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Study: Can Music Help Premature Babies Sleep and Feed?

Last updated on April 17th, 2017 at 08:00 pm

music-and-premature-babies“Playing music to premature babies ‘helps them sleep and improves their breathing’,” is the headline in the Daily Mail about research into the effects of ‘music therapy’ on premature babies.

While positive effects were found, it is still unclear whether this will lead to tangible health improvements.

The researchers in this study speculate that being born premature could be traumatic (from an acoustic perspective) for two reasons:

  • The baby is prematurely separated from the sound of the mother’s heartbeat and the sounds they were accustomed to in the womb
  • The baby is ‘plunged’ into the noisy environment of a neo-natal intensive care unit

Researchers wanted to see whether exposing premature babies to more comforting sounds could help compensate for these proposed sources of trauma.

They investigated three types of live music therapy, administered with the help of a certified music therapist:

  • A lullaby or any other song chosen by the parent that was modified to be like a lullaby, preferably sung by a parent
  • An instrument designed to replicate womb sounds
  • An instrument that sounded like a heartbeat

The researchers found that the therapies were associated with slowing of infants’ heartbeats, calmer breathing, and improved feeding and sleep patterns. The therapies were also associated with decreased stress levels in the parents.

It is unclear whether music therapy does improve premature babies’ health outcomes. For example, if infants receiving music therapy are able to leave hospital earlier or have better long-term health outcomes.

Where did the story come from?

The study was carried out by researchers from the Beth Israel Medical Centre, New York and was funded by the Heather on Earth Music Foundation, a non-profit organisation that provides funding for music therapy programmes in children’s hospitals.

The study was published in the peer-reviewed journal Pediatrics. This article was open access, meaning that it can be accessed for free in full from the journal’s website.

This research was well-covered by the Daily Mail. The paper also contains an aside (presumably included in an accompanying press release) that one parent chose to sing a ‘lullabied’ version of Marvin Gaye’s soul classic ‘I Heard It Through the Grapevine’ and another chose 70’s funk standard ‘Pick up the Pieces’ by Average White Band.

What kind of research was this?

This was a randomised crossover trial that aimed to determine whether three different live music interventions in premature infants could affect:

  • Physiological functions, such as heart and respiratory rates, oxygen saturation levels and activity levels
  • Developmental function such as sleep patterns, feeding behaviour and weight gain

The three interventions administered with the help of a certified music therapist were:

  • A lullaby, either Twinkle, Twinkle Little Star or any other song chosen by the parent which was modified to be like a lullaby, preferably sung by a parent
  • An ‘ocean disc’ musical instrument, which is a round disc containing metal beads that aims to replicate womb sounds
  • A ‘gato box’, a 2- or 4-tone wooden box or drum that is played with the fingers to provide a rhythm in a manner that simulates the heartbeat sound that the baby would hear in the womb

The ocean disc and the gato box were played live and were coordinated to the infant’s breath rate. All infants received each of the three possible treatments (lullaby, gato box, ocean disc) as well as a control where no sound stimulation was given.

A randomised crossover trial is similar to a randomised control trial, but after a participant has received one treatment they are swapped over to another treatment arm, meaning that all participants received all three treatments and the control.

The trial design does have the disadvantage that the benefits obtained from one treatment might still be present when a second treatment is tested.

What did the research involve?

The researchers recruited 272 premature infants aged at least 32 weeks old with respiratory distress syndrome, clinical sepsis and/or small size for gestational age in neonatal intensive care units.

The infants received each of the three possible treatments (lullaby, gato box or ocean disc) or no explicit sound stimulation (to act as a control).

Each treatment was given twice during the two-week trial (three treatments per week). The day each treatment was given and the time of day (morning or afternoon) was randomised. If the infant received an intervention in the morning, the control was given in the afternoon and vice versa. The interventions were delivered by music therapists in conjunction with parents.

Heart rate, oxygen saturation, respiratory rate and activity level were measured at one-minute intervals during the 10-minute phase before the intervention, the 10-minute phase during, and the 10-minute phase after the intervention.

The researchers also analysed the infants’ vital signs, feeding behaviours, and sleep patterns daily during the two-week period.

In addition, self-perceived stress levels in parents of infants in neonatal intensive care were assessed before and after the two-week trial.

What were the basic results?

Activity Level

The percentage of ‘quiet-alert time’ (one of several states of alertness ascribed to newborns) increased during a lullaby. After the lullaby, it decreased.

Heart Rate

All three interventions showed a significant effect over time (before, during, after) on heart rate. Heart rate decreased the most during the lullaby and gato box interventions, and after the ocean disc treatment.

Respiratory Rate

The ocean disc also decreased the number of inspirations per minute during and after the treatment.

Developmental Behaviours

Use of the ocean disc was associated with increased ‘positive sleep patterns’ and ‘sucking pattern behaviour’ increased after the gato box treatment.

Parental Stress

The music interventions were also associated with a decrease in parents’ perception of stress.

How did the researchers interpret the results?

The researchers conclude that the live sounds and lullabies applied by a certified music therapist can influence cardiac and respiratory function, may improve feeding behaviours and sucking patterns, and may increase prolonged periods of quiet-alert states. These interventions also decrease the stress felt by parents of premature infants.

Conclusion

This research has found that live music therapies may slow infants’ heartbeats, calm their breathing, improve sucking behaviour important for feeding, improve sleep patterns and promote states of quiet alertness.

Different interventions led to different patterns of improvement, but all three types of musical therapy appeared to have a positive effect on the infant. The therapies also seemed to help the parents of premature infants feel less stressed.

Although this research is interesting, it is still unclear whether music therapy can lead to tangible health improvements, for example, the researchers did not measure whether infants receiving music therapy were able to leave hospital earlier or had better long-term health outcomes.

There are also practical considerations in that access to musical therapists is likely to be limited.

Despite these limitations, the study seems to provide a degree of evidence that the deep-seated human instinct to sing lullabies to your baby does them good.

For more information, read Getting your baby to sleep

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

Summary

“Playing music to premature babies ‘helps them sleep and improves their breathing'” is the headline in the Daily Mail about research into the effects of ‘music therapy’ on premature babies. While positive effects were found, it is still unclear.

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Pediatrics Academy Issues Updated Infant Safe Sleep Guidelines

Last updated on November 6th, 2016 at 06:01 pm

The American Academy of Pediatrics (AAP) held their annual conference this week in San Francisco, and has used this event as a platform for announcing new or updated policy guidelines in a number of areas. One we reported on earlier this week was about New Guidelines on Children’s Exposure to Digital Media.

We report here on another set of updated guidelines – this time focused on safe sleep environments for infants.

The Problem

Baby sleeping safetyMore than 3500 infants die each year in the US from sleep-related deaths. This number includes cases of SIDS (Sudden Infant Death Syndrome), plus other sleep-related deaths like accidental strangulation in bed. The rate of infant sleep-related deaths had been dropping up to the 1990s – but little change has been seen in recent years. The issues behind these deaths can all be addressed by similar improvements to enhance the safety of a baby’s sleep environment.

Overview of the Guidelines

Several of the elements outlined in the updated policy are not new, though nonetheless very important. The AAP has long been recommending that babies be put to sleep on their backs (supine position) – and that soft bedding be avoided. They also emphasize the importance of breastfeeding and avoiding smoking and drug use while pregnant – and exposure to smoke/drug use after birth. While most people are likely aware of the risks to babies from exposure to these toxins, not all may know that smoking and drug-use environments are associated with increased infant sleep-death risk, including SIDS. Details of all the guidelines are listed in the box at the end of this article.

What is particularly new and notable in these guidelines is the recommendation for babies to sleep in their parents’ room for up to the first year after birth – especially for the first 6 months when 90% of SIDS cases occur. Research suggests that infant sleep-related deaths could be reduced by 50% through “room-sharing” – as long as the baby is sleeping in their own safety-approved crib or bassinet and not in the parental bed.

“Couches and armchairs are extremely dangerous places for infants.” – AAP Guidelines

The authors of the new guidelines note that “bed-sharing” greatly increases risk for SIDS and other sleep-related infant deaths – and are “especially dangerous” in the following cases:

  • When one or both parents are smokers, even if they are not smoking in bed
  • When the mother smoked during pregnancy
  • When the infant is younger than 4 months of age
  • When the infant is born preterm and/or with low birth weight
  • When the infant is bed-sharing on excessively soft or small surfaces, such as waterbeds, sofas, and armchairs
  • When soft bedding accessories such as pillows or blankets are used
  • When there are multiple bed-sharers
  • When the parent has consumed alcohol and/or illicit or sedating drugs
  • When the infant is bed-sharing with someone who is not a parent

“Skin-to-skin care is recommended for all mothers and newborns immediately following birth” – AAP Guidelines

The updated guidelines FOR PARENTS from the AMERICAN ACADEMY OF PEDIATRICS on safe sleep environments for infants are:

  • Back to sleep for every sleep. Babies should be put to sleep on their backs on a surface that meets the Consumer Product Safety Commision (CPSC) should be used. These include cribs, bassinets, portable cribs or play yards. Once babies are able to roll into different positions they can be allowed to sleep in those positions.
  • Use a firm sleep surface with NO soft objects or loose bedding. Infant beds should have firm mattresses and tight fitting sheets – and nothing else – including no crib bumpers.
  • Breastfeeding is recommended. Breastfeeding reduces the risk of SIDS and the more that a mother exclusively breastfeeds, the greater the reduction in risk. But the authors note that “any breastfeeding is more protective against SIDS than no breastfeeding”.
  • Room-sharing with the infant on a separate sleep surface is recommended. Having the baby sleep in its own crib or bassinet is best, but bedside sleepers that are CPSC-approved can be used. No safety guidelines have been developed for in-bed sleepers and there is currently no evidence regarding their ability to reduce SIDS risk – so these are not recommended.
  • Avoid overheating and head covering in infants. AAP does not provide specific room temperature guidance, but states that babies should wear only one more layer than an adult would to be comfortable in the room.
  • Consider offering a pacifier at nap time and bedtime. Although experts do not yet know why, use of pacifiers has been shown in multiple studies to guard against SIDS. The pacifier should be used when laying the baby down to sleep. It does not need to be put back in the mouth if it falls out while the child is asleep.
  • Avoid smoke exposure and alcohol/illicit drug use during pregnancy and after birth. Prenatal and environmental smoking exposure are major risk factors for SIDS.
  • Prenatal care and immunization of infants is important. Both prenatal care and infant immunization have been shown to have a protective effect against SIDS.
  • Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. There is no evidence these reduce risk of sleep-related death.

The Academy has also recommended against use of products marketed to reduce risk of SIDS – such as wedges and positioning devices. These are not CPSC-approved and do not have scientific evidence to support their claims, and may actually pose hazards. They also caution against swaddling. However, the authors do support daily tummy time for babies to promote development.

Finally, AAP has also provided guidelines for health care providers (including in NICUs, nurseries, and childcare centers), public health officials, and manufacturers. These can be found on the AAP website.

 

 

BreathableBaby Crib Bumpers – For Baby’s Safety AND Comfort

Last updated on August 31st, 2015 at 12:41 am

For more than ten years, parenting experts, child product safety organizations, and new parents have been talking about the potential safety hazards of using traditional crib bumpers inside infants’ cribs despite the benefits of preventing head, arm and leg injuries.

We are Dale and Susan Waters, married entrepreneurs from Minnesota who turned fear for our baby’s safety inside her crib into a mission to create something that would not only help protect babies but also provide peace of mind for parents. We invented the Breathable Mesh Crib Bumper; a product designed to reduce the risks of suffocation caused by traditional bumpers, while protecting a baby’s limbs from becoming entrapped in the crib slats.

BreathableBaby is Born

12 years ago, we woke to the sound of our 3-month-old daughter screaming in agony from her crib. Our daughter, Sierra had gotten her legs twisted and wedged between the slats of her crib. Her face was pinned against the mattress.

There were many sleepless nights for us and our daughter – no matter what we tried she kept getting her little arms and legs caught between the crib slats. In addition to the obvious pain of being stuck, we feared she would break an arm or leg, or develop neuropathy. But we refused to use a soft, pillowy crib bumper for fear of suffocation.

Research shows that a baby can snuggle up right against their crib bumper. If the baby’s nose and mouth are too close to the bumper, it can potentially cause dangerous re-breathing of carbon dioxide or suffocation. A baby can also get wedged between crib slats and the mattress, unable to escape and possibly suffocate. Because the safety and potential dangers of crib bumpers has been in the news recently, many parents are unsure about how to keep their babies comfortable and safe.

As parents, we were frustrated and upset to learn there was no practical solution available in the marketplace. As designers and entrepreneurs we decided we had to do something about it and devoted ourselves to developing a safer, “breathable” solution – preferably one that was affordable and easy to use. So, we took a break from the media, marketing and music company we owned, and focused on creating a safer solution for babies.

We researched and sourced fabrics, designed and engineered prototypes, held focus groups with mothers and sought extensive third party safety evaluations by a world-leader in safety consultation before finally introducing a safer, smarter mesh crib bumper to the market three years later in 2002.

What makes BreathableBaby mesh crib bumpers so much safer is our Air Channel Technology™ (A.C.T.) designed to prevent suffocation. A.C.T. maintains air access should a baby’s mouth and nose press up against the fabric. When the BreathableBaby fabric is compressed it is virtually impossible to form an airtight seal. In fact BreathableBaby has “fabric cards” available so that parents can experience the A.C.T. safety feature for themselves — just send in a request along with your address information to customercare@BreathableBaby.com and we’ll send you one free of charge.

Since its launch, we’re proud to say that the BreathableBaby™ brand has forged a new category in “breathable” bedding, and is embraced by parents worldwide. Our products have won numerous awards including The Child Safety House Calls Award of Excellence, and National Parenting Center Seal of Approval for innovation, functionality, design and contribution to creating a safer, healthier crib environment.

It’s imperative that parents are aware of the potential dangers that may be part of a baby’s sleep environment. New information is available all the time, so we urge all expectant parents – first time or otherwise – to seek relevant news, alerts, studies and guidelines from news and safety organizations such as the ones listed in our Healthful Hints below.

Wishing you and your little one sweet dreams.

HEALTHFUL HINTS:

Six Steps to a Safe Sleep Environment For Your Baby

  1. Crib Mattress Should be Firm. A soft mattress may increase suffocation risks. Select a firm mattress that fits the crib tightly and a fitted sheet. You should have a fitted not be able to fit more than two fingers between the mattress and the crib side. Before purchasing a crib, visit www.cpsc.gov to make sure the crib you selected has not been recalled.
  2. No Blankets for Baby. Do not place anything in baby’s crib that could be a suffocation hazard, including blankets. If you’re worried about keeping your baby warm, a better solution is an infant sleeper or wearable blanket that zips around your baby and can’t ride up over her face.
  3. Breathable Mesh Crib Bumpers. Crib bumpers that are plush, pillowy, and made of non-breathable fabric can increase the risk of suffocation. A safer crib bumper option is one that is mesh or breathable and allows for air flow – even when pressed against a baby’s mouth.
  4. De-Clutter the Crib. For most parents, all those cute stuffed animals and soft blankets might seem a natural fit for the crib, but unfortunately they all pose suffocation risks. Toys and stuffed animals are best saved for interactive play time.
  5. A bottle. Parents of older infants who have started holding their own bottles may be tempted to slip a bottle into the crib in case their baby wakes at night. But even a bottle can pose a suffocation risk. Plus, babies who fall asleep with a bottle in their mouths are prone to tooth decay from the milk sugars that sit on their teeth all night.
  6. Pacifiers. Some studies have shown that giving your baby a clean, dry pacifier reduces SIDS rates.

Resources For More Information On Safe Sleep and Crib Safety

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Editor’s Note: So often with health and safety issues we have to make trade-offs between one risk and another: take a medicine to address a disease, but deal with the side-effects; exercise for health benefits but risk injuries. In the case of babies and cribs, parents have long had to make a trade-off between keeping babies safe from suffocation due to crib bumpers and protecting them from entanglement and injury in the crib slats. BreathableBaby mesh bumpers help parents address both these issues with peace of mind. We first ran this BreathableBaby post in 2011 and the company has continued to thrive, with additional products and awards to their credit.

How Much Sleep Do Kids Need?

Last updated on November 3rd, 2014 at 07:23 pm

There’s no magical number of hours of sleep that all children in a particular age group need, but here is a guide to the hours of slumber they should aim for.

Sleep is very important to a child’s wellbeing. A lack of sleep can cause a child to become hyperactive and disagreeable, and have extremes in behaviour.

Here are some approximate “child sleep” numbers based on age, as recommended by the Millpond Children’s Sleep Clinic:

Essential Sleep Habits for Kids1 week

  • daytime: 8 hours
  • night time: 8.5 hours

4 weeks

  • daytime: 6.75 hours
  • night time: 8.75 hours

3 months

  • daytime: 5 hours
  • night time: 10 hours

6 months

  • daytime: 4 hours
  • night time: 10 hours

9 months

  • daytime: 2.75 hours
  • night time: 11.25 hours

12 months

  • daytime: 2.5 hours
  • night time: 11.5 hours

2 years

  • daytime: 1.25 hours
  • night time: 11.75 hours

3 years

  • daytime: 1 hour
  • night time: 11 hours

4 years

  • night time: 11.5 hours

5 years

  • night time: 11 hours

6 years

  • night time: 10.75 hours

7 years

  • night time: 10.5 hours

8 years

  • night time: 10.25 hours

9 years

  • night time: 10 hours

10 years

  • night time: 9.75 hours

11 years

  • night time: 9.5 hours

12 years

  • night time: 9.25 hours

13 years

  • night time: 9.25 hours

14 years

  • night time: 9 hours

15 years

  • night time: 8.75 hours

16 years

  • night time: 8.5 hours

Baby Sleep Solutions for a Safe & Well Rested 1 Year Old

Last updated on June 7th, 2014 at 10:03 pm

Safe Sleep Solutions for BabyYour baby is growing rapidly and acquiring new skills during the last legs of his first year. All of this change and progress affects his sleep, of course. By now, he’s probably been weaned off his nighttime feeding routine. It’s likely, though, that he still wakes up every few hours during the night. Check out these baby sleep solutions to help ensure that your little one stays safe and gets the rest he needs.

Put in the hours

Your older baby requires less sleep than he did as a newborn – about 14 hours in a 24-hour period. However, he’ll still be taking his usual two naps per day, which are important for growth and development.

Keep it consistent

A regular bedtime routine is a big step toward no-fuss nights. However, you may notice that as your baby gets older, his interests change. If your routine isn’t working as well as it used to, consider switching one of the activities in your bedtime routine (say, read a book instead of singing lullabies). Just remember to keep the activities quiet and calming, and do them in the same order every evening so your baby knows to expect bedtime at the end of the nightly ritual.

Don’t linger in your baby’s room

At this age, one developmental milestone is that your baby starts understanding object permanence, or the fact that people and things still exist even when they can’t be seen. Knowing that you’re somewhere else in the house, your baby may make a fuss when you leave the room in an attempt to get you to come back. If you do hear your baby cry out, poke your head back into the room but avoid turning on the light, picking her up, or staying too long. This will help teach your baby to soothe herself back to sleep on her own.

Ensure your baby’s room is safe

At around 12 months, another developmental milestone your baby may reach is the ability to pull herself up to a standing position without help. Be sure that the crib’s mattress is placed on the lowest setting and that the crib is away from all windows, draperies, and cords. You’ll also want to remove any artwork or decorations that she may be able to reach from her crib.



An Unexpected Danger for Baby’s Hearing

Last updated on March 2nd, 2018 at 02:22 pm

How often do you think about the impact on your hearing from listening to music on your iPod, maybe a little too loudly? Do you wear hearing protection when mowing the lawn? What about hearing protection for your baby or child? When is that needed?

Certainly that was a concern for me and my husband when we started taking our son to a local air show when he was a toddler. The sounds of the jets were unbearable at times – even for me. And Elliott certainly let us know it was an issue for him, so we got big over-ear protectors that made a real difference.

So, if a sound is loud enough to harm our child’s hearing, we will know, right? The baby will cry. The toddler will cover his ears.

Well, not so, according to a new study by researchers at the University of Toronto. A review of popular baby sleep machines – such as the Graco Sweet Slumber Sound Machine and Baby Einstein’s Sea Dream Soother – found that, set on maximum volume, all of these machines exceeded recommended decibel levels for hospital nurseries – and a few exceeded workplace safe hearing limits for adults. You can read more about the findings of the study in this New York Times article.

The authors point out that these machines, which emit white noise or nature sounds to soothe babies to sleep, can mostly likely be used safely by keeping the machine at a lower volume and away from the baby, and also limiting the duration of use. But the thing that is so concerning is how widespread the recommendations to use these machines have become, without a proper understanding of their potential impact. We certainly used something like this – and never dreamed it could have negative effects on our son. These findings should also raise the question for all parents about other potentially damaging noises for babies. One example that comes to mind is the sound level of music at a church I’ve been to on occasion. The music was so loud that it actually hurt my ears. Although babies in the congregation were napping or playing – clearly this isn’t an all-clear signal that the noise level is safe.

The article also got me thinking about hearing protection as children age. One of the most common concerns is with tweens and teens and loud music – particularly when using ear buds. But there are other concerns as well, like loud sporting events and power tools at home. Some great advice on these and other hearing concerns for kids can be found at It’s a Noisy Planet, a program of the National Institutes of Health. And you can click here to download a brief Noisy Planet tip sheet, Sound Advice on Hearing Protection for Young Ears.

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