Abstract
Premature infants and their parents experience significant stress during the perinatal period. Music therapy (MT) may support maternal-infant bonding during this critical period, but studies measuring impact across the infant's first year are lacking. This nonrandomized feasibility study used quantitative and qualitative methods within a critical realist perspective to evaluate the feasibility, acceptability, and suitability of the treatment arm of the Longitudinal Study of music Therapy's Effectiveness for Premature infants and their caregivers (LongSTEP) (NCT03564184) trial with a Norwegian cohort (N = 3). Families were offered MT emphasizing parent-led infant-directed singing during neonatal intensive care unit (NICU) hospitalization and across 3 months post-discharge. We used inductive thematic analysis of semi-structured interviews with parents at discharge from NICU and at 3 months and analyzed quantitative variables descriptively. Findings indicate that: (1) parents of premature infants are willing to participate in MT research where parental voice is a main means of musical interaction; (2) parents are generally willing to engage in MT in NICU and post-discharge phases, finding it particularly interesting to note infant responsiveness and interaction over time; (3) parents seek information about the aims and specific processes involved in MT; (4) the selected self-reports are reasonable to complete; and (5) the Postpartum Bonding Questionnaire appears to be a suitable measure of impaired maternal-infant bonding. Parents reported that they were able to transfer resources honed during MT to parent-infant interactions outside MT and recognized parental voice as a central means of building relation with their infants. Results inform the implementation of a subsequent multinational trial that will address an important gap in knowledge.
Highlights
As medical advances have contributed to improved survival rates for infants born preterm, there is a corresponding shift to concern for the long-lasting sequelae of prematurity
Three eligible families consented to participate in the feasibility study and completed all study procedures during the neonatal intensive care unit (NICU) phase
One of these families declined to continue participating in Music therapy (MT) post-discharge, citing that they were overwhelmed with commitments related to their other children
Summary
As medical advances have contributed to improved survival rates for infants born preterm, there is a corresponding shift to concern for the long-lasting sequelae of prematurity. Attachment describes the lasting relationship that forms between an infant and primary caregiver that serves an adaptive purpose for the infant, enabling the infant to establish a secure base from which to explore the world (Bowlby, 1969). The quality of a child’s attachment is demonstrated in situations when the child becomes stressed by a stranger in the absence of the primary caregiver, most famously demonstrated in experiments of the Strange Situation (Ainsworth & Bell, 1970; Ainsworth & Wittig, 1969). In comparison to secure attachment styles, insecure attachment styles are correlated with an increased risk of psychosocial and mental health problems as the child develops into adolescence and adulthood (Bornstein, 2014; Groh et al, 2017; Mikulincer & Shaver, 2012; Spruit et al, 2020)
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