What a great question and I do like to know any information regarding this. Just have one little concern about the live music. In a busy NICU with sick babies it is hard to imaging a group of musician playing music without affecting a coding or family that is not into music.

Certainly no group of musicians.... But in Germany, there are a few NICUs in which a single music therapist makes music e.g. with guitar, singing, low level rhythm instruments. It is reported that introducing music into the noisy NICU reduces the general noise level and calms things down. But specific effects? On the long term?

I envy your environment. Single room unit may conduct this kind of research but then multiple different instrument and quality of performance may confound the result (Mozart versus heavy metal music). Personally I believe music should help but how to standardize the methodology will be an issue. How about the effect of recorded placenta flow effect on premies?

As in many other areas there are no really good data on the effect of "music therapy" on preterm infants and certainly this term does not mean a real music band playing in front of the incubatrors.... The basic idea behind real music therapy (and not music just coming from the mp3 player), however, is that it may be a good way of nonverbal communication between caregivers and the preterm infant which may be good for mood and brain (of both sides). I recently heard a quite interesting talk by a music therapists, Friederike Haslbeck, who now teaches in Zurich/CH. You will find some citations in google, e.g.: http://www.haslbecks.info/page0/page8/files/MTT5_4_Haslbeck.pdf, which also presents some video material.

In any way, it may be diffiult to proof benefits fom such interventions.

Dear Dr. Teig, dear "neighbour"!

Thanks for this insight and the web link. Being a musician myself, I am convinced that music can reach the children and their families on a different communication level. However, how do we know, what to do, which setting/instruments to choose? How should we measure effects? Wouldn't it be the most natural thing to encourage the parents to sing for their children? I would be glad to discuss this topic with you during one of our upcoming meetings.

I am not personally aware of long-term studies for babies in the NICU. I can, however, provide anecdotal evidence and some research regarding music therapy in the NICU setting. I was the providing music therapist and worked 1:1 with babies in the NICU. I used only voice so that the babies could be held or manipulated physically at the same time, tactile and auditory stimulation. The results were decreased respiratory rate, increased oxygen saturation, maintenance of steady heart rate ad more relaxation for the baby. I worked collaborative with an occupational therapist who would place the child into a more appropriate body position for healthy development. I have contacted few colleagues who could provide you with significantly more information than I. This article by Jayne Standley should point you in a good direction: http://www.ncbi.nlm.nih.gov/pubmed/22908052

She created a pacifier system that was linked to recorded music. So any non-nutritive sucking caused music. This generalized into better eating, resulting in babies gaining weight faster and being discharged more quickly from the hospital. Please contact me if I can be of more assistance.

A fellow music therapist has created an infographic regarding music and music therapy with neonates that gives a nice, informative view of the research.

http://www.thegeorgecenter.com/2012/12/12/infographic-music-therapy-and-premature-infants/

Great, this is really helpful and very impressive. THANK YOU! We will start next year, and I am excited to see the responses and to share this experience.

You may want to work this music has an effect on the pain of preterm

Although, I will remain sceptical about music therapy, it is a very interesting thought!!

A quick PubMed search ((Music) AND Infant) AND Newborn revealed 187 hits and when search was limited to RCTs and human there were 22 hits.

I suggest to do a meta-analysis of available trials to identify areas of research.

This is a very important question, especially for infants who have long admissions and are exposed to considerable unpleasant noise. The literature in this field is now considerable. We have a range of music therapies in our unit (located in a children's hospital), including live music, ambient recorded music and specific music for individual babies, as part of a coordinated developmental care approach. Most of us working have moved from being sceptical to very supportive of this aspect of our infants overall care. It also makes for a very nice place to work when live musicians are playing!

Our unit has a full-time funded post doctoral music therapist addressing many of the issues raised in this Q&A. If you would like to make contact with her I can ask.

In the nama of Allah

I think something that has not yet proven its effectiveness and safty should not be used except in research work.

I strongly encourage you to work with a Music Therapist (ie, someone who has completed significant training in the field of Music Therapy). I say this because those who have gone through the training have significant knowledge of the music-brain interaction. The challenging part is, there are many different schools of thought regarding what Music Therapy is across the globe. For example, in the US music therapy only occurs with a music therapist present whereas there are other musical experiences that are not goal-oriented/directed that occur with other specialties. I am happy to help with connections, if needed.

claire theyskens ZOL Campus St Jan Genk

From our expierence, we can tell that music therapy has certain some benifit !

But it is difficult to mesure it on a scientific way.

It would have to respectfully disagree with Claire. Music therapy in the NICU can be measured with O2 saturation, respiration rate, heart rate, level of alertness (depending upon desired outcome) as well as time to discharge from NICU. In addition, the PALS system, I referenced earlier, also tracks the rate of improvement for learning to suck and translates it to feeding and weight gain, all of which are quite measurable. There are different schools of thought regarding music therapy, however, depending upon country and University training. Even in the US there are least 4 different approaches, all valid when conducted in the appropriate manner by a trained MT-BC. Just a few weeks ago, the New York Times (I believe) posted an article and corresponding video regarding the use of music therapy with a mother and her baby born at 26 weeks.

Virginia, thank you for your valuable comments. I will recommend our music therapist to get in contact with you, just to exchange some thoughts before she starts the project in our hospital.

Dominik, I would recommend contacting music therapists at Florida State University. They are significantly more knowledgeable than I am in this area and have developed specialized training as well as a pacifier system to encourage the development of nutritive sucking.

We also work with a music therapist who just published a livret entitled "musicothérapie en réanimation pédiatrique. une aide au bébé en detresse". It is in french . She has working with us for more than 10 years no, and we are perfectly aware of the benefit, not only for the baby but also for the parents.

Hi I think music reduce all risk factors of prematurity such as apnea of prematurity .

I belief low volume and solemn music should have positive long time effect on neonates since reading into the hearing of neonates have been suggested to improve the rate of learning/level of intelligence.

[4515.167] Mozart or Bach? The Effect of Classical Music on Energy Expenditure in Preterm Infants

Hila Rosenfeld Keidar, Dror Mandel, Francis B. Mimouni, Shaul Dollberg, Gina Ashbel, Ronit Lubetzky. Neonatology, Tel Aviv Medical Center, Tel Aviv, Israel; Pediatrics, Tel Aviv Medical Center, Tel Aviv, Israel; Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

BACKGROUND: We have recently shown that W.A Mozart music significantly lowers resting energy expenditure (REE) in healthy preterm infants (Pediatrics 2010;125:e24-8). Whether or not this effect is specific to Mozart is unknown. For instance, repeated melodic lines, found more frequently in Mozart music, are known to affect electric brain activity in a manner different to that of the music of other classical composers.

OBJECTIVE: To study whether J.S. Bach music has a lowering effect on REE in preterm infants similar to that of Mozart music.

DESIGN/METHODS: Prospective, randomized clinical trial with cross-over in 12 healthy, appropriate weights for gestational age, gavage fed, metabolically stable, preterm infants. Infants were randomized to a 30-minute period of either Mozart or Bach music or no music over 3 consecutive days. REE was measured every minute by indirect calorimetry and averaged over three 10-minute periods.

RESULTS: Three REE measurements were performed in each of 12 infants at age 20±15 days. Mean gestational age was 30±2 weeks and mean birthweight was 1246±239 g. REE was similar during the first 10 minutes of all 3 randomization periods. During the next 10-minute period, infants exposed to music by Mozart had a trend toward lower REE than when not exposed to music (P=0.07). This trend became significant during the third 10-minute period (P=0.005, Paired Wilcoxon). In contrast, music by Bach or no music did not affect significantly REE during the whole study. On average, the effect size of Mozart music upon REE was a reduction at 20-30 minutes of approximately 4.5% from baseline.

Resting energy expenditure (kcal/kg/day)

Mozart music Bach music No music

First 10 minutes 78.83 ± 9.25 79.49 ± 10.67 81.67 ± 12.80

10-20 minutes 75.87 ± 10.20 79.82 ± 11.81 81.06 ± 9.67

20-30 minutes 75.36 ± 10.88 79.68 ± 15.0 83.39 ± 10.7

P 0.005* NS* NS*

*Last period compared to first period

CONCLUSIONS: Mozart music significantly lowers REE in healthy preterm infants whereas Bach music has no similar effect. We speculate that the "Mozart effect" must be taken into account when incorporating music in the therapy of growing preterm infants, since not all types of music may have similar effects upon REE and growth.

E-PAS2012:4515.167

Session: Poster Session: Neonatal Fetal Nutrition & Metabolism (10:00 AM - 2:00 PM)

Date/Time: Tuesday, May 1, 2012 - 10:00 AM

Room: Exhibit Halls A/B - Hynes Convention Center

Board: 167

Course Code: 4515

Christoph Fusch, MD, PhD, FRCPC

Inaugural Holder of the Jack Sinclair Chair of Neonatology

Professor and Division Head

Neonatal Intensive Care Unit

Department of Pediatrics

McMaster University

Room 4F5

1280, Main Street West

Hamilton, Ontario L8S4K1

Canada

the poster was presented at Boston PAS meeting 2012; it is a group from TelAviv. you might want to ask these guys directly

CF

In Brazil, in this month we ended a randomized clinical trial (Doctorate Thesis) triple blind about use of music in premature neonates at Neonatal Intensive Care Unit. We used three interventions: 1.music, 2.glucose 25%, 3.glucose 25% and music. The sample was 80 premature and we uses the PIPP to measure pain. In the near future, the results will be published. I hope share the results with you.

Maria, what was the criteria for the music?

Christopher Fusch, what were the pieces and their tempi? were they the same BPM or different? What about instrumentation?

I suggest asking the group directly. I believe the paper has also been published recently

Dear Dominik, you might want to check articles from Friederike Haslbeck. She has now working at Zurich University Hospital where they are about to start a prospective trial on whether creative music therapy will improve the infants' brain growth and development at the time of their expected date of delivery as well as their neurobehavioral development at the age of 2 and 5 years. Here is the URL: http://www.neonatologie.usz.ch/LehreUndForschung/Musiktherapie/Seiten/default.aspx

I have had around 3 27-29 weekers and 7 30-34 weekers in the past 6 months, In all instances, I encouraged the parents to play panpipe music for variable amounts of time- but this was only after the babies were fit for KMC. Apnoea of prematurity was observed in 80% of the cases initially, but these had reduced significantly after starting KMC and music.I also observed better feeding efforts. I will have to plan a study on this in the coming year to assess the benefits of music, KMC and a combined approach in the coming year. I would be happy for a collaborative effort from other researchers in other countries as well.