Smart bioelectronic pacifier for real-time continuous monitoring of salivary electrolytes

Monitoring electrolytes is critical for newborns and babies in the intensive care unit. However, the gold standard methods use a blood draw, which is painful and only offers discrete measures. Although salivary-based detection offers promise as an alternative, existing devices are ineffective for real-time, continuous monitoring of electrolytes due to their rigidity, bulky form factors, and lack of salivary accumulation. Here, we introduce a smart, wireless, bioelectronic pacifier for salivary electrolyte monitoring of neonates, which can detect real-time continuous sodium and potassium levels without a blood draw. The miniature system facilitates the seamless integration of the ultralight and low-profile device with a commercial pacifier without additional fixtures or structural modifications. The portable device includes ion-selective sensors, flexible circuits, and microfluidic channels, allowing simplified measurement protocols in non-invasive electrolyte monitoring. The flexible microfluidic channel enables continuous and efficient saliva collection from a mouth. By modifying the surface properties of the channels and the structure of the capillary reservoir, we achieve reliable pumping of the viscous medium for quick calibration and measurement. Embedded sensors in the system show good stability and sensitivity: 52 and 57 mV/decade for the sodium and potassium sensor, respectively. In vivo study with neonates in the intensive care unit captures the device's feasibility and performance in the natural saliva-based detection of the critical electrolytes without induced stimulation.