Exploring Music's Complexities

Music and the Newborn

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Role for Music in Infancy

Kristin S. Padilla, RN, BSN, RNC

The News and Views provided are for informational purposes only and are not intended to diagnose or treat any condition.

In this post we are moving on from pregnancy and birth to the role of music in infancy with a focus on research with newborns that spend time in the NICU (neonatal intensive care unit).

As a first time mother of an eight-and-a-half month old, I’d like to begin with a personal anecdote of how music has already had an influence on my child’s life.

Since the day that we brought my son, Luke, home from the hospital, I have been playing music or singing to him (albeit, not well but he seems to like it!). I didn’t think much about music having the ability to calm him down until one day I was driving down the freeway and he started to become very fussy and cry. I had a family member sitting next to him in the backseat that had been entertaining him, but he was getting tired and cranky and was done with the car seat. I put in Dr. Daniel Kobialka’s CD, “Lullaby” into the player, turned up the volume (loud enough to be heard over his crying) and hoped for the best.

Lullaby

To our amazement, within a couple of minutes, Luke stopped crying and as my family member describes it, “got a very peaceful look on his face and just seemed to be listening.” He drifted off to sleep eventually and needless to say, I couldn’t have been happier.

Since then, there have been several instances, especially during nap or bedtime that he has stopped fussing or squirming when the lullabies come on and they have become an important part of the “sleepy time” routine.

I was blessed to give birth to a healthy, full-term infant with no medical complications and we were able to come home from the hospital the next day. With advances in medical care, very sick babies as well as babies as young as 23 weeks are surviving but not without spending weeks to months in the NICU.

I was blessed to give birth to a healthy, full-term infant with no medical complications and we were able to come home from the hospital the next day. With advances in medical care, very sick babies as well as babies as young as 23 weeks are surviving but not without spending weeks to months in the NICU.

Although the doctors and nurses caring for these fragile infants do a wonderful job of keeping the environment as calm and quiet as possible, as a nurse that has spent a decent amount of time in various NICUs, I can tell you, this is no easy task. There always seems to be a monitor alarming or an IV pump beeping somewhere. The environment can potentially be over stimulating which can be detrimental to these infants by increasing their workload (for example, during crying when the respiratory and heart rates increase). Several studies have been conducted to research whether music therapy in the NICU can assist in soothing infants and aid in their care during their stay.

One study, conducted by Dr. Stephen Malloch, a Research Fellow from the University of Western Sydney, found that infants that received music therapy during their stay in the NICU at Royal Children’s Hospital in Melbourne were less irritable and less likely to cry.

Forty infants were involved in the study and they were placed into three groups: those that received music therapy during hospitalization, those that were hospitalized and did not receive music therapy, and healthy infants cared for at home with no music therapy. Developmental tests were preformed two times on each infant about a month apart.

During the month, infants receiving music therapy were sung to in up to twelve sessions given by Helen Shoemark, a Senior Music Therapist at Melbourne’s Royal Children’s Hospital. Dr. Malloch reported, “We found that music therapy supported the infants’ behaviour-these infants maintained the same levels of irritability and crying that they had on admission. Meanwhile, those babies the in the Neonatal Unit who did not have music therapy deteriorated in their irritability and crying behaviour-coping less with their hospitalization as time went on.”

He concluded that the findings suggested that the infants that received the music therapy used less energy than the infants that did not receive the therapy. When an infant cries and is very irritable, the metabolic rate is increased and this can have an impact on the rate of “healing and weight gain, two significant factors which contribute to the length of a hospital stay.”

Ms. Shoemark stated that she is “analizing the specific characteristics of the therapy so that it can be applied by other therapists in this field.”

Another fascinating use of music in the NICU is “Pacifier Activated Lullaby (PAL).” Before the gestational age of about 34 weeks, the suck/swallow reflex is weak and uncoordinated. This reflex can also be difficult to elicit in infants that have been intubated as they tend to develop an aversion to anything in their mouths (understandably so). PAL is showing promise in teaching these infants suck by rewarding them with a lullaby when engaging in active sucking. The pacifiers used are connected to a small computer that is able to detect when an infant is sucking properly. When this occurs, it activates a CD of female-voiced lullabies as a reward. If the baby stops sucking, the lullabies shut off after 10 seconds and will restart when the baby begins sucking again.

Dr. Jayne Standley, a music therapist at Florida’s Children’s Hospital in Orlando, is the creator of these pacifiers in the hopes that “babies could be taught to feed properly with the right reinforcement.” After spending 10 years developing the pacifier and studying it’s ability to teach infants how to coordinate their suck and swallow skills, she has found that premature infants at 34 week can learn from the device in minutes. This learned suck and swallow has been retained during breat and bottle feedings leading to more effective feeding sessions and faster weight gain. This musical pacifier has been approved by the FDA for use in newborns. Another study also showed that infants in the NICU that used PAL gained more weight than those that did not.

Music therapy is an inexpensive, non-invasive way to assist fragile infants in the NICU to thrive and be able to go home to their families as healthy babies. It is my hope that the use of music therapy and PAL become common place in NICUs around the country.

References

Cevasco, AM, Grant RE. Effects of the pacifier activated lullaby on weight gain of premature infants. Journal of Music Therapy. 2005 Summer; 42(2):123-39

Standley, J. The effect of music-reinforced nonnutritive sucking on feeding rate of premature infants. Journal of Pediatric Nursing, Volumn 18, Issue 3: 169-173

University of Western Sydney (2006, February 14). Rockaby Baby: Research Shows Gentle Singing Soothes Sick Infants. ScienceDaily. Retrieved April 25, 2010 from http://www.sciencedaily.com/releases/2006/02/60213102134.htm

Sound. Vibration. Music. Harmony. Music relaxes, comforts, strengthens and helps heal us. Music inspires yoga, spas, massage and meditation. These musicians, doctors, authors, therapists and visionaries celebrate the wonders of sound and music with us.

 

 

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