Music Therapy in the NICU: An RN’s Perspective

I recently asked Shelley Frazier, RN, BSN, IBCLC, what she thought about music therapy. She is the Lactation Consultant, Discharge Planner, and Education Coordinator for the Newborn ICU at Tallahassee Memorial Hospital in Florida. Shelley also helps facilitate the National Institute for Infant & Child Medical Music Therapy at Florida State University. The research in NICU music therapy program at Shelley’s hospital has been established since the early 1990s.

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What do you notice that music therapy does for the infants, and what criteria do you use for referrals?

The babies love the music therapy!  We do several different kinds here. They enjoy when we take them out of the isolette and gently touch them and sing softly to them. So often touch in the ICU is harsh and disturbing to the baby. Rolling them over, sticking them for labs, putting nasogastric tubes down their noses. The touch from music therapy is kind, soft and gentle. The babies love it. We also do the music therapy where they suck on a pacifier to turn on the music, and I have found that this is helpful for getting the ready to suck/swallow/and breathe babies ready to eat. They will suck to hear the music and music gives them pleasure and the longer they suck the better it is. It helps to increase their endurance for sucking and in the long run helps them to be ready to feed.

The criteria is not really in hard print. A baby needs to be intermediate care status. In an isolette or open crib. Not having a lot of apneic episodes. Stable on an oxygen source or on room air. Not an irritable BPD baby.  Someone that can benefit from suck endurance. Around 31 weeks gestation or more.

Does music therapy overstimulate infants?

We watch the babies closely for when they are physiologically ready for music therapy. Everything kind of has to fall into place for the individual baby to receive Music Therapy….and stay in place. In other words, a baby can qualify one week, start to feel bad the next week, and we will need to postpone the therapy until later. We really don’t start music therapy until the kids are ready to start getting a bit of stimulation. Music therapy is also a way to teach parents about the right kinds of stimulation for their baby (e.g. gentle though, quiet voices).

How does music therapy change the general NICU environment?

I feel that music therapy is very helpful to the parents as a calming tool, something they can do/ be trained to do with their baby. It is something that they can continue to do at home after the baby is discharged. It can lend some “normalcy” to an otherwise very high tech environment. As for the babies, they love it. They respond well to it, and it can also be a continuation of activities at home. It can lower their heart rate and assist them with becoming accustomed to touch and sound in our world.

How does music therapy change parents’ attitudes, visitations, and/or behaviors in the NICU?

Some parents are very receptive to outsiders working with their babies, and some are not. I do find that a very stubborn difficult parent to an NICU nurse/RT/doctor, can be sweet and kind to the music therapist. The parents can have some control with music therapy. I have found that if you prearrange a time with parents, they love to visit during music time.  A large percentage of our parents are from out of town and have a lower socioeconomic status and are unable to visit frequently, but if they live in town and have a car they will visit during music time.

For more information about NICU music therapy, please see the following posts:

9 Research-based Effects of Music in the NICU
45 Hospitals around the World that Provide NICU Music Therapy
Does Music Therapy in the NICU Overstimulate Infants?
NICU Music Therapy Overview (video)
Book Review: Bella’s Blessings

Let me know you thoughts, comments, and/or questions about music therapy and babies.