The Use of Music Therapy in the NICU

While music therapy has been used for some time as a healing therapy for patients, its presence in the NICU is a relatively new development. Proper utilization of music therapy in the NICU could be the next great step for improving developmental outcomes for our smallest patients. Specialties NICU Knowledge

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The Use of Music Therapy in the NICU

For centuries music has been used as a way for people to express joy, pain, excitement, sorrow, and many other emotions. Music is woven into the very fabric of our lives, running itself through the veins of our society. Music has also been an integral part of the healing process, and music therapy allows the healing aspects of music to enter the confines of the hospital.

What is Music Therapy?

When people first hear about music therapy, their initial thoughts tend to go towards listening to the radio, learning to play an instrument or working through a tough emotion with singing. However, music therapy entails much more than just listening to and playing music.

Music therapy is the use of carefully crafted music and musical elements that are used to help infants reach their own unique goals. Music therapy interventions are developed using clinical and evidence-based knowledge. It is provided by highly skilled therapists that have completed a required music therapy program and have passed the national credentialing exam. Music therapists use their years of education to craft individualized music interventions for each infant they are seeing1,3.

How is Music Therapy Used in the NICU?

Music therapy is used to assist infants in obtaining increased levels of rest, increase parent-child bonding and improve neurological development. These goals are reached by using a wide range of methods1.

Some of the more common methods used include1,3:

  1. Individualized lullabies in the infant's native language
  2. Pacifier-activated lullabies (PAL)
  3. Recordings of caregivers singing
  4. Infant-Driven singing
  5. Recordings of caregivers' heartbeats

The volume, rhythm and type of music are carefully crafted to suit each infant's specific needs. Preterm infants benefit best from calm, quiet melodies with little to no change in volume or rhythm. The music can also be synchronized with the infant's breathing and heart rate. Sounds that mimic the internal womb environment and the use of parental voices are also used, with singing noted to be the most effective method2,3,4.

Benefits of Music Therapy

With music therapy being a relatively new practice, more research needs to be done in order to understand its effectiveness in the NICU fully. However, the current research findings are promising. Numerous benefits of music therapy have been shown, some of which include1,2,3:

  • Promotes social development
  • Improves oral feeding
  • Shortens length of hospital stays
  • Improves oxygen saturations levels
  • Increases weight gain
  • Slows heart rate
  • Increases time infant is in a quiet, alert state
  • Increases tolerance to painful stimuli
  • Increased pain management

Contraindications to Music Therapy

Although music therapy has been shown to help multiple infants during their hospital stay, not every infant will benefit from music therapy. Infants born 28 weeks or younger should not take part in music therapy until they are older. Infants born prematurely lack the same brain maturity as term infants, making them much more prone to heightened responses to environmental stimuli and changes. Noise and tactile stimulation can cause stress on the premature infant and should be avoided as much as possible1,4.

Infants who are under sedation should also not receive music therapy as these medications can increase an infant's sensitivity to sound. Being mindful of an infant's response to sound and using appropriate interventions to lessen those responses will go a long way in protecting an infant's neurologic development1.

The Future of Music Therapy

While more research is needed to fully understand the role music therapy can play in the NICU, I think it is safe to say that music therapy will become another tool in our tool belt, using it to provide the best care we can to our tiny patients.


  1. Music Therapy and the Neonatal Intensive Care Unit (NICU): The American Music Therapy Association, Inc.
  2. Music as Medicine: American Psychological Association
  3. Benefits of a Comprehensive Evidence- Based NICU-MT Program: Family- Centered, Neurodevelopmental Music Therapy for Premature Infants: Pediatric Nursing
  4. Music therapy for neonatal stress and pain—music to our ears: Journal of Perinatology

Rande Ludwig BSN RN has 10 years of experience and specializes in NICU.

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Specializes in Health Communication and Patient Experience.

I know that I myself read and write better when I have certain types of music playing in the background. So to me music therapy in the NICU makes sense and is definitely a topic that merits further exploration. This subject has piqued my interest -- makes me wonder to what extent my own hospital uses it. Thanks for addressing this topic!