Music Therapy Innovation in NICU Helps Newborns

Written by J. Todd Frazier

Music Therapy is a board-certified health care degree and profession where practitioners are trained in the fields of mental health and rehabilitation therapies and strategically use the motivational and stimulating elements of music in achieving clinical goals for patients. Houston Methodist’s (HM) Center for Performing Arts Medicine (CPAM) is proud that this human-centered therapy has been effective with patients and is a growing part of unique and innovative solutions throughout our hospital system. One of the applications that embraces technology and is currently being used in the Houston Methodist Willowbrook Hospital NICU is called the PAL.

The Pacifier Activated Lullaby System (PAL), developed by Jayne Standley who is a music therapy professor at Florida State University, is designed to assist premature infants in mastering the complex motor skills required for breastfeeding or bottle feeding and to expedite their weight gain and early discharge from the hospital. With nearly 500,000 premature births annually in the United States alone, these fragile infants often face a multitude of challenges, including medical interventions, underdeveloped nervous systems, and the need to coordinate the intricate process of sucking, swallowing, and breathing essential for feeding. The PAL, an FDA-approved device with a patented design, addresses these challenges by rewarding correct sucking coordination with soothing lullabies, recorded by the parents when possible, and has allowed infants to learn feeding skills 2.5 times faster and experience a calmer hospital stay. Moreover, the PAL sessions provide vital opportunities for parental bonding, offering both medical and emotional benefits, and are currently being introduced to NICUs worldwide, promising to significantly improve the care and development of premature babies.

Hannah Mata, a Houston Methodist CPAM music therapist with advanced training in the NICU, has introduced the PAL among other interventions to help newborns achieve normal respiration, develop sucking and swallowing skills, and to gain weight - all contributing to less time in the NICU and improved overall health results. The PAL system includes a specialty crafted, lightweight pacifier with ergonomic design that the infant sucks on. When the baby successfully coordinates its sucking, the pacifier transmits a signal to a speaker, which in turn, rewards the infant's efforts by playing soothing lullabies. This speaker is equipped with an LCD screen, enabling both medical staff and parents to closely monitor the baby's developmental progress and adjust the settings to the infant's sucking strength. To ensure hygiene and infection control, the system is thoughtfully designed with a sealed case that simplifies the cleaning process.

A demonstration of the PAL can be found in this video from UCLA Mattel Children's Hospital:

Hannah has been tracking the use of the PAL at HM Willowbook in preterm births where infants are at risk of developing respiratory distress syndrome and transient tachypnea due to underdeveloped lungs and may require respiratory support during their stay in the NICU. Furthermore, preterm infants may experience slow feeding and require observation for sepsis, which can lead to increased stress and vulnerability to stimulation. Hannah wanted to demonstrate the effectiveness of music therapy in improving the vital signs and tolerance to stimulation of preterm newborns with RDS, TTN, slow feeding, and/or a history of pre-eclampsia, maternal diabetes, and nuchal cord.

The findings of the research at Houston Methodist are consistent with prior research studies on the benefits of music therapy provided by a NICU music therapist, showing that music therapists can improve physiological stability, reduce stress and pain, and promote positive neuro-developmental outcomes (Standley, 2012). At HM Willowbrook, Hannah’s data demonstrated a striking improvement in infants' heart rate, respiration rate, oxygen saturation, pain and weight gain. At Houston Methodist, we are proud to be at the forefront of testing and implementing new applications across the entire healthcare continuum, including music therapy, that offer innovative solutions to today’s and tomorrow’s health challenges.