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Bev Foster • May 23, 2012

Music Care in the NICU – Pacifier Activated Lullaby Device

Each year in Canada, 8% of babies are born prematurely. In the US, that number is 12%. In both countries, premature births are up more than 25% since the 1980s. Although most pregnancies last about 40 weeks, premature or preterm birth is medically defined as childbirth occurring earlier than 37 completed weeks of gestation. Premature babies, sometimes called preemies, are extremely fragile and have an increased risk of death in the first year of life. Prematurity is the leading cause of newborn death within one month of birth in 25% of cases. Survival rates for preemies in the NICU have increased over the past several years while the cost of hospitalization has increased. As well, the benefits of using music with preemies has been researched and documented. For example, according to studies done by music therapist Jane Standley at Florida State University, positive outcomes of music with premature infants listening to lullabies had significant reduction in: • weight loss • length of stay in NICU/isolette/hospital • stress behaviors A new musical device, developed by Dr. Standley, reduces the length of a premature infant’s hospital stay by an average of 5 days. This innovative instrument, known as Pacifier Activated Lullaby (PAL) is now being sold to hospitals through a partnership with Powers Device Technologies Inc. PAL uses a specially wired pacifier and speaker to provide musical reinforcement each time the baby sucks on it correctly. By continuing the sucking motion, the babies hear more of the pleasing, gentle music. The infants learn to suck while being comforted by the music. Standley says “Unlike full-term infants, very premature babies come into the world lacking the neurologic ability to coordinate a suck/swallow/breathe response for oral feeding. The longer it takes them to learn this essential skill, the further behind in the growth process they fall. PAL uses musical lullaby reinforcement to speed this process up, helping them feed sooner and leave the hospital sooner.” Reflecting on the impact of this seemingly simple concept and device, I could have used PAL when our youngest child was born prematurely, at 36 weeks. For the first 4 days, she was in NICU in an isolette, hooked up to machines, intravenous. When we were finally able to begin breastfeeding, her sucking reflex was faint, almost non-existent. It took perseverance and the help of an amazing nurse to stimulate our wee one to latch on and begin to suck. The auditory stimulation and reinforcement would have enhanced the process. Perhaps these two parents, one dad and one mom, would agree. In any event, the songs they have each written about their personal experience helps us understand and even empathize with both the auditory and emotional perceptions in the NICU.

By Shelley Neal March 8, 2024
I initially trained with MUSIC CARE to work with Seniors in Long Term Care who were experiencing dementia and Alzheimer’s Disease. This is the path I travelled with my mom. My training with Music Care and Room 217 supported capacity building in selecting music that was played on my harp or chosen recorded music. The music centered on the care of the individual and their specific needs. My job was to determine the individual’s specific and select music to address these needs. The music selected helped to build community, support sleep, talk about life experiences, create a background landscape of sound, support connection to decrease isolation and loneliness, as well as coming alongside people dying. My training with Music Care helped me understand how to support people “where they were” physically, emotionally, and spiritually. Through using beat, tempo, melody, and timbre, I could cater the music and desired support required for individuals or small groups. My profession is teaching. I am a special education teacher and use music in my primary teaching as a method for learning, practicing language skills, transmitting information about science studies or math equations, as well as having fun and creating our own songs. My teacher toolkit married exceptionally well with the knowledge and skills provided by the Music Care Certification training. Recently, my work with students has involved individual programming for the medically fragile children and the palliative children. I use music (repeating the chorus several times) to engage and connect with the kiddos. We use music to "talk" about feelings (our communication is through eye gaze, eye blinks, and squeezing hands), and content material. I use music to enjoy our relationship of being together. At times, due to medication for seizures, my little ones can be very sleepy. I increase the tempo, engaging in tapping the beat on her hands and using silly action songs. The giggles and wiggles make it magical. I also use music to tell stories (my students have CVI, cortical vision impairment, so visual perception is difficult). This helps the child to engage in the story arch and adventures. Music is my conduit for reaching out and being with the students. Recently, I had the sacred journey of visiting one of my children in ICU at Sick Kids. I was invited to come to say "goodbye". A dear friend who was an ICU nurse in a different department told me (AKA, insisted) that I bring my harp with me. I wasn't sure if this would be appropriate for the family. However, with the permission of the mom, I bravely packed my harp up and took it to the Unit. It was a beautiful evening of talking with their mom and dad about how special their child was in my life. I played the kiddo's favorite songs and then ended with "The More We Get Together". The little one opened their eyes and stared at me. We hugged, and I left. They passed the next morning. I consider this time to be a sacred gift. Music Care Certification has given me the confidence and toolset to work alongside people and to journey together. It is a time a beautiful, difficult, or sacred time that I have been honoured to participate in.  Thank You
By Julia Cara March 29, 2022
This article was written by Julia Cara, and is part of a series provided by upper year Health Sciences students at McMaster University.
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