John Wallace Gardner and Dr. Rosalie R. Pratt, Music

Prematurely born infants begin life with underdeveloped systems and organs and lack the stability to live optimally outside the womb without significant support from technology and trained professional staff. Preterm infants may suffer from low weight, difficulties with consumption and digestion, exposure to high stress, uncontrolled motor movement, and numerous other difficulties. Most of these infants spend their first weeks and even months of life as high-risk patients in a newborn intensive care unit (NBICU or NICU).

Appropriate sound stimuli constitute one method used to facilitate enhanced physiological and neurological development of preterm infants. Researchers have investigated the effects of recorded music on infants’ growth and development and have demonstrated significant positive effects of music on outcome measures including caloric intake, weight gain, and shorter length of stay in care units. The question then arises whether live music played on traditional instruments, such as the harp, might have similar influences on the same outcome measures.

This study investigated the hypothesis that appropriate live harp music can increase preterm infants’ caloric intake and weight gain and consequently lead to shorter time in care units. The research also investigated gender-related response. A matched pairs block design was used. The 16 premature infants in the experimental group (E) were exposed to the live harp music; 4 babies met all the experimental criteria and 12 others met a portion of the criteria. The control group (C) was composed of a data sample from 89 matched infants who experienced the normal routine in the NBICU. Each individual in the E group was compared to approximately 10-15 infants in the C group who were matched according to gestational age, gender, similar condition, birth weight, and birth within 1 year prior to the infants in the E group. The inclusionary criteria for subjects included 25- 35 weeks gestational age and 5-minute APGAR scores of 7 and above. The age was extended to 38 weeks to include one infant of 37 weeks and one of 38 weeks in the E group. Exclusionary criteria included neurological problems or abnormal hearing in either ear and 5-minute APGAR scores below 7.

The harp repertoire was selected by ShruDeLi Ownbey, Professor of Harp at BYU, for the following characteristics: essentially consonant melodies, regular rhythmic movement, slow harmonic rhythm, and little dynamic variation. One small pedal harp was placed within the NBICU just outside the nurse station approximately 7 feet away from the nearest infants and 22 feet from the farthest infants. Each of the 22 volunteer harpists played the selected repertoire in the LDS Hospital NBICU for approximately 1½ hours between 7:00 and 9:30 p.m. each evening from January 6 to February 4, 1999. The repertoire duration was approximately 25 minutes and the sequence was repeated twice.

The caloric intake of subjects in the E (music) and C (control) groups was compared using the beginning weekly measurement for each baby. The weight gain of subjects was compared using the difference between the weekly weight and the lowest weight. The length of infants’ stay in the NBICU was compared using the total number of days infants spent in isolettes. The data did not indicate that male and female babies in the music group responded differently to the live harp music. The gender p-values were as follows: caloric intake, 0.3280; weight gain, 0.8370; and length of stay, 0.7119. The following chart displays the other results:

While the null hypothesis was not rejected, larger studies have proven that appropriate musical stimuli significantly enhance neurological and physiological growth among prematurely born infants. Inherent limitations of resources and time may account for the inconclusive results of this study. The time allotted for the study did not produce a sample size large enough to determine significant findings. The results on weight gain and length of stay may have been more significant with an increased sample. Music infants who fit the full criteria for the study generally exhibited shorter lengths of stay than babies in the control group. The majority of the music group could not receive the complete listening period because of time constraints which also hindered a desirable extension of the study. A more precise matching process of music and control groups may also lead to more conclusive results.

Possible confounding factors may also explain the inconclusive results. It was not possible to place the harp equidistant from each baby. Some infants were closer than others, some units were open while others were closed, and medical attention may have required infant rotation. The treatment was therefore not equal for all babies. Information regarding the location of each infant and isolette condition (open or closed) was unavailable. The unexplained discrepancy between the lower caloric intake in the music group and their higher weight gain may support the theory that the caloric intake data are insufficient. Caloric intake may not be a useful measurement because of the difficulty in recording extra calories given to infants by mothers, families, and staff.

Some parents noted the music’s calming effect on both themselves and their infant. The live harp music helped create a relaxing and peaceful ambiance that reduced stress levels and facilitated parental and staff involvement. This study also led to a 5-minute TV news feature shown nationally, a donated harp to LDS Hospital, and further investigation which may lead to a larger related study in three Utah hospitals and better infant health.