In a recently released study in Pediatrics, Tora Söderström Gaden and a group of international colleagues present the results of a well-conceived study examining the effect of parent-led, infant-directed singing, supported by a music therapist, on parent-infant bonding among stable premature infants born at <35 weeks gestational age (10.1542/peds.2021-052797). The authors cite evidence that maternal voice interventions are associated with physiologic stabilization of preterm infants, as well as an association of singing with improved mother-infant closeness among mothers of full-term infants. This 2-arm parallel, pragmatic, randomized controlled trial enrolled 213 medically stable preterm infants and their parents from eight NICUs in Argentina, Colombia, Israel, Norway, and Poland. One hundred and eight infant-parent dyads were allocated to usual care, while 108 were randomized to the music therapy group, which included three 30-minute sessions per week throughout the hospitalization (up to 27 sessions).
The investigators paid careful attention to the fidelity of the music therapy intervention, included an advisory board composed of parents of preterm infants as consultants and carefully tuned (no pun intended) the use of parental voice to infant tolerance. The main outcome was maternal-infant bonding as measured by a 25-item validated survey, the Postpartum Bonding Questionnaire (PBQ), with secondary outcomes of maternal anxiety and depression, again assessed with validated measures.
What surprised me most (spoiler alert) was the absence of a significant impact of the intervention on the chosen outcomes. Was this due to the low baseline levels of impaired bonding, maternal anxiety and depression in both groups? Possibly music therapy is more effective in a parent population at higher risk for compromised bonding. Or was the PBQ not a sufficiently sensitive measure for this population or this study? Or was just 3 sessions per week not intensive enough to make a measurable impact? The thought-provoking discussion explores other possible reasons that this was a negative study. My own intuition, though, based on literature cited by the authors and additional studies1, is that music therapy in fact has meaningful potential to help both preterm infants and their parents, and that additional research is needed. Please share your thoughts on this interesting topic!
- Yakobson D, Gold C, Beck BD, Elefant C, Bauer-Rusek S, Arnon S. Effects of Live Music Therapy on Autonomic Stability in Preterm Infants: A Cluster-Randomized Controlled Trial. Children (Basel). 2021 Nov 22;8(11):1077. doi: 10.3390/children8111077. PMID: 34828790; PMCID: PMC8618386.