How PAL® Technology Works


What PAL® Does
The Pacifier Activated Lullaby (PAL®) technology stimulates non-nutritive sucking (NNS) and organized breathe-suck-swallow activity through a pressure transducer system that provides individual lullaby/voice feedback to a correct “suck” technique. The technology exploits infants’ natural appetite for music and applies it in a medically useful way in neonatal care.

How PAL® Works
Proprietary sensing, control and feedback algorithms are integrated into a discrete device that can be calibrated to each baby’s needs. The PAL® is wired to deliver a specifically timed lullaby each time the infant correctly sucks, meeting the preset pressure criteria. It teaches the infant how to suck and, through the use of contingent music, helps the infant to become an involved participant in learning, rather than a passive recipient.

Why PAL® is Critical for Premature Babies
Non-nutritive sucking is an essential life skill for infants. In utero, NNS begins at 28 weeks, but is not fully developed until weeks 32 through 34. When babies are born pre-term, this development is abruptly stopped. The survival of premature babies relies upon them being taught how to suck productively and develop the breathe-suck-swallow reflect outside of the womb, but it requires the extreme coordination of several muscle groups. Without NNS, these babies do not know how to feed, and thus their survival is significantly compromised.

PAL® is critical in overcoming this challenge. Capitalizing on a baby’s natural appetite for music, the PAL® uses lullaby therapy to stimulate non-nutritive sucking and assists in developing the rhythmic oral patterns that babies need to use to feed and breathe.

More on the Neurological Development of Babies

In utero, the third trimester (28 weeks to birth) is critical for the correct development of the infant brain. The human fetus is adding 250,000 neurons per minute in the developing brain. Sleep is the time of greatest brain activity and development. The womb is ideally suited for this – it is warm, quiet, dark, and comfortable. During infant sleep, vital sensory information is organized into meaningful and permanent brain circuits (learning pathways and connections). Sleep is also needed to regulate hormones, store energy needed for growth (glycogen), and develop hearing, touch, vision, taste, and smell.

But infants who are born pre-term are abruptly removed from this development process and subjected to the neonatal intensive care unit, which is a stark contrast. Premature infants lack neurological maturity and are unable to effectively process and respond to this sensory overload of lights, noise, touch, and pain. They cannot regulate their state of organization (self-soothe) and they remain highly stressed. They have great difficulty adjusting to the environment and attempting to move from one behavioral state to another – waking, sleeping, crying

The neonatal intensive care unit (NICU) environment is in stark contrast to the physical environment of the womb. In the NICU, babies face significant challenges, and have great difficulty moving from one behavioral state to another – awakening, sleeping, crying, and quiet. Additionally, many diagnostic and therapeutic procedures performed in the neonatal intensive care unit are painful for infants. Pain is therefore a central issue in neonatal intensive care nursing, and often babies have very little means to comfort themselves.

According to research, non-nutritive sucking is critical in helping preterm infants cope with and adjust to the environment outside of the womb. Non-nutritive sucking helps infants learn to “self-soothe.” Without this skill, they often lack the ability to help themselves, and will be unable to achieve the levels of quiet, non-stress and deep sleep that they need to continue normal neurological development.