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This Pacifier Has Been Supercharged With Music To Help NICU Preemies in LA

Julian Middleton was born 11 weeks early. Here he is during a music therapy session with a device called the Pacifier Activated Lullaby (PAL). (Priska Neely/KPCC-LAist)
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A high-tech pacifier is helping some of L.A.'s premature babies learn to eat and bond with their parents while they're in the neonatal intensive care unit, or NICU.

The humble paci is harnessing the power of music therapy using something called a "Pacifier Activated Lullaby," or the PAL.

It's basically a fancy little speaker that's connected to a pacifier.

When the baby sucks, a song plays. And not just any old song. Music therapists at UCLA Mattel Children's Hospital work with parents to record special songs for tiny, vulnerable ears -- and sometimes even write their own.

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The process encourages babies to develop their feeding skills by using music and their parents' voices as a reward. "They learn really quickly that when they suck, they get this beautiful lullaby sound," said Jenna Bollard, the expressive arts therapies manager at the hospital.

Babies start practicing with the device for 15 minutes a day.

For preemies born six weeks early, the muscles and reflexes that allow sucking, swallowing and breathing to happen at the same time haven't fully developed yet.

Music therapist Sandra Cheah with Julian Middleton and his mom Jamie during a music therapy session with the PAL (Pacifier Activated Lullaby). (Priska Neely/KPCC-LAist)

Building up their muscles and reflexes helps them transition more quickly from feeding tubes to drinking milk. That transition to bottle or breastfeeding is often one of the last hurdles before a baby can go home.

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Babies "thrive better at home than they will in the hospital," said Jayne Standley, the Florida State University music therapist who invented the PAL. "Because when they go home, they can be held. They can be nurtured."

Studies have shown that when mothers sing to their babies during skin-to-skin contact, babies' heart rates become more stable and the mothers' anxiety was reduced.

In the hospital, music therapists teach not only parents, but nurses about the types of songs and sounds that are developmentally appropriate. "We definitely see a difference in the babies when they hear the music," said NICU nurse Sanna Howell. "We see their vitals change for the better."

The FDA-approved device is currently being used at hospitals across the country but music therapists are collecting data in the hopes that the PAL can become part of standard care for preemies at UCLA Mattel Children's Hospital.

Jenna Bollard is the expressive arts therapies manager at UCLA Mattel Children's Hospital. (Priska Neely/KPCC-LAist)
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The device has been shown to help preemies start feeding faster, and it can shave off days in the hospital. Since each day in the NICU costs thousands of dollars, the individual and collective impact of that is substantial -- one in 10 babies are born early in the U.S.; nearly 41,000 per year in California.


When Jamie Middleton's son Julian was born 11 weeks early he was just 2 pounds, 13 ounces and connected to all sorts of machines in the neonatal intensive care unit. "He was very, very tiny and bright red," she told KPCC/LAist. "He had a respirator and feeding tubes, IV. It was hard to see."

In the days before she could hold him, being part of the music therapy program made her feel connected to her son. "There's not a lot you can do as a NICU parent. And a lot of times you have limitations in how you can comfort your baby," she said.

Middleton worked with a music therapist, Sandra Cheah, to reimagine the John Lennon classic "Beautiful Boy" as alove song for her son.

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She called the experience one of the "little rays of sunshine" during that time in the NICU. Middleton and her husband took their son home after eight weeks, and they plan to keep the music going. They're creating a special playlist for Julian, and will add to it every year until his 18th birthday.

Jamie Middleton feeding her son, Julian, who has been in the neonatal intensive care unit for 8 weeks. (Priska Neely/KPCC-LAist)

This story also ran on the radio. Listen here.