An Interview With A NICU Music Therapist (MT)

We were fortunate enough to conduct an interview with a NICU MT recently, and we wanted to share with everyone today. Although music therapy is nothing new it seems less talked about and less common then other types of therapy a baby may experience in the NICU. We ran a poll recently and most people who participated said they didn't have a NICU MT while their preemie was in the hospital and were not given the option. When researching new topics surrounding the NICU and preemies, I came across some information about music therapy, and decided I wanted to learn more! I also thought the information would be beneficial for parents in and out of the NICU who might be interested in this form of therapy. So I found a music therapist and conducted an interview! I ended up learning about the field in greater detail and hope you do as well. ~Amber @ Preemie Prints

Interview With A NICU MT

Amber Collier - Director Preemie Prints & NICU Mom

Annie Cross - Texas NICU MT 

Amber: Hi Annie, thank you so much for answering a few of my questions. On behalf of NICU families all over the nation we really appreciate it!! Can you briefly describe what a NICU-MT does when you work with a baby?

Annie: Sure! As a NICU-MT we work with patients to help promote their adjustment to the NICU/hospital environment.  Since many, if not all of our babies are born prematurely and are medically fragile, their body systems are often not prepared to cope with the sites, sounds, and multiple sensory stimulations present in a hospital environment.  We use soothing, appropriate touch/infant massage, paired with auditory stimulation of voice and sometimes quiet guitar music (when appropriate) to help these babies acclimate to their new environment in a way that promotes relaxation and appropriate stimulation without stressing out the baby emotionally or physically.  It is awesome to watch the monitors in a patients room as we implement this technique, because you can see the baby start to calm as their heart rate slows and steadies along with their respiration rate and their oxygen saturation (or the effectiveness at which they are taking in oxygen) starts to increase and top out at 100%.   When appropriate and available, we also like to include parents in this process, having them provide the infant massage to promote bonding with their baby, and help calm and relax both baby and parent.  It is also a really helpful tool for them to use upon discharge to help baby self soothe at home. In addition to this multimodal stimulation work we do with babies, we often co-treat with physical therapists, occupational therapists, and speech therapists to help promote their goals and provide motivation/stimulation for the infant they are working with.

Amber: Does the hospital you work at schedule music therapy or can a family request for you to come in and offer this therapy to their baby? 

Annie: Because we have a hospital wide music therapy program, the NICU is only one of my areas of coverage.  After receiving my NICU-MT certification we began expanding our services into the NICU.  I also cover the hematology/oncology floors, the pediatric intensive care unit, and the neurosurgery floor. Our hospital is lucky to have 3.5 music therapy positions, so we are able to cover the entire hospital between our team.  We typically see patients based on a referral system.  Referrals can be made by medical staff, support staff, parents, or even the patients themselves.

Amber: Is this a fairly new field and area of therapy being used in the NICU?

Annie: While NICU music therapy isn’t necessarily new, it is definitely a rapidly expanding field of music therapy.  There has been a lot of research done by a music therapist out of the University of Florida named Jayne Standley who has been fortunate enough to be able to collect data on the effects and benefit of music therapy on prematurely born infants. This has done a lot to legitimize our presence in the NICU and create a case for the benefits of our services in this area.

Amber: How do you choose which babies would benefit most from this therapy in a certain NICU or do you work with all of them?

Annie: We typically chose patients to work with based off the nursing staff recommendations.  On a typical day I will go up to the NICU and talk with nurses to see if they have any patients that they believe would be appropriate.  Some patients are too medically fragile and run the risk of being overstimulated, so we may not see them on that visit, but they may be able to be seen by the next time we return.  Usually babies that are awake and alert, or agitated are the patients we will work with to try and help them calm down and return to a steadied heart and respiration rate as well as a more efficient oxygen saturation rate.  If parents are present with a baby, they will often request music at bedside for their infant, and we will see them regardless of if they are sleeping or awake.  Sometimes we even have parents create recordings of their voices singing or reading stories to leave at bedside for the patient that can be played when they are not present.

Amber: Are there any tips or advice you could give to current families in our network who might be interested in implementing some basic or general forms of this therapy on their own, if a NICU-MT is not on staff? I guess I'm trying to ask if there is anything a parent could do on their own that might benefit their baby in the NICU if they don't currently have access to a NICU-MT?

Annie: We encourage all of our parents to sing, talk, and read to their infants.  Hearing is the very first sense developed in the womb and occurs around week 20.  The infant is able to recognize mom’s voice at birth and loves to hear it.  Singing during breastfeeding or bottle feeding is an excellent opportunity to promote bonding with pt and develop healthy eating patterns.  Even if you think you don’t have a great voice, you’re baby thinks you sound just like Celine Dion, so don’t be shy about using your voice!  Humming is also a really outstanding form of stimulation as well, so if you don’t know the words to songs, just go ahead and hum.

Amber: Thank you so much Annie for your time!

Annie: No problem, if you or any Preemie Prints families have any further questions please don't hesitate to contact me! 

-End Of Interview-

Music Therapy

Music Therapy in Neonatal Intensive Care

At a time when babies are usually growing and developing in their mother’s womb, premature infants are exposed to the busy medical environment of the neonatal intensive care unit and commonly endure painful treatments and procedures. The critical process of neurological development that takes place during the 3rd trimester is usually delayed due to the stress these infants experience in the NICU. Through specific research based techniques, music therapy has been proven successful in increasing premature infants’ tolerance to stimulation resulting in faster weight gain and a decreased length of stay. There are 2 main treatments music therapy uses in the NICU. The first is multimodal stimulation. This treatment is to help increase each baby’s tolerance to different types of stimulation in the NICU. Using live lullaby music sung with classical guitar accompaniment, the music therapist administers 3 different types of stimulation – auditory, tactile (massage) and vestibular (rocking). Through this process, each baby learns to tolerate the different sounds in the NICU as well as being touched and held. The second treatment is using a device called the PAL or Pacifier Activated Lullaby and is used with preemies who are having a hard time feeding. This machine helps to teach preemies the suck, swallow, breath reflex needed when being bottle fed using music as a reward each time the baby sucks. As a result, these babies gain weight and leave the hospital faster.

http://www.floridahospitalforchildren.com/en/specialties-and-programs/pediatric-music-therapy

Music Therapy In The NICU

Music Therapy For NICU Babies

Research is showing that Music therapy may be another way for caregivers to positively alter the environment of NICU premature babies and sick newborns.

• Desirable Impact of Music on NICU Babies
• Aids in brain and language development
• Conveys security to babies.
• Improves Oxygen saturation levels.
• Helps babies to sleep.
• Decreases pain.
• Increases weight gain.
• Shortens duration of hospital stay.

According to an article published in JAMA in 2000, playing music in the neonatal intensive care units can also play a role in holding down the noise level in the NICU's.
Guidelines for Using NICU Music
These guidelines come from Dr. Fred J. Schwartz, anesthesiologist and one of the leading authorities on using music with newborns:

• Try not to disrupt the baby’s normal sleep state.
• Consider the baby’s mood or behavioral state when music is played.
• Use music to help change or transition the baby’s behavioral state e.g. an agitated or fussy baby can go to sleep or become more quietly alert.
• Adjust volume and amount of time music is played if needed.

Here is another great article on music therapy:
Preemies and Music Therapy



Article Credit: http://nicuparentsupport.blogspot.com/2007/06/musics-ability-to-soothe-and-nurture.html