The sounds of live music confer health benefits on the tiniest and most vulnerable people—premature babies who are being treated in the neonatal intensive care unit, a new study says.

When the preemies in intensive care listened to live music, they showed measurable improvements in heart rate, sucking behavior, sleep patterns and calorie intake, according to the study. In addition, music helped parents and babies bond, and eased the stress of mothers and fathers.

The study involved 272 premature infants in neonatal intensive care units, or NICUs, at 11 hospitals. The infants had health issues such as breathing problems, bacterial bloodstream infections or were small for their age.

While prerecorded music has health and psychological benefits, unlike live music, it can involve instruments, rhythms and melodies that can overstimulate a newborn who is used to the “enclosed sound environment of the womb,” the researchers wrote. That environment is defined by the mother's heartbeat, breath patterns and voice.

A musical intervention

The researchers involved in the study looked at preemies' responses to three types of music therapy. One involved a Remo ocean disc, which is an instrument that produces a soothing “whoosh” sound; and another intervention involved a gato box, which is a drumlike wooden box that is played softly with the fingers. The ocean disc mimics the sound of the in utero enviroment, the researchers said, and could have a soothing, sleep-enhancing effect, while the gato box would sound like a mother's heartbeat.

During the third intervention, parents sang a lullaby to their baby that had a cultural, childhood or religious meaning — what researchers call a “song of kin.” If the parents didn't have a song of kin, they sang the default tune, “Twinkle, Twinkle, Little Star.”

Each baby was exposed to each intervention for 10 minutes three times a week for two weeks. (The babies received no aural stimulation the rest of the time.) Each newborn's vital signs, feeding behaviors and sleep patterns were recorded daily during the two weeks.

Results showed that each music intervention had different health benefits. For example, preemies whose parents sang to them had the greatest increase in activity or alertness. The whooshing sound of the Remo ocean disc was linked with the greatest improvement in sleep patterns, and the sounds emitted by the gato box increased babies' sucking behavior, which helps with swallowing and breathing.

Babies who heard a song of kin consumed more calories than babies who listened to “Twinkle, Twinkle, Little Star.” On the other hand, babies who heard “Twinkle, Twinkle” had slightly higher levels of oxygen in their blood.

Parents who sang to their babies reported feeling much less stress.

The findings mean musical therapies could be tailored to the specific needs of a preemie, said study researcher Joanne Loewy, director of the Louis Armstrong Center for Music & Medicine at Beth Israel Medical Center in New York City.

Why live music?

Unlike prerecorded music, live music can be adapted to meet the needs of the preemie.

“Live sounds are the key,” Loewy said. “When a music therapist teaches parents to entrain with the baby's vital signs, it can have a therapeutic effect.” Entraining means matching sounds or music to the meter of the infant’s breathing.

“The infant is the conductor,” Loewy said.

Music therapy can be integrated with medical care, Loewy said. “When infants are admitted to the NICU, they need so much care that sometimes parents feel a loss of control,” she added. But the sound of their voices can comfort the infant, and holding their baby while singing to him or her enhances bonding.

Parents can mimic the sounds of the ocean disc and gato box. For example, whispering “ah” while cradling the baby replicates the whooshing sound of the womb; holding a baby against the heart and gently tapping his back creates a “predictable rhythm” much like the gato box does, Loewy said. While the study focused on preemies, music interventions can also benefit full-term babies, Loewy said. Live music can help parents “during difficult transitions, such as sleep time,” she explained.

Just “keep the music soft,” Loewy advised. The sounds researchers used during the study ranged from 55 to 65 decibels, equivalent to the volume of a moderate rainfall or a conversation. Also, let the baby's mood determine the tempo. If the baby is alert, the music can be more active, Loewy said. If she seems sleepy, slow the music down.

Parents who are tone-deaf needn't be wary of crooning an off-key lullaby. “Even if a parent sings out of tune, the baby recognizes that voice” and draws comfort from it, Loewy said.

The study is published online today (April 15) in the journal Pediatrics.

Pass It On: Listening to live music may help preemies.

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