Parent of Hospitalized Babies
Other Awards and Accolades


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Areas of development

Neurobehavioral development

Als’ Synactive Theory of Development is based on the premise that it is through behavior that the neonate communicates functional stability and his/her limits for stress (Als H, 1986 ) The subsystems, which are interrelated and interdependent, mature simultaneously. Therefore, instability in one subsystem can greatly affect the other subsystems, and subsequently how the neonate responds to the environment. As the neonate develops, the developmental tasks related to each subsystem also evidences a development sequence (Holditch-Davis D and Blackburn ST, 2007; Gardner SL and Goldson E, 2011; Carrier CT, 2010. The Zakys and Kangaroo Zaks have become the most effective tools that facilitate infant development in the NICU, with neurological development being on the top of the list.

Click here to learn more about neurobehavioral development and its subsystems: autonomic subsystem, motor subsystem, state subsystem, attention/interaction subsystem, and self-regulation subsystem.

There is evidence that premature babies have 5 times the risk of experiencing psychiatric (psychological or behavioral) disorders than a full-term baby. Our job is to provide products that are designed to help decrease the morbidity of newborns, especially those born prematurely. 

The brain is one of the last organs to develop in the womb, and one of the most fragile.

Here is a picture of the baby's brain maturation according to gestational week. See the different stages of brain maturation and why we need to protect it:

brain at 24 weeks gestation brain at 40 weeks gestation

Sensory Systems that require sleep for normal development (Graven, 2008)

1. Somatesthetic (Touch)
2. Kinesthetic (Motion)
3. Proprioception (Position)
4. Chemosensory (Smell and taste)
5. Auditory (Hearing)
6. Vision (Seeing)
7. Limbic (Emotion)
8. Social learning
9. Hippocampus (Memory)

brain at 24 weeks of gestation
(2 inches wide)

brain of a healthy baby
at 40 weeks of gestation

The brain grows 400% between week 26 and 40 of gestation, and another 400% until 21 years of age.


Babies at 32 weeks in the womb sleep 20-22 hours per day, and everything that we do (or don't do) to the premature baby may impact the brain. According to research by Dr. Graven, babies only develop their brain during deep sleep.

The Zakys maternally scented reduced life threatening apnea and bradycardia events to ZERO and significantly improved self-regulation for the babies in the randomized clinical trial. See the presentation of the independent research here

When the baby is not being held in Kangaroo Care with the Kangaroo Zak, The Zakys simulate the feeling of being held, by providing boundaries, comfort, a soothing hand, and the scent of the parent, allowing your baby to feel a sense of protection 24/7 and fall asleep.

How can you help your baby?

  • Hold your baby in Kangaroo Care with the Kangaroo Zak as many hours a day as it is possible and use The Zakys at all other times
  • Become the guardian of your baby's brain by helping the nurses reduce unscheduled interventions, loud noises, light, interruptions, and by using The Zakys at all times.
  • Scent The Zakys (by placing them behind the neck or on the chest for one hour or one night) and help the baby learn self-organization behaviors that allow him/her to return to a state of calm.
  • Avoid swaddling for long periods of time, as it restricts movement and it is not recommended. Use The Zakys instead, which give the baby containment without obstructing the view to the baby or restraining movement.

Ask if the NICU practices evidence- based care. If so, they use or recommend The Zaky and practice Kangaroo Care as both have evidence of the medical benefits to the baby.

We encourage everyone to always question the need of each intervention before touching or waking up a baby that is in quiet sleep developing the brain. This decision might help that baby decrease future neurological deficiencies such as learning disabilities, sensorial problems, or ADHD.

Read Dr. Jackson's articles: "Developmental Care Matters" and "Apnea and Bradycardia of Prematurity: Nature of Nurture"

Our products help you achieve the best results and support you through what can be the toughest time for you and your baby.


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Areas of development

Physical Development

Babies who are born prematurely are welcomed to a world of life, death and separation, and their parents’ shock to the dream they had in their hearts of providing a healthy start for their baby. NICU nurses are challenged to keep up with the advancing developmental growth of the infants and individualize the care depending on the gestational age, medical condition, family situation, etc, and learn/practice evidence-based developmental care that starts with knowing the vast variety of positioning requirements due to the baby’s lack of muscle tone and skeletal development.

Tone starts developing from the toes and goes up, so it is backwards from the development of any other system. An infant born at 24 weeks basically only has ankle dorsiflexion which, if not protected, plantar flexion might eventually result in the child walking on the toes and require many therapy sessions to resolve. At 27-28 weeks an infant has flexion to the knee but no tone in upper extremities so she
or he requires full support to maintain good alignment and musculoskeletal development. Infants begin to show some flexor tone in the upper extremities and increasingly in the lower extremities around 31-36 weeks. Arms and legs are flexed around 36-37 weeks so the infant can finally attempt to pull the body into midline.

Organized behavior also develops on a continuum, like tone. Nurses, therapists and parents have to pay attention to hips, shoulders, necks, airways and molding of the soft heads, not to mention the loud monitors, bright lights, scent of alcohol, and the large number of interventions and devices in a variety of challenging settings including different modes of ventilation, sensors, leads, vascular access devices, catheters, wounds, stomas and drains.

If you were a baby, would you be able to self-regulate and sleep soundly under these conditions or while you are scared or feeling excruciating pain? Not likely; however we are expecting babies to sleep so they can develop their brain—and the mother, the principal source of comfort for the baby, is often denied the opportunity to be the primary developmental caregiver of her own child. All this is changed with The Zakys and Kangaroo Zaks.

The babies always go first when using our products. With The Zakys, the baby is always placed and properly positioned first, and then secured by The Zakys. Avoid devices that must be placed first and then work the baby around it, or products that create pressure points, creases, or an uneven pressure.

Use The Zakys to provide sound musculoskeletal development, without restraining movement or access to the baby. They very likely may decrease or even eliminate the need for some future physical therapy.

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Areas of development

Physiological Development

When moms are pregnant the womb automatically meets four basic needs for the baby: oxygen (breathing), warmth, nutrition, and development.  When the baby is born, the absence of at least one of the first three is life threatening.  If your baby cannot do any first three on his own, he will get assistance from a machine (life support) or else he will die:

If the baby cannot breath he is hooked up to a ventilator/canula,etc., if he cannot get warm he is placed in Kangaroo Care, in an incubator or under a warmer, if he cannot eat he would have an IV or a feeding tube.
Your baby, just as any baby, is born unable to provide proper DEVELOPMENT on his own. While "development" is not always life-threatening it is extremely important for his quality of life.

Development, when it is not given by the womb, comes from the caregiver and no matter the size of the baby, he cannot comfort or position himself at birth, nor he is able to feel protected on his own so he will waste precious calories trying to feel protected. With The Zakys, the baby is handled less as the alarms go off less, and they give the necessary support to heal, get comfortable, and develop correctly.

Contrary to popular believe, a newborn baby cannot be "spoiled" by being held too much, nor he is able to "manipulate" the parents - especially preemies. Research shows that babies that are held on Kangaroo Care the longest do better than those that are not held. When holding is not possible, then The Zakys effectively simulate parental intervention.

  • The Zakys are an effective non-medicinal pain management aid, for colic and other more serious conditions.
  • Builds confidence and sense of protection of the infant.
  • Parents easily learn how to position the baby to achieve comfort.
  • Reduce stress levels and improves positioning allowing the baby to develop correctly.
  • Provide sensorial stimulation needed for proper development.
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Areas of development

Psychological (Social and Emotional) Development

Babies that are premature or hospitalized for any reason at birth are particularly vulnerable to having issues with attachment/bonding, associations such as touch with pain and movement with stress. The brain is not formed and everything we do or don't do can potentially affect the emotional and social development when they grow.

A baby learns his mother’s scent through the amniotic fluid in the womb; he could hear your voice and your heartbeat. You provided warmth, breathing, nutrition, and protection. If each parent scents The Zaky by sleeping with it on the chest or placing it behind the neck for a couple of hours, the baby recognizes the scent of mom and starts learning the scent of dad facilitating early bonding and the comfort to fall asleep.

If the baby has colic, can’t sleep, or needs extra comfort, warm The Zakys by placing them in the dryer for a couple of minutes then place them on the baby. Some parents choose the Pink Zaky to be scented by Mom, and the blue Zaky to be scented by Dad.

Have you noticed when toddlers feel scared or hurt, they run to their mothers/fathers? And often, her love and kiss will dissipate the pain and fear.  Your baby is no different. Your baby feels much better if he knows that you are there, or if he feels your presence with The Zakys. It is also important for his development and sense of security.

As an adult, you can’t sleep when you feel stressed and/or unprotected - babies are no different, yet we are surprised if they don't sleep - they rest better when they feel protected and comfortable. Swaddling is not recommended and unfortunately you cannot hold him all the time. The Zakys become an extension of you, especially if they smell like you (by placing it behind the neck or on the chest for at least one hour or all night), until is time to hold him again!

The Zakys are so easy to use, and they increase sense of control and confidence of the parents.

The Zakys provide a “security blanket” for babies when they are moved or transferred to different environments.  Again, it gives a sense of protection when everything else is changing:  the lighting, the noise, the scents, the temperature, etc. The Zakys are transportable and very versatile. It also helps the baby stay calm when it taken care by someone other than the parents. Mothers say they feel more comfortable at work if they leave The Zaky with the baby when they have to be back at work. When you are busy or away, The Zaky simulates your presence and helps you bond with your child.  Moreover, it has been successfully used as a bonding and a non-medicinal pain management aid since 2001 in Neonatal Intensive Care Units.  When you are not there, leave a scented Zaky to assure him that he is not alone.