NICU Music Therapy

• Introduction to Music Therapy in the NICU • The NICU Music Therapy Program at Beth Israel Medical Center • Environmental Music Therapy in the NICU • The Heather on Earth Multi-site Music Therapy Study • Referral Form for NICU • Assessment Form for NICU

Improving Sound Hazards in the NICU

Photo by Stephan Elleringmann

There is a dearth of information in the music therapy literature regarding the concern of sound hazards in the NICU environment, as well as its negative impact on the fetus. In 2000, the American Academy of Pediatric's special division of Perinatology devoted an entire journal to the hazards of noise and depicted specific conditions that pose threats to neonates. Of large concern is the decibel level in most NICU's within the United States. This hazard was recognized by the American Academy of Pediatrics in 1997 and was more vigorously addressed in three articles in the Journal of Perinatology (American Academy of Pediatrics, 2000): NICU Sound Environment and the Potential Problems for Caregivers (Thomas & Martin, 2000), Measuring Sound in Hospital Nurseries (Gray & Philbin, 2000), and Facility and Operations Planning for Quiet Hospital Nurseries (Evans & Philbin, 2000). Schwartz and Ritchie (1998) and Zahr & Traversay (1995), as well as Stewart and Schneider, (2000) have made compelling cases against the hazards of loud and abrupt sounds that can pose negative threats to the infants in the NICU. Recommendations and considerations are suggested.

Environmental Music Therapy (EMT)
Environmental Music Therapy (Stewart & Schneider, 2000) was implemented in Beth Israel's NICU. Its application was based on noise and sound investigation that demonstrated that the majority of the babies who presented as asleep prior to environmental music appeared to go into a deeper sleep state (heart rate decreased) with the environmental music therapy. The babies who were awake prior to the sleep, seemed to become more active and alert (heart rate increase) during the therapy. This reflects the impact that music therapy can provide. Specifically, music therapy assists in stimulation, which has been noted as important (Shoemark, 1998) and deepens a relaxed state, which is an essential need noted in the literature. Sleep helps the infant retain weight, and is important to the infant's overall growth and development.

The Hammered Dulcimer is a gentle subtle instrument that can create a soft sound that carries throughout the unit. The EMT music therapist plays to the sounds already present in the environment. For instance, the machines when beeping, beep in a particular key and at a certain rhythm. The music therapist uses this sound frame at the beginning of the music and eventually softens the perception of noise in the environment.

More pages on NICU Music Therapy at Beth Israel:

• Introduction to Music Therapy in the NICU
• The NICU Music Therapy Program at Beth Israel Medical Center
• The Heather on Earth Multi-site Music Therapy Study
• Referral Form for NICU
• Assessment Form for NICU

References
Evans, J.B. & Philbin, M.K. (2000). Facility and operations planning for quiet hospital nurseries. Journal of Perinatology , Dec 20(8 Pt 2), S105-12.

Gray, L. & Philbin, M.K. (2000). Measuring sound in hospital nurseries. Journal of Perinatology, Dec 20(8 Pt 2), S100-4.

Shoemark, H. (1998). Singing as the foundation for multi-modal stimulation of the older premature infant. In R. R. Pratt & D. E. Grocke (Eds.), MusicMedicie Vol. 3. MusicMedicine and Music Therapy: Expanding Horizons, 140-151.

Schwartz, F.J. & Ritchie, R., et.al. (1998). Perinatal stress reduction, music, and medical cost savings. Paper presented at the VIIth International Music and Medicine Symposium, Melbourne, Australia. July '98.

Stewart, K. & Schneider, S. (2000) Environmental Music Therapy. In Loewy J. V. (Ed) Music therapy in the NICU. NY, NY: Satchnote Armstrong Press.

Thomas, K.A. & Martin, P.A. (2000). NICU sound environment and the potential problems for caregivers. Journal of Perinatology, Dec 20(8 Pt 2), S94-9.

Zahr, L.K., Traversay, J.D. (1995). Premature infant responses to noise reduction by earmuffs: effects on behavioral and physiologic measures. Journal of Perinatology, 15(6), 448-455.