Therapy Program Brings Music to Premature Babies' Ears

VANCOUVER, Wash. — Haley Giese sits in a chair in the corner of the room, a pillow and blankets covering her lap. The dimly lit room is quiet as Giese adjusts her infant son in her right arm.

Susan Palmieri lightly strums her guitar from her spot on the couch next to Giese. Together, they softly sing.

I hope you never lose your sense of wonder,

you get your fill to eat but always keep that hunger,

may you never take one single breath for granted,

Miles begins to fuss, ready for his bottle of breast milk. Palmieri pulls an ocean disc from her bag and slowly tilts the instrument. Small pellets slide from one side of the disc to the other, creating the sound of moving water.

Palmieri resumes singing as Miles drifts off to sleep.

I hope you dance. I hope you dance.

Palmieri, a music therapist, began visiting Miles in the neonatal intensive care unit at PeaceHealth Southwest Medical Center shortly after his Dec. 1 birth. Miles was born at 30 weeks gestation, about 10 weeks early.

His arrival coincided with the launch of the NICU's new music therapy program. The first year of the program is being funded by money raised by contestants in Union High School's 2015 Mr. Union pageant.

PeaceHealth Southwest is using music therapy in the NICU to help with pain management, facilitate feeding and stabilize vital signs, such as heart rate and respirations. The therapy is also beneficial to families who are dealing with the daily stresses of having a child in the NICU, as well as staff in the department, Palmieri said.

Palmieri spends three days a week in the hospital's NICU. She began an early January visit with Giese and Miles by singing the family's "kin song," chosen by Miles' parents.

They sing the song to Miles when things are calm. Then, as he gets older, Miles will associate the song with a sense of peace, which can be used to calm him, Palmieri said.

"It becomes a conditioned response," she said. "It's also great for mom because it helps give her a sense of control and power over the situation."

When Miles' bottle was warmed and ready for the infant to eat, Palmieri pulled out a Gato box. Palmieri tapped her finger on the top of the rectangular wood box each time Miles sucked on the bottle.

Gradually, Palmieri slowed and evened the pace of her tapping and Miles adjusted his sucking accordingly. The goal, Palmieri said, is to help Miles pace his eating and to remind him that it's time to eat so he doesn't doze off before finishing a bottle.

"That's a big goal for us because that's how they gain weight and go home," Palmieri said.

Throughout her visit with Giese and Miles, Palmieri carefully watched the monitor in the infant's room. She kept an eye on his heart and respiratory rates and his oxygen levels to ensure he wasn't being overstimulated.

Positive stimulation

When Miles finished his bottle, Palmieri gathered her things and headed down the hall. She poked her head inside the room of baby Silas Chaychuk-Ray, born at just 25 weeks gestation on Nov. 28.

Palmieri stood beside the tiny baby's bed and ever-so-softly hummed "Twinkle, Twinkle, Little Star."

Silas is still too young for longer therapy. The baby would likely become overstimulated by instruments or longer sessions, Palmieri said. So she keeps her visits to no more than 10 minutes.

Still, those few minutes are beneficial to Silas, Palmieri said.

Research has shown that music therapy can help promote neurological and language development in premature babies, Palmieri said. The therapy provides positive stimulation that encourages growth, she said.

Research has also shown that premature babies who remain in quiet, single-room NICUs — like that at PeaceHealth Southwest — have decreased language development and motor skills development because they're not getting enough stimulation, Palmieri said.

In the womb, the baby would be exposed to sounds, such as the mother's heartbeat, her voice and other outside noises. But if a baby is born prematurely and placed in an always-quiet NICU room — which does have some benefits — he or she is missing out on that natural stimulation that promotes brain development, Palmieri said.

Filling a void

Palmieri and the NICU staff hope the music therapy program will fill that void.

"We wanted to look at novel tools, including music therapy, to see that we're leading babies to the best potential outcome," said Dr. John Evered, a neonatologist and medical director of the NICU.

The NICU staff is also looking at unconventional ways of using music therapy for pain management in premature babies.

Premature babies are at risk for eye problems due to abnormalities in their retina development. If those abnormalities aren't caught early and managed, they can lead to blindness, Evered said.

The NICU performs a screening test for the abnormalities, but it's not a pleasant experience for the baby or parents, Evered said. Typically, the baby's heart rate spikes and oxygen levels plummet during the exam, he said. Those changes can last for hours or even days after the test, Evered said.

Palmieri joined Evered for a recent test and played soothing music as they prepared to begin. Throughout the screening, Palmieri used the ocean disc and hummed a simple melody.

During the test, the baby's heart rate never climbed above 185 beats per minute — typically, heart rates surge into the 200s — oxygen levels never dropped and the baby only cried twice, Palmieri said.

Evered and Palmieri hope to continue using music therapy during the screening tests in the future.

"None of us have seen anything like this," Evered said. "It's unheard of for the heart rate not to go up."

That kind of outcome is exactly what the NICU staff hoped to achieve with the program, said Melanie Fain, NICU nurse manager.

"We really wanted to transform the care," she said, "not just buy a piece of equipment."