MUSIC FOR PREMATURE EARS
At any given moment, there are 30 to 40 babies in the Neonatal Intensive Care Unit at Oregon Health & Science University.
Whether they came into the world too early, too fragile or too sick, their medical intervention-heavy introduction to life often is more painful and bewildering than for most babies.
"We have babies that, at times, they're really irritable because they don't have a normal newborn life," said nurse Louise Darling, a 20-year veteran of the NICU. "We do some really invasive procedures on them."
During a recent instance of "baby rage," as Darling calls it, she called on the volunteer services of Gladstone resident Laura Beer. Within 30 seconds, not only had the baby calmed down, Darling says, but so had the nurse herself.
What was this magic technique?
"The babies in the NICU do not have language; their world is a musical one," said Beer, director and associate professor of music therapy at Marylhurst University, "and so with music therapy, we find a way to connect to them, support them developmentally, and help them learn how to self-regulate and self-soothe."
Inspired by her grandson's own journey through the NICU in 2011, Beer is training a new generation of music therapists to work not only with adults and children but with these youngest patients. The board-certified music therapists graduate to work in settings from medicine or special education to group homes or mental health clinics. The two-to-four-year program currently has 10-15 students graduate per year.
Oregon began licensing music therapists for practice in 2015 after passage of a bill sponsored by Rep. Julie Parrish, R-West Linn.
However, even though nurses attest to the remarkable benefits of music therapy, OHSU doesn't yet hire music therapists for the NICU.
"We would hope (OHSU would) because it's so valuable," NICU assistant nurse manager Nikki Wiggins said. The question, Wiggins added, is who would fund it.
Beer said charitable foundations sometimes help with the cost but she would like to charge for music therapy through Medicaid and other insurance, just as occupational and physical therapists can for their NICU visits.
It's unclear what effect Measure 101 would have on that route, however. The Jan. 23 ballot measure, also spearheaded by Parrish, puts $330 million of Medicaid funds in question.
Health care professional associations say the measure's failure would jeopardize the health insurance for thousands. Parrish and her supporters say government needs to better manage the funds it already has and not institute a tax on health insurance that could be passed through to vulnerable consumers.
"The real fix that needs to happen is that we need to allow these kinds of therapists to bill under Medicaid," Parrish tweeted in response to a question from Pamplin Media Group. "That's where they'd get funding."
Currently, only a few of the lucky babies who happen to be at OHSU on Thursday mornings get to experience Beer's musical presence.
Musician responds to baby, environment
Jose Ochoa-Ramirez, a 6-day-old preemie, is asleep when Beer brings her special ocean sound instrument. But even, so his heart rate — flashing constantly on the overhead monitor — decreases significantly when she plays. Beer says this is evidence that he is calmed by the sounds, leading to deeper sleep.
"Even though he appears asleep, that's a reminder of how much these babies are taking in," Beer said.
As a music therapist, Beer is not simply playing a song — she is improvising along with the particular lullabies that a child hears from caregivers, the ambient sounds in the room, and the reactions of the child.
In a NICU, the alarm monitors sound regularly and response to an emergency can get intense. Beer selects keys in B or B-flat to match the monitor sounds, she times her soothing lullabies in 3/4 or 6/8 rhythms to correspond to breathing (and breathing machines) and makes sure to play quietly enough not to damage sensitive ears.
"I think the music adds something critical to the babies' lives," she said, noting some babies live their entire lives in these hospital rooms. "Developmentally, there are few things in this setting that can have a positive effect."
An increasing body of scientific research is showing that music therapy has tangible benefits. The patterns of music help a baby recognize sensory input and organize the world around them. Music requires a baby to use both hemispheres of their brain together. It also has a positive effect on the nervous system.
A little-known nerve in the face, back of the throat and abdomen — called the vagus nerve — responds to vocal-range vibrations. This can lead to lower heart rates, better digestion and other stress-reduction benefits.
"The human nervous system evolved to be very selective of these frequencies," wrote Dr. Stephen Porges of the Brain-Body Center of the University of Illinois at Chicago. Porges posits that the face-to-face social interactions are just as important as the music.
A study published in 2013 in the official journal of the American Academy of Pediatrics found that premature infants exposed to interactive live music therapy boosted caloric intake, lowered heart rates, recovered
faster from painful procedures and had prolonged periods of quiet-alert states.
Babies, parents and nurses may not be able to cite the research, but they can say how the music makes them feel.
"The amount of wonderfulness in my day increased and my stress level decreased," Darling said.