It's no secret that music in and of itself is a beautiful and beneficial thing. What about premature infants, though? How could music ever be beneficial to them? As they are in their open cribs or isolettes in that Level II nursery, what could simple music listening do for them? I've witnessed two different schools of thought when it comes to music listening and premature infants. Either it's:
"YES LET'S HAVE MUSIC ALL DAY IN THE NICU!"
DON'T EVER BRING MUSIC IN HERE; IT WILL OVERSTIMULATE THE BABIES.
What many people don't realize is that there is over 20 years of research in this area. Music therapists like Dr. Jayne Standley, Dr. Jane Cassidy and Dr. Darcy DeLoach have researched to figure out what exactly music does to premature infants. In fact, there is an entire book that discusses Music Therapy with premature infants (Disclaimer: it's called Music Therapy with Premature Infants). In all the research that they and others before them have done, here is what they found. Now mind you, this is just with music listening.
For premature infants who are at least 28 weeks gestational age, music listening caused:
- Immediate increased oxygen saturation
- Reduced frequency and duration of inconsolable crying following painful procedures
- Improved physiological measures of heart rate, respiration rate, oxygen saturation, and mean arterial blood pressure following painful procedures
- Improved behavior state following painful procedures
- Longer intervals of quiet sleep and less crying during kangaroo care
- Shortened length of hospital stay for premature infants exposed to 1.5 hours of music listening per day
- Shortened length of hospital stay for premature infants exposed to 4 hours of music listening per day
How incredible is that? Music listening was useful for these infants' physiological measures, pacification, self-soothing, decreased the length of hospital stay and was also useful for masking ambient and aversive auditory stimuli in the NICU (alarms, loud talking, etc.).
Oh, and I forgot one other detail. Music was not contraindicated for premature infants in their first week of life. In layman's terms, that means that the music wasn't overstimulating or harmful to the infants.
There were conditions, though.
Most of these researchers kept the decibel level at about 65-75dB Scale C, based off of the recommendations from the American Academy of Pediatrics. Not only that, but research shows there must be a strict limit on how long a premature infant listens to music and what kind of music to which they are exposed. One study showed that infants who listened to 8 hours of music per day in the NICU actually had an increased length of hospital stay! In addition, the music presented in many of these studies were simple, lullaby-style melodies and songs. This is a simple illustration of why it is important to have a board-certified music therapist facilitating the "musical happenings" in the NICU, so that the infants are being exposed.
In writing this blog post, I was overwhelmed and exhausted with the amount of research on this subject matter. Multiple studies have been conducted to explore the effects of music listening on premature infants, and the results are consistent among every study. Music, when presented correctly, improves behavior states and physiological measures, masks aversive auditory stimuli in the NICU and can be used as a gentle and soothing source of stimulation that facilitates acclimation to this new, strange, environment into which the infants have been prematurely placed.
Next week, we'll explore the specific, research-based techniques used in NICUs with music therapists, such as Multimodal Neurological Enhancement and the Pacifier-Activated Lullaby. We'll look into what these techniques are and how they benefit infants, parents, and hospitals alike, based off of research done. Let me tell you, it is incredible, and you definitely do not want to miss it!
American Academy of Pediatrics. Committee on Environmental Health. (1997). Noise: A hazard for the fetus and newborn. Pediatrics, 100 (4), 724-727.
Caine, J. (1992). The effects of music on the selected stress behaviors, weight, caloric and formula intake, and length of hospital stay. Journal of Music Therapy, 28(4), 180-182.
Cassidy, J.W., & Standley, J.M. (1995). The effect of music listening on physiological responses of premature infants in the NICU. Journal of Music Therapy, 32(4), 208-227.
Coleman, J.M., Pratt, R.R., Stoddard, R.A., Gerstmann, D.R., & Abel, H. (1997). The effects of the male and female singing and speaking voices on selected physiological and behavioral measures of premature infants in the intensive care unit. International Journal of Arts and Medicine, 5(2), 4-11.
Keith, D., Russell, K., & Weaver B. (2009). The effects of music listening on inconsolable crying in premature infants. Journal of Music Therapy (46)3. 191-203.
Lai, H., Chen, C., & et al. (2005). Randomized controlled trial of music during kangaroo care on maternal state anxiety of preterm infants' responses. International Journal of Nursing Studies, 43(2), 139-146.
Shoemark, H., Wolfe, R., & Calabro, J. (2003). The effects of recorded sedative music on the physiology of behavior of premature infants with a respiratory disorder. Australian Journal of Music Therapy, 14, 3-19.
Standley, J. (1991). The role of music in pacification/stimulation of premature infants in neonatal intensive care. Music Therapy Perspectives, 9, 19-25.
Standley, J., Walworth, Darcy. (2010) Music Therapy with premature infants: research and developmental interventions. Silver Spring, MD: American Music Therapy Association, 74-84.