3

Seven clinical studies

Neonatology

STUDY DETAILS

WHAT Live music can favourably influence the development of premature babies in neonatal intensive care units.

WHO Principal investigator, Dr. Carmen Pallás, Head of the Neonatology Department at Hospital 12 de Octubre

WHY It is known that the lack of adequate auditory stimuli during neonatal admission can interfere with the development of the baby. Some studies recommend parents read to their babies and artistic exercises with music. This study was fuelled by the belief that live music can play an important role in helping the development of preterm infants in neonatal intensive care units.

HOW The NIPE (Newborn Infant Parasympathetic Evaluation) method was used to assess the comfort levels of infants. This is a non-invasive method that measures variations in heart rate and this measurement can be used to establish comfort levels in newborns. The conclusions drawn so far indicate that live music is viable in and well tolerated by premature infants and that it could be a useful measure to improve the development of newborns admitted to hospitals.

WHEN Three one-hour interventions per week during the morning shift, from 1 March 2017 to 28 February 2018.

CHARACTERISTICS OF THE SERVICE

Situation of the patients

At neonatal units such as the one in Hospital 12 de Octubre (complexity level iiiC), it is common for there to be, on the one hand, very immature and very premature infants admitted, many weighing less than 1,000 g and even some less than 500g, and, on the other hand, children with malformations, such as congenital heart disease, digestive malformations or other types of malformations requiring surgery in the first days of life, intensive care support, etc. This is a group of extremely fragile patients.

The space

“The problem we faced then was that the unit had a common box-type design and if there was a very unstable or very seriously ill child, or a child who were dying, you could not separate them and that sometimes made the dynamics a little difficult. We have now changed the design into 19 intensive care posts, of which 11 are single rooms, thus allowing us to carry out much more selective interventions, focused on a specific child and family. In spite of all these limitations, Dr. Carmen Pallás, head of the Neonatology Department, considers that the experience was very good.

“A baby hearing music becomes alert, and that alertness is not bad, it's good because it means the baby is focusing its attention”

Dra. Carmen Pallás

OBJECTIVES

To compare the degree of comfort of premature infants when exposed to live music while in kangaroo care with the degree of comfort when exposed to music while in the incubator.

CONCLUSIONS

This study shows how exposure to live music is well tolerated, even by very premature babies, while in kangaroo care. The children maintained their degree of comfort in both the incubator and kangaroo care. As regards exposure to music, there is some concern regarding premature children’s tolerance to music because this stimulus can sometimes cause a certain degree of stress. Our results are reassuring in this regard. Live music was not observed to increase the degree of comfort of the premature babies, but this is not the desired effect either. As mentioned previously, exposure to live music is one alternative for preventing sensorial hearing loss and it seems to be a safe method because it does not increase stress in the child. As expected, the kangaroo care infants were significantly more comfortable than the incubator infants both before and immediately after music exposure.

Live music will probably play an increasingly important role in our neonatal units. In the future, it may be a very useful tool for improving the development of hospitalised newborns.