Music Therapy with Premature Infants in the NICU

By Clements-Cortès, Amy | The Canadian Music Educator, Spring 2015 | Go to article overview

Music Therapy with Premature Infants in the NICU


Clements-Cortès, Amy, The Canadian Music Educator


Dr. Amy Clements-Cortes is Assistant Professor, Music and Health Research Collaboratory (MaHRC), University of Toronto and Senior Music Therapist/Practice Advisor, Baycrest, Instructor and Supervisor, Wilfrid Laurier University. Amy has extensive clinical experience working with clients across the lifespan. She has given over 80 conference and/or invited academic presentations, is published in peer reviewed journals and books, and has supervised over 30 music therapy internships, 30 undergraduate research studies, and 3 Masters students MRPs. She is the Clinical Commissioner for the WFMT, Vice-Chair and BOD Member Room 217, and Past President, (CAMT). Amy is co-editor of the Canadian Association for Music Therapy 40th Anniversary Journal, Chair of the 40th Anniversary Conference and Co-Chair of the 3rd IAMM Conference 2014. Amy is on the editorial review board of the WFMT Journal and Music Therapy Perspectives; Co-investigator in the AIRS SSHRC Project; and coordinator of the MaHRC Alzheimer Study. www.notesbyamy.com

Background on Premature Infants

When speaking about infants, prematurity includes: "preterm infants" (born before 37 gestational weeks); and "low birth weight infants" (premature by birth weight of less than 2500g) (Kelly, 2006). Many premature infants are fragile at birth and require medical care typically provided in neonatal intensive care units (NICU) for days or even weeks (Torpy, 2009). As medical treatment continues to advance the survival rates for premature infants continues to rise, especially when associated with increases in gestational age (GA) (Gooding, 2010).

Developmentally, premature infants often suffer from impairment with respect to several abilities including: the inability to suck or swallow; difficulty with nutrient processing/absorption (which may lead to cognitive impairment); smaller brain volume; and challenges to regulate body temperature (Gooding, 2010; Torpy, 2009). Further, there are several health conditions that premature infants are at risk for such as: jaundice, increased risk of infections, interventricular hemorrhage, patent ductus arteriosus (failure of a fetal heart value to close post birth), respiratory illnesses, apnea, and anemia (Kelly, 2006).

While the NICU environment can be heralded as the reason that many premature babies survive given the high quality of care provided, this environment poses a challenge to premature infants as they navigate their development in a setting quite different than that of the mother's womb (Hanson Abromeit, 2003). Premature infants receive care from multiple caregivers and as a result may be subjected to overstimulation from the sounds, sights and interactions (Whipple, 2005). The problem with overstimulation is that it can lead to maladaptive or even life threatening responses (Hanson Abromeit, 2003). There are many therapeutic interventions provided in the NICU to help address the issues discussed above and music therapy is also one intervention making an impact.

Implications for Music Therapy in the NICU

Music therapy offers a variety of benefits in the NICU to both the premature infants and their parents, but must be implemented with caution as music experiences can also be over-stimulating for premature infants (Standley, 2002). Music therapist, Dr. Jayne Standley has done considerable work with premature infants in the NICU environment and offers guidelines and recommendations on its use. For example, music should have: constant rhythm and volume, and stable and soothing melodies: ideally coming from a single female voice in a higher register or single instrument (Standley, 2002). Since music therapy interventions are tailored to the individual needs of the premature infant they can vary depending on the infant's stage of development. Of importance to consider when designing interventions are the three stages of premature infant development: survival/pacification; cautious stimulation; and the interactive/discharge stage (Standley, 2014). …

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