Music Therapy in the NICU
Every Wednesday morning, I get to play music for and sing to babies. How awesome is that?! My future career as a music therapist is going to be challenging and joyful, and I’m so very excited. At UE, music therapy students are fortunate to get at least six semesters of practicum experience. We learn by doing, being assigned a site in the community to observe and provide music therapy while being guided and supervised. My final practicum before graduation is in the St. Mary’s Medical Center Neonatal Intensive Care Unit. It has been a great experience learning the many aspects of using music therapy in the NICU and working with babies and their families.
Each Wednesday, my practicum partner Elisabeth and I begin the morning by providing Environmental Music Therapy (EMT). We use a combination of guitar, voice, and violin, creating the music’s tempo and volume by observing the NICU’s environment at that moment (live music is MUCH better than recorded for almost all things music therapy). We must keep our volume to a minimum, and we sometimes use a decibel meter to make sure we don’t exceed 60 decibels. We receive many comments each week from the nurses and other staff members that they enjoy working during the music; one positive effect of EMT is that it calms and improves the environment, which can often be stressful and fast-paced, for the workers. EMT can also lower the perceived level of sound in the NICU.
Elisabeth and I then each work with our assigned families. This generally consists of working with the babies, educating mothers and other family members about the importance of singing to their infant, and helping the families with anything specific that will help them and their child. This could include recording the parents and siblings singing for the infant, helping create a playlist for parents’ stress relief and relaxation, teaching the parents lullabies and changing words to fit their child, and much more. Music can be used to help babies relax or become more awake and can help with feeding and parent-child attachment; babies receiving music therapy usually leave the NICU sooner than babies who only receive routine treatment.
The music therapy process always begins with an assessment. Basic information as well as the parents’ musical background is gathered. The mother is usually present, but if she isn’t, I will sing to the baby and watch his reactions and oxygen saturation statistics. I use a technique called vocal holding in addition to lullabies. When the mother is present, I ask her for a “song of kin,” or a song she likes that she’d like to sing to her child. If it isn’t a lullaby, I will change the meter and feel of the song to make it more like a lullaby. I help the mom become comfortable singing in this lilting lullaby style, which is especially effective during kangaroo care, when the baby is skin-to-skin with his mother. We instruct the mother to watch for the baby’s reactions and pay attention to oxygen saturation statistics; if levels drop, an audible sigh can help bring it back up.
Forming a relationship with the family, working with the baby, and helping the parents work with their infant musically are three important aspects of music therapy in the NICU. My practicum has been a great experience, and I’ll enjoy my last few weeks in this setting.