Music Therapy with Premature Infants: Insights and Recommendations from the Current Literature and a German Pilot Project/ la Musicothérapie Avec Les Enfants Prématurés: Observations et Recommandations Basées Sur la Littérature Actuelle et Un Projet Pilote Allemand

By Henning, Ina | Canadian Journal of Music Therapy, January 1, 2012 | Go to article overview

Music Therapy with Premature Infants: Insights and Recommendations from the Current Literature and a German Pilot Project/ la Musicothérapie Avec Les Enfants Prématurés: Observations et Recommandations Basées Sur la Littérature Actuelle et Un Projet Pilote Allemand


Henning, Ina, Canadian Journal of Music Therapy


Preterm birth rates remain high even in industrial countries such as Germany, Canada, and the United States. In Germany 60,000-63,000 premature infants are born every year, which is 9% of all German births.1 In Canada about 8% of the babies born each year are premature,2 and in the United States, although the 2006 preterm birth rate dropped from 12.8% to 12.3%3 prior to 2006, there was an increase of 36% over the past 25 years with more than 500,000 babies (1 in 8 per year) born prematurely.

Premature infants need specialized treatment, which is delivered in neonatal intensive care units (NICUs) where many stressful procedures are performed on a daily basis in order to control and improve the status of the infant. Medical complications of the premature infant include a wide variety of respiratory distress problems such as bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP) due to oxygen toxicity to the blood vessels, infections, bleeding in the brain, gastrointestinal tract problems such as necrotizing enterocolitis (NEC), just to name a few (Standley, 2010; Jorch, 2006).

The causes of premature birth are not fully known. According to a study by Gerke (1995], previous miscarriages as well as psychosocial risk factors such as an unhealthy life style contribute to a woman's risk of giving birth prematurely. Other risk factors that are associated with premature birth include vaginal infections, the age and height of the woman, the number of previous pregnancies, and alcohol and nicotine use (Jorch, 2006). However, sometimes there is no apparent precipitant (Groopman, 2011).

North America and Germany share the same definition of premature birth. The medical diagnosis of premature birth is defined as infants born prior to 37 weeks' gestational age and less than 5 Ib 8 oz or 2500 g (Helmer, as cited in Haslbeck, 2009; Standley, 2010). Due to greater levels of sophistication and research in the medical field, very premature infants born as early as 24 weeks' gestation are able to survive with probabilities that range from 50% in Germany4 to 54% in Canada5 and 56% in the United States.6

However, this positive development in medical science challenges doctors and caregivers to meet the needs of these very preterm infants. Based on earlyinfant brain research, Fischer and Als (as cited in Nöcker-Ribaupierre, 2003) developed the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), which helps professionals to identify and respond to the individual needs of each infant.7 In NIDCAP, the baby is recognized as a competent and active dialogue partner whom the care person is aware of. The caregiver can thus structure medical procedures around the baby's wellbeing (Nöcker-Ribeaupierre, 2003). In Austria, Marcovich (1999/2008) advocated an approach she calls sanfte Pflege (gentle care) that is based on being responsive to infant cues and described how medical interventions could be tempered by paying attention to the natural rhythm of the child. For example, she encourages early contact and communication with the baby using tactile and auditory stimulation with the Rice Infant Stimulating System, a receptive method of pre-recorded womb sounds played at the incubator. Mother-infant bonding is encouraged with a skin-to-skin method, "kangarooing" (Marcovich, p. 115). Lai (2006) reports that kangarooing in combination with music listening is extremely beneficial for preterm infant development.

Empirical studies, mostly from the United States, consistently report positive effects for music therapy in the NICU environment. A meta-analysis by Standley and Whipple (2003] included 29 studies that, with the exception of one study, showed that (a] the presence of music is significantly better than no music in the NICU environment, (b] active musical involvement is favoured over passive music listening, and (c] live music is better than recorded music. A subsequent integrative review by Haslbeck (201O] reported similar findings. …

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Music Therapy with Premature Infants: Insights and Recommendations from the Current Literature and a German Pilot Project/ la Musicothérapie Avec Les Enfants Prématurés: Observations et Recommandations Basées Sur la Littérature Actuelle et Un Projet Pilote Allemand
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