by the movement of the baby, and a heart rate sensor for measuring the heart rate of the baby.
The body temperature of the infant was monitored and controlled by using the wireless radiant warmer.
The readings obtained from the sensors are uploaded to the cloud. The neonates are continuously
monitored by the caretakers by accessing the sensed data via an android application in their mobile
phone. And whenever an abnormal condition is happening in the system, then an alert will be given to
the caretaker’s mobile phone automatically and hence the required care would be provided to the needed
neonate in the early stage which leads to early recovery [17].
A design of a low-cost child assessment kit named Baby Naapp was demonstrated with a smartphone
using less expensive peripherals. This system is then subjected to a laboratory testing and proved that
it compares favorably against the traditional manual measurements. In addition to the basic tools on
measuring the anthropometric measurements, advanced tools are also demonstrated for
photoplethysmography and thermal imaging that can be helpful for the community healthcare staffs for
screening and diagnosis in the primary care clinics. Also, the measurement of bilirubin for jaundice and
hemoglobin for anemia are suggested to be included with the Baby Naapp toolkit [18]. A remote
monitoring system of the preterm baby’s weight within an incubator was designed using the Arduino
UNO R3 microcontroller, load cell as a sensor and active filter. This system is completely integrated
with a GSM module named SIM900 for transmitting the acquired data of the neonate’s body weight to
the medical professionals. This system is then examined by making use of a moving baby doll for the
simulation of moving baby in an incubator. The result showed that, the outcome of this system is stable
even when there is a motion of the baby inside the incubator, also this system can be able to transmit
the captured data to the mobile device through SMS [19]. A fuzzy logic system was proposed for
controlling the heating problem occurring the incubator by monitoring the temperature of both the air
and skin of the babies inside the incubator. This system was examined with a lumped parameter model
of infant-incubator system and is proved that the on-off skin control causes variations the air
temperature inside the incubator, resulting that the air control causes slower rise-time of the core
temperature. Thus, the fuzzy logic system can provide a smoother control with desired rise-time [20].

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3. Proposed Methodology

Whenever the sensors are combined with IoT technology, it can be an illustration of a cyber-physical
system, smart home, smart grid, smart city, intelligent transportation and virtual power plants.
Therefore, the IoT can help in controlling the objects remotely being sensed by the sensors so that the
physical systems can be easily integrated by the computing systems. This advantage not only improves
the accuracy and efficiency of a machine but also minimizes the human intervention needed for
monitoring a machine or a device 24/7. The use of ThinkSpeak platform makes easy to access the data
stored into it by means of IoT-Data Analytics. Moreover, the used sensors in the proposed models are
of low cost and easily affordable so that the cost of periodic maintenance is also easier.
The proposed system consists of an Arduino UNO microcontroller, which is to be connected directly
to the incubator and several sensors are used to sense the biological signals inside the incubator and in
the body of the premature infant. The various sensors used in the proposed model of neonatal incubator
for real-time monitoring and control includes, the Temperature and Humidity sensor (DHT11) for
sensing the temperature and the humidity in the surroundings of the neonate, the Pulse rate sensor to
record the heart rate of the infant, the Gas Sensor to sense the additional gas leakage and the Light
sensor to capture the extra light penetration. Additionally, the IoT Module (ESP8266) is used to for
transmitting the recorded or sensed data wirelessly which are to be uploaded in the ThinkSpeak
platform, which is an open source IoT and Application Programming Interface that is used for the
purpose of storing and retrieving the data from sensors which are then transferred to the receiver’s
device and an LCD is also connected to the microcontroller to display the recorded signals near the
incubator for monitoring.

Fig. 2. System architecture.

The proposed neonatal incubator design consists of 3 sections namely, the terminal device, the
network protocols and the monitoring and control of the neonates. The various sensors connected are
used for monitoring and controlling the incubator via IoT. The Arduino microcontroller is programmed
in such a way to get the output of these sensor and display it on the LCD for monitoring purpose. The
values of the sensors are then uploaded in the ThinkSpeak cloud to display it on the wireless device in
the receiver side, which is then used for enabling the control of the incubator environment.

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 Fig. 2. Flow chart.

The DHT11 humidity and temperature sensor reads the humidity and the temperature in the
surroundings of the incubator environment. The optimum value of temperature should range from
36.5°C to 37.2°C. If the temperature value exceeds the preferred range, then the proposed neonatal
incubator system alerts the caretaker of the neonate in the incubator via IoT to take necessary actions.
Similarly, the light sensor detects the intensity of light penetrating into the incubator and the gas sensor
detects if there is any gas leakage inside the incubator and if the value of light and gas exceeds the
optimum range, then the system alerts the caretaker regarding this through IoT. Also, the pulse sensor
monitors the heartbeat of the neonate and the same alerting system is being executed whenever
necessary.

4. Conclusion

The proposed real-time monitoring and control based neonatal incubator monitors and detects any
changes in the environment surrounding the incubator like pulse rate, temperature, humidity, light and
gas values with the help of the pulse rate sensor, temperature and humidity sensor, light sensor and gas
sensor respectively and sends those signals to the microcontroller, Arduino UNO and the controller then
alerts the doctors or nurses or the caretakers of the neonates inside the incubator via IoT to take
necessary and possible actions so as to maintain the health of the preterm infants within the incubator.
This system helps in preventing the unusual accidents and deaths that occurs in an incubator due to
improper monitoring of it. Eventhough the proposed neonatal incubator monitors all the essential
parameters needed for the environment of a preterm baby, there is still an issue of exposure to high
level of noise inside the Neonatal Intensive Care Unit (NICU). Hence the behavior of NICU should be
modified so as to reduce the noise exposure. In addition to this, the Electromagnetic Fields (EMF)
impacts the health of the preterm baby is still unclear. Therefore, in future the preterm babies’ incubators
would be designed in such a way that the noise and EMF exposure to the neonate to be minimized.

References

[1] Saikat Sahoo, Biswajeet Champaty, Kunal Pal, Sirsendu S Ray “Wireless transmission of
alarm signals from baby incubators to neonatal nursing station”,
10.1190/ACES.2014.6808003, May2014.

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[2] Simbruner, G., E. M. Ruttner, A. Schulz, and K. Perzlmaier. “Premature infants are less
capable of maintaining thermal balance of head and body with increases of thermal
environment than with decreases”. Am. J. Perinatol. 22:25–33, 2005.
[3] Alexandru Archip, Nicolae Botezatu, Elena Serban, Paul Corneliu Herghelegiu and Andrei
Zala, “An IoT based system for remote patient monitoring”,
10.1109/CarpathianCC.2016.7501056, Jun2016.
[4] Shin, D.I., Huh, S.J., Lee, T.S., Kim, I.Y., “Web-based remote monitoring of infant incubators
in the ICU”, International Journal of Medical Informatics vol. 71 issue 2-3 September, 2003.
pp. 151-156.
[5] Freddy Jiménez and Romina Torres, “Building an IoT-aware healthcare monitoring system”,
10.1109/SCCC.2015.7416592, Nov2015.
[6] L. Nachabe, M. Girod-Genet, B.ElHassan, and J.Jammas, “M-health application for neonatal
incubator signals monitoring through a CoAP-based multi-agent system”,
10.1109/ICABME.2015.7323279, Nov2015.
[7] Ashish.B, “Temperature monitored IoT based smart incubator”, 10.1109/I-
SMAC.2017.8058400, Feb2017.
[8] Sarfraz Fayaz Khan, “Health care monitoring system in Internet of Things (loT) by Using
RFID”, 10.1190/ICITM.2017.7917920, May2017.
[9] Andreas Tobola, Heike Leutheuser, Markus Pollak, Peter Spies, Christian Hofmann, Christian
Weigand, Bjoern M. Eskofier, and Georg Fischer, “Self-Powered Multiparameter Health
Sensor”, 10.1109/JBHI.2017.2708041, Aug2017.
[10] A. Ahmed et al, “Low cost transportable infant incubator,” IEEE 39th Annual Northeast
Bioengineering Conference (NEBEC), IEEE Conference Publications, pp. 165-166, 2013.
[11] B. Priya, S. Rajendran, R. Bala and Gobbi. R, “Remote wireless health monitoring
systems”, 10.1190/CITISIA.2009.5224177, Aug2009.
[12] Hittu Mittal, Lini Mathew and Ashish Gupta, “Design and Development of an Infant
Incubator for Controlling Multiple Parameters” International Journal of Emerging trends in
Electrical and Electronics, Vol.11(5), pp.65-73, 2015.
[13] M. Sruruthi and S. Suma, “Microcontroller Based Baby Incubator Using Sensors”
International Journal of Innovative Research in Science, Engineering and Technology,
Vol.4(12), pp.12038-12044, 2015.
[14] S. Sendra, P. Romero-Díaz, J. Navarro-Ortiz and J. Lloret. “Smart infant incubator
based on LoRa networks.” 2018 IEEE/ACS 15th International Conference on Computer
Systems and Applications (AICCSA), Aqaba, pp. 1-6, 2018.
[15] Hall, Virginia, Eric Geise, and Nasser H. Kashou. “The IncuLight: Solar-powered
infant incubator.” In IEEE Global Humanitarian Technology Conference (GHTC 2014), pp.
223-226, 2014.
[16] Lee, Won, Heenam Yoon, Chungmin Han, Kwang Joo, and Kwang Park.
“Physiological signal monitoring bed for infants based on load-cell sensors.” Sensors Vol.16,
no. 3, 409, 2016.
[17] Debashis De, Anwesha Mukherjee, Arkaprabha Sau and Ishita Bhakta (2017) “Design
of smart neonatal health monitoring system using SMCC’, IET Journals & Magazines, vol. 4,
no.1, pp.13-19
[18] R. Fletcher, X. Soriano Díaz, H. Bajaj and S. Ghosh-Jerath (2017) “Development of
smart phone-based child health screening tools for community health workers”, 2017 IEEE
Global Humanitarian Technology Conference (GHTC), pp.1-9.
[19] Arif Widianto, M. Raditya Gumelar, Pradipta Mahatidana, Rizky Ramadian Wijaya,
Intan Nurfitri, Kresna Devara and Retno Wigajatri Purnamaningsih (2017) “The effect of

2126
 moving load on remote weight monitoring system for simple infant incubator”, 2017
International Conference on Broadband Communication, Wireless Sensors and Powering
(BCWSP), pp.1-4.
[20] Reddy, Narender P., Mathur, Garima, Hariharan, “Toward a Fuzzy Logic Control of
the Infant Incubator”, Annals of Biomedical Engineering vol. 37 issue 10 October 2009. pp.
2146 – 2152.

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