Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents.

Łucja Bieleninik,Mark Ettenberger,Shulamit Epstein,Cochavit Elefant,Shmuel Arnon

doi:10.3390/ijerph18168557

Abstract

Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant’s response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic–pituitary–adrenal axis’ role in stabilization of behavioral state, the autonomic nervous system’s role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.

Highlights

Introduction published maps and institutional affilThe evidence-based movement within music therapy (MT) research in the NeonatalIntensive Care Unit (NICU) has been constantly growing over the last several decades, providing empirical support for the effectiveness of MT on treatment success for both preterm infants and their parents
We will discuss in detail the main results of MT during skin-to-skin contact (SSC), focusing on infant- and/or caregiver-related variables and excluding studies with designs that are less rigorous than randomized controlled trials (RCTs)
“questions that examine the mechanisms through which interventions produce their benefit and attempt to identify which specific interventions will work best for specific individuals” [75] (p. 2). In this perspective article we discussed a few potential mechanisms of MT interventions, considering interventions aiming at parents and preterm babies during KC or SSC

Summary

Introduction

Introduction published maps and institutional affilThe evidence-based movement within music therapy (MT) research in the NeonatalIntensive Care Unit (NICU) has been constantly growing over the last several decades, providing empirical support for the effectiveness of MT on treatment success for both preterm infants and their parents. Systematic reviews [2,3,4,5,6,7] and meta-analyses of randomized controlled trials (RCTs) [8,9,10,11] have indicated that MT and music-based interventions bring benefits for both preterm infants and their caregivers. With respect to the latter reviews, Bieleninik, Ghetti, and Gold [8] conducted a meta-analysis of 14 RCTs involving 964 preterm-born infants and 266 parents and found a significant large effect of MT for infant respiratory rate (RR) and maternal anxiety. 13 RCTs with 1093 preterm-born infants and reported a favorable effect of MT on heart iations.

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