The use of disposable feeding bottles at the Erasmus MC Sophia Children’s Hospital is a major contributor to the environmental footprint of the entire paediatric department. Reusable feeding bottles are commercially available, but their introduction into the hospital is hindered by concerns about safety, hygiene, limitations in physical infrastructure and financial constraints.

This project combines a qualitative study investigating the journey of a feeding bottle from arriving as an empty product to its disposal as waste in the paediatric intensive care unit (PICU), with a quantitative waste audit. This audit revealed that annually, a minimum of 555 kilograms of feeding bottles are discarded from the PICU alone. The consistent use of accessory products, such as feeding teats or enteral feeding sets, further adds to this material waste. Based on this in-depth investigation of the current feeding practices and waste flows, ten sustainability hotspots were determined, leading to the development of eight explorative interventions to reduce the environmental footprint.

The designed mono-material feeding pouch reduces the material weight required to transport an equivalent amount of formula milk by 60% compared with conventional bottles. This saves more than 329 kilograms of plastic waste from the PICU annually. The smaller size of the feeding pouch decreases the generated volume of waste by two-thirds and requires 40% less transportation capacity to deliver.

Integration into the existing infrastructure of the hospital is ensured with the developed stackable preparation and transportation tray and the bedside pole holder, which supports both teat-based and enteral feeding for the proposed next generation of feeding containers.

The project also highlights the current use of sterile water, which more than doubles the disposed mass associated with feeding bottles, while being supported by potentially outdated guidelines. This topic is suggested as a key opportunity for immediate changes by the Sophia Children’s Hospital.

Introducing any new medical device is a complex challenge, and the development of this next generation of feeding containers and the necessary accessory products must be supported by a questioning of the established practices surrounding infant feeding. Reducing the environmental footprint of infant feeding at the Sophia Children’s Hospital, therefore, requires looking beyond the bottle to the wider system of feeding practices and hospital-wide processes and infrastructure.