You know the terror in a parent’s eyes when their baby arrives prematurely. Those babies have, at best, a tenuous hold on life and a long period of hospitalization, before they really can survive on their own. Some 500,000 premature births occur annually – about 1 in every 9 births here in the US. And, then, there’s also the problem when well-meaning therapies are not explained well.

As has just been found with a multi-year, multi-institution study of the effects of oxygen augmentation to preclude blindness in premies, without developing neurological problems or, worse yet, the death of the child. The results (New England Journal of Medicine) were that higher levels of oxygen led to blindness (twice as likely) and that lower levels of oxygen slightly increased the chances of death. But, the potential adverse effects of this study were not properly explained to the parents.

So, I’m pleased that a new study (with reasons from a second one) can actually bring hope to parents of premature babies. Those lullabies that many of us know- it turns out they can be extremely beneficial to the development of premature babies. But, not all music- because some of it can trigger problems with the children. Live music- played or sung- can slow heartbeats, calms breathing, increase oxygen saturation levels, and even increase the sucking behaviors of premature babies. The music reduces the stress within the baby, so that their vital signs become stabilized.

Joanne Lowey (Beth Israel Hospital), Kristen Stewart, Ann-Marie Dassler, and Drs. Aimee Telsey and Peter Homel published the results of their studies in Pediatrics. The research was aimed to determine if the practice of using music, instead of sedating the babies, was as effective and safer to prepare the premature babies for sonograms and/or the application of brain monitors. There also had been reports that music aids the development and family bonding of the premature babies; it may even afford the babies the possibility of leaving the hospital sooner.

It turns out these stories were true- but only if the music is organized- and, therefore, different from the unpredictable cacophony that exists in neonatal units. After all, the neonatal units are replete with loud machinery, alarms, pumps, and the comings-and-goings of staff in a hurry. Loud sounds can be damaging to- but meaningful noise can augment- brain development.

This was a two year study aimed at determining if rhythm, melody, and timbre could effect positive developments upon the baby’s heartbeat, breathing, alertness, sucking, and sleep behaviors. 272 premies, each over a two-week period, were subjected to singing, special musical instruments”, or no music at all. All of the music chosen was arranged to simulate the sounds of the womb. The instrumental sounds came from a rectangular wooden drum (gato box, that mimicked two-tone heartbeat sounds) or metal beads (an ocean disk cylinder) that provided “whooshing” sounds. The singing was from lullabies or favorite songs arranged by the clinicians to slow down the tempo or change the rhythm to waltzes. (If the parents had no preferential song, the musical choice was “Twinkle, Twinkle, Little Star.)

The gato box, ocean disk, and singing did, indeed, slow the baby’s heart rate. But, the singing provided the best results. Singing also extended the alert time of the babies. On the other hand, the gato box helped the sucking behavior the best, and the ocean disk promoted better sleep and slowed the breathing rate the best. Interestingly, when the parents chose the song, the child ate better and garnered more calories (compared to “Twinkle”)- but the “Twinkle” premies had higher oxygen saturation levels. And, it made no difference to the results if the therapists sang or the parents did, whether the babies were held or kept in the incubators.

While many would wonder why recorded music was not studied, the researchers wanted the ability to lower the volume, if the child were about to fall asleep. A recording would need extensive equipment to be able to adjust to such parameters.

Moreover, another new study headed by Dr. Kami Kuroda (with Drs. Esposito, Yoshida, Ohnishi, Tsuneoka, del Carmen Rostagno, Yokota, Okabe, Kamiya, Hoshino, Shimizu, Venuti, Kikusui, and Kato) published in Current Biology explains why this happens so quickly.  It turns out holding a baby while walking around slows down the heart rate (with the baby also ceasing voluntary movements) in under 3 seconds.  And, this neural process is faster for babies under 3 months that it was for 6 months; adults can’t slow down their heart rates that quickly at all.

Now, we need to determine if the findings from the music study can be extended to the sickest and most premature babies. Those cohorts were excluded from either study. Nor was it determined if there were clinical improvements in the development of premature babies that others have claimed (like removing oxygen or feeding tubes earlier).

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