Singing Eases Stress for Preterm Babies and Anxious Moms

Singing Eases Stress for Preterm Babies and Anxious Moms

By Jim Windell

            About one of every 10 infants born in the United States is premature – commonly referred to preemies. Babies who are born prior to the 37th month of pregnancy usually weigh much less than full-term babies and because they did not have enough time in the womb to develop they are often beset by various health problems – breathing difficulties, feeding problems, hearing and vision problems and other developmental delays.

            Because of the delays, preemies often need special medical care in a neonatal intensive care unit, or NICU. Typically, they stay in a NICU until their organ systems can work on their own.

           Being a preemie is obviously stressful for the babies themselves, but the stress of a premature birth and being separated from their baby who is in an NICU increases the risk of anxiety and depression for mothers. Consequently, this set of circumstances – with maternal stress along with depressive symptoms – may interfere with mother and infant interaction. However, a new study indicates that there are things that mothers can do to boost the wellbeing of both themselves and their infants.

           Researchers from the University of Helsinki, reporting in the Nordic Journal of Music Therapy, suggest that singing during kangaroo care has a positive effect on both maternal wellbeing and the mother-infant relationship following a preterm birth.

           In this study, researchers observed 24 mothers who sang or hummed over the course of kangaroo care (in kangaroo care, the preterm infant is placed on the parent's chest to establish skin-to-skin contact) to their preterm infants during a period corresponding with weeks 33 to 40 of pregnancy. A music therapist guided the parents in the intervention group to sing in a manner appropriate for the age of the preterm infant and also provided them with singing material.

           In the control group, 12 mothers carried out kangaroo care as standard practice up to week 40 without any specific encouragement to sing. Maternal anxiety was measured at the beginning and end of the intervention. After the singing period, the mothers in the singing group completed a questionnaire on their singing experiences. The mothers in both groups kept a journal where they recorded the duration of their daily interventions, while the control group mothers also recorded information on the auditory environment associated with kangaroo care.

           The findings as reported by doctoral student Kaisamari Kostilainen from the University of Helsinki and her colleagues showed that anxiety had been statistically reduced in the group of singing mothers after the intervention period compared to the mothers in the control group. Also, the results of the questionnaire show that singing also had a positive effect on maternal mood and general wellbeing. A total of 18 mothers (85%) reported that singing improved their mood, and 14 mothers (67%) felt singing helped them cope in a difficult situation. Sixteen respondents (76%) said that singing improved their wellbeing in general.

           Furthermore, the mothers felt that singing relaxed both themselves and their babies, as well as supported the establishment of the mother-infant relationship. A total of 19 mothers (90%) reported in the questionnaire that their baby reacted to their singing in kangaroo care by relaxing. Seventeen mothers (80%) said their babies fell asleep while listening to the singing. Nearly all mothers (95%) felt singing promoted interaction with their infants and made it easier to establish an emotional connection.

           According to Kaisamari Kostilainen, "Prior research has shown that the mother's voice and singing have positive effects on the development of preterm infants, among them the potential to stabilise their physiological state.” In addition, Kostilainen pointed out that previous  music therapy studies have demonstrated that music therapy and singing by mothers in conjunction with kangaroo care already in intensive care can positively affect the mothers in particular by reducing their anxiety.

           Kostilainen also says that "The results show that singing in kangaroo care after preterm birth can support maternal wellbeing and the mother-infant relationship by creating interactive situations and promoting an emotional connection.” However, she advises, mothers may need support, guidance and privacy for singing. “According to our findings, mothers may benefit from support and guidance provided by a trained music therapist in singing and using their voice in support of wellbeing and interaction while in hospital care," Kostilainen says.

           Finally, it was found that all of the mothers in the singing group reported they had continued singing at home after the study and that singing became established as an element of daily family routines.

           To read the original study, find it with this reference:

Kaisamari Kostilainen, Kaija Mikkola, Jaakko Erkkilä, Minna Huotilainen. Effects of maternal singing during kangaroo care on maternal anxiety, wellbeing, and mother-infant relationship after preterm birth: a mixed methods studyNordic Journal of Music Therapy, 2020; 1 DOI: 10.1080/08098131.2020.1837210


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