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Published on: July 1, 2015
The Role of Music Therapy with Infants with Perinatal Brain Injury
Kirsty Ormston1, Rachel Howard2, Katie Gallagher2
1Noah's Ark Children's Hospice, University College Hospital London, London EN5 4NP, UK.
Insights
Music therapy (MT) can help infants with perinatal brain injury by reducing pain and improving feeding, while also supporting parental bonding. However, some infants may show stress with complex interventions, necessitating further research.
Area of Science:
- Neonatal care
- Neuroscience
- Developmental psychology
Background:
- Perinatal brain injury affects 5.14/1000 live births in England, including hypoxic ischaemic encephalopathy (HIE) and intraventricular haemorrhage (IVH).
- Standardized care for these infants involves minimal handling, which can impede parental bonding and increase parental stress.
- Music therapy (MT) shows potential for facilitating parental bonding without physical contact.
Purpose of the Study:
- To systematically evaluate the use of music therapy (MT) in infants diagnosed with perinatal brain injury within a neonatal intensive care unit (NICU).
Main Methods:
- A systematic review following PRISMA guidelines was conducted across eight electronic databases.
- Eleven studies involving music or vocal stimulation for infants with perinatal brain injury were identified and assessed for quality.
- Interventions included live or pre-recorded vocal soothing and pre-recorded instrumental music.
Main Results:
- Music interventions reduced infant pain scores and cardiorespiratory events during procedures.
- Improved feeding abilities, including increased oral feeding rates and volume intake, were observed.
- Larger amygdala volumes and support for developmental milestone acquisition were noted in infants receiving MT.
Conclusions:
- Music therapy positively impacts infants' behavioral and neurological parameters and enhances parental involvement in developmental care.
- Vocal soothing is an accessible intervention for parents, though complex interventions may cause stress in infants with periventricular leukomalacia (PVL).
- Further feasibility studies are needed to refine outcome measures and parental support for future large-scale randomized controlled trials.
Abstract:
Perinatal brain injury occurs in 5.14/1000 live births in England. A significant proportion of these injuries result from hypoxic ischaemic encephalopathy (HIE) in term infants and intracranial haemorrhage (IVH) or periventricular leukomalacia (PVL) in preterm infants. Standardised care necessitates minimal handling from parents and professionals to reduce the progression of injury. This can potentially increase parental stress through the physical inability to bond with their baby. Recent research highlights the ability of music therapy (MT) to empower parental bonding without handling, through sharing culturally informed personal music with their infant. This review therefore aimed to systematically evaluate the use of MT with infants diagnosed with perinatal brain injury in a neonatal intensive care unit (NICU). Search terms were combined into three categories (audio stimulation (MT), population (neonates) and condition (brain injury), and eight electronic databases were used to identify relevant studies following PRISMA guidelines. Eleven studies using music or vocal stimulation with infants diagnosed with perinatal brain injury were identified and quality assessed using Cochrane ROB2, the ROBINSI Tool and the Newcastle Ottawa Scale. Studies used either voice as live (n = 6) or pre-recorded (n = 3) interventions or pre-recorded instrumental music (n = 2). Studies had two primary areas of focus: developmental outcomes and physiological effects. Results suggested the use of music interventions led to a reduction of infants' pain scores during procedures and cardiorespiratory events, improved feeding ability (increase oral feeding rate, volume intake and feeds per day) and resulted in larger amygdala volumes than control groups. Additionally, MT intervention on the unit supported long-term hospitalised infants in the acquisition of developmental milestones. Vocal soothing was perceived to be an accessible intervention for parents. However, infants with PVL showed signs of stress in complex interventions, which also potentially resulted in an increase in maternal anxiety in one study. MT with infants diagnosed with perinatal brain injury can have positive effects on infants' behavioural and neurological parameters and support parental involvement in their infants' developmental care. Further feasibility studies are required using MT to determine appropriate outcome measures for infants and the support required for parents to allow future comparison in large-scale randomised control trials.
