1. Beal, Judy DNSc, PNP, RN

Article Content

Neal, D. O., & Lindeke, L. L. (2008). Neonatal Network, 27, 319-326.


The literature is replete with studies documenting the adverse effects of noise in the NICU and the need for widespread support for NICU redesign to decrease the intensity of ambient or unpatterned noise in this setting. Although some studies have reported that using music with preterm infants enhances physiologic and neurobehavioral development, others have documented adverse effects of overstimulation and physiological stress; the body of research on this topic with preterm infants has been criticized for its lack of rigor. This article presents a summary of all published research on the efficacy and safety of the use of music with preterm infants and concludes that the support for its use is substantial and warranted, as is future research.


More than 80 studies on the topic were reviewed, including a meta-analysis conducted by Standley (2002). Based on his analysis, Standley made 3 broad, easily implemented recommendations for the safe use of music therapy for preterm infants: (1) to play soothing recorded lullabies at higher vocal ranges with a constant and stable rhythms starting at 28 weeks' gestation, (2) to sing live infant-directed lullabies combined with additional stimuli, such as touch and eye contact at 32 weeks' gestation, and (3) to use music to reinforce nonnutritive sucking starting at 30 weeks' gestational age. He also warned that contraindications to music therapy include not only apparent deafness but also a hypersensitive response when music is played. He advised against radio music, musical toys, and live performances in the NICU. This very interesting article presents a variety of safe choices of music therapy for NICU nurses to implement with preterm infants. A thorough review of the anatomy and physiology of hearing during prenatal development, an in-depth discussion of types of sounds and their effects on infant development, and a specific checklist for clinicians who plan on conducting research on musical interventions with infants (Philbin & Klaas, 2000) are included.


Comment by


Judy Beal




Philbin, M. K., & Klaas, P. (2000). Evaluating studies of the behavioral effects of sound on newborns. Journal of Perinatology, 20(8, Pt 2), S61-S67. [Context Link]


Standley, J. M. (2002). A meta-analysis of the efficacy of music therapy for premature infants. Journal of Pediatric Nursing, 17, 107-113. [Context Link]