Assessing HeartSong as a Neonatal Music Therapy Intervention

Abstract

Background:The music therapy HeartSong intervention pairs newborn infant heartbeats with parents' Song of Kin. Formal evidence on professional and personal caregiver perspectives of this intervention is lacking. Purpose: This survey study evaluates the HeartSong music therapy intervention from parent and staff perspectives. Methods: A qualitative study assessing inclusion of HeartSong for family neonatal intensive care unit (NICU) care surveyed 10 professional caregivers comprising medical and psychosocial NICU teams anonymously reflecting their impressions of the intervention. Digital survey of parents/guardians contacted through semistructured phone interviews relayed impressions of recordings: subsequent setup, Song of Kin selection, and use of HeartSong, including thoughts/feelings about it as an intervention. Results: Professional and personal caregivers valued the HeartSong intervention for bereavement support, family support, including parental, extended family/infant support, and to enhance bonding. Emergent themes: memory-making, connectedness/closeness, support of parent role, processing mental health needs of stressful NICU days, and subsequent plans for lifelong HeartSong use. Therapeutic experience was named as a crucial intervention aspect and participants recommended the HeartSong as a viable, accessible NICU intervention. Implications for Practice and Research: HeartSong's use showed efficacy as a clinical NICU music therapy intervention for families of critically ill and extremely preterm infants, when provided by trained, specialized, board-certified music therapists. Future research focusing on HeartSong in other NICU populations might benefit infants with cardiac disease, parental stress, and anxiety attending to parent-infant bonding. Costs and time benefits related to investment are needed before implementation is considered.

Music therapy in tertiary neonatal intensive care: A matter of unlikely allies?

“…Within the womb, the foetus hears his or her mother's heartbeat, breathing and gait and shows recognition of the mother's as well as the father's voice. 4,5,13 From 30 weeks onwards, the foetus and also a pre-term-born infant is able to distinguish between varying speech tones and timbres and is also able to process complex auditory sounds. 4,7,16 This point likely marks the start of speech and language development.…”

“…Most frequent pathologies include pulmonary and cardiac problems, difficulties in temperature regulation as well as gastrointestinal problems [9][10][11][12][13]15,[17][18][19][20][21] Moreover, neurodevelopmental problems have a longterm impact, resulting in behavioural problems, cerebral palsy, epilepsy and motor and cognitive impairment, more evident in extremely preterm infants and infants with neonatal encephalopathy. 10,17 Besides these physical challenges, children also suffer from deficits in socioemotional development, impacting parent-child bonding 9,13,22 as well as social and biological distress due to medical procedures, pre-term birth itself and over-exposure to artificial sounds (i.e. heart monitor, oxygen supplies, heating element) and light sources.…”

“…4,5,16,18 All of these, even though necessary for the survival of the infant, influence the recovery and overall well-being of the child. 5,[9][10][11][12][13]15,22 Against this setting, one could argue that music, with its complex structure and rhythm and harmonies, can be overstimulating for the child. 19 Indeed, van der Heijden et al reported that music can have an overstimulating effect on neonates in some instances, but this has to be seen in perspective of playing either recorded music or providing life performed music.…”

“…Amplified Cardiopulmonary Recordings, Hearts Beat Recordings, Music Therapy Heart Sounds or simply the HeartSong is a unique therapeutic approach, where the sound of the beating heart (child, parent or both) is recorded and translated into a meaningful song. 13,26 The goal of the HeartSong in the NICU is to leave a meaningfully translated lasting auditory memory of the patient. 13 It can also be used to record both parent and child's heartbeat to facilitate bonding using music composed around both heartbeats.…”

“…8 Various methods have been developed and proven effective in clinical trials with positive impacts on neurodevelopment. 5,[7][8][9][10][11][12][13][14] A recent resting fMRI study indicated music exposure in pre-term infants in NICU significantly increased coupling between brain networks and led to the development of a functional brain architecture similar to term infants. 12 Yet, music-based therapies and interventions have not found their way to all NICUs.…”