Couple finds their version of Bob Marley’s “Three Little Birds” has helped their triplets learn to suckle and develop.
In the halls of a hospital’s neonatal intensive care unit (NICU), you wouldn’t be surprised to hear coos of babies, chatter from parents, and the occasional wail of a disgruntled newborn.
What you might be surprised to hear, however, is Bob Marley.
But his song “Three Little Birds” wafted through the NICU of UCLA Mattel Children’s Hospital in summer 2018 when triplets Ada, Kian, and Nico were being cared for.
Born to parents Jana Gallus, 32, and Gregor Martynus, 35, the trio arrived early, at 31 weeks. Their weights ranged from 2.5 to 4 pounds, and they were immediately moved to the NICU for observation and treatment.
Amid the assembly of nurses, physicians, and NICU staff that tended to the babies, Gallus and Martynus met the hospital’s music therapists, specialists who use music to help babies grow and develop.
The therapists told the new parents the triplets could be great candidates for a musical intervention program called Pacifier-Activated Lullaby (PAL).
PAL is an FDA-approved medical device that looks and works like a small boombox. However, the infant has to do work, specifically practicing non-nutritive sucking, to get the music.
The new parents, curious about the intervention and the potential it might have to help their babies grow, gave therapists the go-ahead.
Premature babies, especially those born before 34 weeks, don’t always have the vital suck-swallow-breathe reflex that’s necessary for them to be able to drink from a bottle or breastfeed.
Indeed, one of the last hurdles preemies often must overcome before they can go home is the ability to feed independently and gain weight.
Non-nutritive sucking, such as nuzzling on a pacifier, is one step toward being able to maintain feedings. Infants might be able to hold a pacifier, but the muscles in their mouth may not be strong enough to pull fluid from a bottle or nipple in order to eat.
That’s where intervention training can help.
“The PAL is a speaker that’s attached to a sensor, so each infant gets their own sensor,” said Jenna Bollard, a music therapist and manager of expressive arts therapies at UCLA Mattel Children’s Hospital. “We attach their own pacifier to the sensor. They trigger it by sucking and it will play music.”
The PAL was invented earlier this decade by Florida State University professor of music therapy Jayne Standley. It’s designed to help little ones quickly learn the muscle movements that are necessary to suck and feed by reinforcing the proper movements with calming, engaging music.
For the Gallus and Martynus triplets, proper sucking let out a soft, flowing rendition of Marley’s “Three Little Birds,” as written and recorded by their father, with the help of the UCLA musical therapists.
“The musical therapists approached us when we had been at the NICU, explaining the kind of work they do in general, and when we heard what they wanted to do with PAL, we just liked it a lot,” Martynus told Healthline. “We had no objections whatever.”
In fact, Gallus, who’s an economist and assistant professor at UCLA, was so interested in the study, she offered to treat some of the couple’s babies with the device but not others to compare them closely.
The music therapy team decided all three could benefit from the program.
For their infants’ personalized lullaby, Martynus worked with music therapist Kristina Casale to rewrite the song’s verses, creating one for each of the triplets.
“Kristina turned the song into a smooth lullaby version and we worked around some of the lyrics,” Martynus said, “making like one verse per baby.”
Then Kristina and Martynus sang the song together, recording it for the triplets.
Don’t worry, about a thing
Cause every little thing is gonna be alright
Singing don’t worry, about a thing
Cause every little thing is gonna be alright
[Verse 3 – Kian]
Fiesty Little Kian
You smile like the rising sun
Your cute little nose
Wiggles in your sleep
We’ll sing a sweet song
A melody pure and true
Singing: this is our message to you
Martynus and his wife chose “Three Little Birds” because, in what might be seen as foreshadowing, lyrics from the song hang in the couple’s bedroom.
“In the beginning, they had some music prerecorded when the kids would suck, but they gave us the option to record the song ourselves,” Martynus said.
When the triplets would successfully suck hard enough and long enough on their individual pacifiers, the PAL would begin playing the song at a level that’s appropriate for neonates, around 60 decibels.
Martynus says his babies took to the PAL right away — and certainly benefited from it.
The trio went home after 52 days in the NICU.
The suck-swallow-breathe reflex that’s vital for infants requires a great deal of training and development in neonates.
The PAL is one of many devices that have been studied to see if it might help premature infants develop this reflex more quickly.
Indeed, Bollard told Healthline that previous PAL research shows the device can help babies learn to feed faster. That translates to shorter hospital stays.
Another found that infants who used the PAL before feeding time gained more weight than infants who didn’t use the positive reinforcement system.
In her own research, Bollard said she’s found that “70 percent demonstrated an increased average number of coordinated sucks within five minutes of the PAL session when the lullaby was used.”
These are encouraging numbers, Bollard says, considering the population she and her team often work with.
“We work on a level with really critical care,” she said. “Some babies are just 21 to 23 weeks gestation. We wanted to see if this additional intervention to our routine care could work for this population.”
The role of the parents is equally important to the use of the PAL system, Bollard says.
Another previous study found that mothers who sing to their babies during skin-to-skin contact experience less anxiety, while the babies’ heart rates also become more stable.
While not all neonates can be held immediately after birth, the PAL system offers an opportunity for the parents to be involved and close to their child, even when they can’t be in the NICU.
“This process greatly decreases stress and decreases feelings of hopelessness,” said Bollard, whose position is supported by the Peterson Family Foundation and whose research is funded by the Music Man Foundation. “More is coming out about how the mental health of caregivers and their anxiety state correlates directly to the health outcome of the infants.”
The PAL system, Bollard says, is actually a great way for parents to become part of the care for their infants.
“There’s a psychosocial component to writing the song,” Bollard said. “Over weeks or multiple sessions, we’re building report and helping the caregivers process this journey. The songwriting process helps them share wishes they have for their baby, process their birth story and emotions, and express whatever they would like to express.”
Before you rush out to buy one of these devices, it’s important to know they’re currently used in hospitals and not available to consumers.
“Technically, as soon as they’re taking full oral feedings, you could stop,” Bollard said.
She points out that the PAL has other benefits besides encouraging feeding, including soothing babies.
Likewise, parents shouldn’t try to use this device without the aid of a trained therapist. The PAL devices are programed to specific decibel levels and shouldn’t be used for extended periods of time.
“There’s a fine line and balance between using it and encouraging the behavior and tiring them out,” she said.
The PAL device is meant to be an aid to help an infant reach an important milestone in their development, one they should hit before they leave the hospital. If your child doesn’t seem to be sucking or feeding properly, talk with their doctor before trying any intervention on your own.