NICU

A PAL for Preemies: Musical Pacifier Helps Babies Learn to Eat

Posted on Jul 24, 2019 in California Pacific Medical Center, NICU, Pediatric Care, Quality, Scroll Images

SAN FRANCISCO — Born a month and a half early at just 34 weeks, tiny baby Olive O’Neill was so premature that she was unable to feed orally. But by sucking on a pacifier that plays a lullaby sung by her parents, baby Olive quickly learned how to feed and has successfully gone home to her family.

Baby Olive using the PAL

The innovative device is called a PAL, short for Pacifier-Activated Lullaby. The PAL works by motivating babies to suck on a specially designed pacifier to help strengthen their sucking reflex.

At birth, premature infants often lack a developed sucking reflex. The inability to feed on their own is a common reason they remain hospitalized after birth. To help these newborns develop the sucking reflex more quickly so they can go home sooner, California Pacific Medical Center (CPMC) Van Ness Campus hospital in San Francisco, part of Sutter Health’s integrated not-for-profit network of care, is now using the PAL in its Neonatal Intensive Care Unit (NICU).

Research backs the PAL

According to music therapist Elisha Madsen, MME, MT-BC, who works with parents in CPMC’s NICU to train their infants with the special pacifier, studies show that premature infants who receive PAL therapy develop an increased ability to eat on their own more quickly, gain weight and have a reduced length of NICU hospitalization.

Studies have determined that average NICU hospital stays were 20 percent shorter (nine days on average) for babies who received PAL treatment versus babies who did not. Studies also have shown that babies increased their sucking rates up to 2.5 times more than infants who did not receive PAL. Increased sucking translates to improved oral feeding skills, which can directly affect a baby’s ability to go home from the NICU sooner.

How PAL works

The PAL is attached to a sensor that measures the strength of the baby’s sucking. When the PAL detects that the baby has sucked on the pacifier to a predetermined strength, the baby earns a reward – a lullaby recorded by the baby’s mom or dad. Music therapist Madsen explains that hearing their parent singing a lullaby motivates babies to continue sucking on the pacifier, which in turn improves the sucking reflex.

Charles and Alissa O’Neill, who recorded the traditional lullaby “London Bridge is Falling Down” for their daughter Olive, credit the PAL with helping her develop the ability to feed.

“Having the PAL is great because you could see instantly that she had a really good response to both her mom’s voice and my voice – which helped her develop her sucking,” says Olive’s dad, Charles.

“The last couple of weeks of our stay at CPMC were focused around feeding and helping Olive [learn to] feed on her own,” adds mom Alissa. “After we used the PAL, we also sang to Olive to help encourage her to feed.”

Madsen says that, within a couple of minutes, most babies learn they will have to suck on the pacifier to receive their music reward. “Parents light up when they see their baby is responding to their singing voices and is learning the skills needed to eat and go home,” Madsen says. “It is just precious to see this reaction.”

CPMC’s Level III NICU: Life-saving Technologies and Compassionate Support

CPMC’s Van Ness Campus hospital NICU is a designated level III NICU capable of caring for very small or very sick newborn babies that may need continuous life support and comprehensive care. Level III NICUs also offer a full range of pediatric medical subspecialists capable of providing critical medical and surgical care and to address problems that premature and critically ill newborns may have.

Studies have shown better outcomes for very low birth weight infants and premature infants who are born at level III centers, leading to recommendations that women at risk be transported to these centers to give birth. Through Sutter Health’s integrated network of care, women with high-risk pregnancies, and babies born prematurely or with complications, can be transported to a higher level of NICU with seamless coordination of medical care and support. This seamless care can reduce complication, reduce hospital readmissions and reduce the overall cost of care.