Babies born prematurely face special challenges; they are presented with a world of sensory experiences they are not yet wired to take in. Not surprisingly, an infant with a pre-term neurological system will be hyper-sensitive to full-term sights, sounds, movement, and touch. Because of their fragile state, infants delivered before 37 weeks routinely face the stressful medical necessities of feeding tubes, ventilators, needle sticks, alarms, and cries in the neonatal intensive care unit (NICU).
Infant brain development occurs at an astonishing pace, especially in utero, yet any time a preemie reacts to sound, touch, or visual stimuli with a stress response, that flood of neurological connections shuts down until the child can regain equilibrium. Any time lost at this crucial stage of development can have negative long-term cognitive, emotional, social, and medical complications into childhood and adult years. On top of the developmental and emotional toll this takes on infants and their parents, the financial cost of NICU care can be overwhelming. All of this underscores the need for appropriate nurturing interventions for these little ones.
VIDEO: NICU Music Therapy
Pioneering research in the field of music therapy over the past 20 years has found that music used in the right way can help premature infants adapt to the challenges of the NICU, learn oral feeding, self-soothe, gain weight, and most importantly: go home sooner.
NICU patients as young as 28 weeks are not yet able to use a pacifier or benefit from soothing touch when they are upset. Yet soft (65 dB, C scale), slow, non-alerting music such as lullabies presented with a simple texture (voice only or voice with simple accompaniment) for no more than four hours a day can serve as a calming stimulus that also masks potentially stressful environmental sounds. Studies have shown that this type of listening-only music therapy significantly improves oxygen saturation levels, lowers heart rate, and shortens the duration of hospital stay by as much as two weeks for these babies.
We are used to soothing a crying baby with a pacifier or even a finger — a skill known as non-nutritive sucking. For preemies with low birth-weight requiring a feeding tube, pairing pacifier sucking with tube feedings helps them lower activity levels and get back to sleep faster, leading to improved weight gain by helping these babies conserve energy.
But what if the baby is having trouble developing that suck-swallow-breathe reflex? In a fascinating case of very early behavioral conditioning, a device known as the pacifier-activated lullaby (PAL) was created and researched to teach this crucial skill. Infants as early as 32 weeks who had been identified as poor feeders were presented with a pacifier that rewarded them by playing recordings of developmentally appropriate music when sucked — and within just one 20-minute session, they had learned the cause-and-effect relationship between their behavior and the contingent music by sucking at a higher rate! These babies also increased their feeding rates later the same day. This intervention has also been shown to help infants return from a distressed state to a calm one following painful medical procedures more quickly than a pacifier without music.
Each of these interventions detailed above can be accomplished with appropriate recorded music; the next NICU music therapy blog entry will detail the extraordinary benefits of live music used interactively with pre-term infants.
Peter Muszkiewicz, MT-BC
Franciscan Life Process Center
Lowell, MI 49331
Peter Musczkiewicz received his Bachelor of Music Therapy from Western Michigan University, Kalamazoo, in 2009. He completed his internship at the Franciscan Life Process Center in March 2009 and started work there as a full time employee that June. Pete received his designation of Neurologic Music Therapist (NMT) in February 2010. He serves clients with neurological impairments and developmental disabilities, and also works with geriatric groups and hospital patients. Pete teaches percussion and guitar at the Center, and is interested in using technology to expand the scope of Music Therapy practice. He has presented on music therapy in a variety of professional and educational settings.