Each year in the United States 12% of all infants born prematurely, 8.2% of those are at low birth weight (Centers for Disease Control and Prevention, 2005). Survival rates for these premature infants in the neonatal intensive care unit (NICU) have increased over the past several years, as the cost of hospitalization for these infants (Marbella, Chetty, & Layde, 1998). Many positive outcomes of music with premature infants has been noted in recent years including: listening to lullabies had significant reduction in weight loss, length of NICU, isolette, and hospital stay; and stress behaviors (Cassidy & Standley, 1995; Standley, 2000, 2003; Standley & Moore, 1995). Standley’s 1998 study notes that female infants participating in multimodal stimulation left the hospital an average of 11.9 days earlier than the control females and the male infants that participated in multimodal stimulation left the hospital 1.5 days earlier. Pacifier Activated Lullaby (now named Luna 1), patented by Flordia State University has been widely research by Standley used contingent music and found that infants performed slightly better in the nipple feeding immediately following the trial when compared to control babies. With a post-hoc analysis, it was determined that these infants had increased weight gain (2003).
Multimodal stimulation is the layering of auditory, tactile, vestibular, and visual stimulation to teach toleration of stimulation, which in turn, is important to neurological development of the infant.
The Luna 1, created by Dr. Jayne Standley, Ph.D., MT-BC and Healing Healthcare Systems, is a tool used in the NICU to teach premature infants the suck-swallow-breath reflex using music as a contingency. This reflex, the first rhythmic behavior an infant learns, is crucial to the neurological development and survival of a newborn infant. It is important to note, that all of these procedures should be performed and supervised by a board-certified music therapist.
Annotated Bibliography of Research: 1993 – 2003 Music Therapy Research with Premature Infants
Music listening increases oxygen saturation. Cassidy, J. W., & Standley, J. M. (1995). The effect of music listening on physiological responses of premature infants in the NICU. Journal of Music Therapy, 32 (4), 208-227.
Standley, J. M., & Moore, R. S. (1995). Therapeutic effects of music and mother’s voice on premature infants. Pediatric Nursing, 21(6), 509-512.
Music increases tolerance for stimulation and results in earlier discharge. Standley, J. M. (1998). The effect of music and multimodal stimulation on responses of premature infants in neonatal intensive care. Pediatric Nursing, 24(6), 532-539. Premature infants are reinforced by music, discriminate the contingent relationship within 2.5 minutes, and significantly increase sucking rate.
Standley, J. M. (2000). The effect of contingent music to increase non-nutritive sucking of premature infants. Pediatric Nursing, 26(5), 493-495, 498-499.
Music reinforced non-nutritive sucking improves feeding rate. Standley, J. M. (2003). The effect of music-reinforced non-nutritive sucking on feeding rate of premature infants. Journal of Pediatric Nursing, 18(3),169-173.
A meta-analysis of 10 studies using music in the NICU reveals all results in a positive direction with a mean d = .83. Standley, J. M. (2002). A meta-analysis of the efficacy of music therapy for premature infants. Journal of Pediatric Nursing, 17(2), 107-113.
A meta-analysis of 8 studies revealed an overall d = 1.15 when music is used to reinforce infant behavior. Standley, J. M. (2001, Spring). The power of contingent music for infant learning. Bulletin of the Council for Research in Music Education, 149, 65-71.