The Power of Music in Pediatrics
5-7 Minute Read
Authors: Marin Gillis, PhD, LPh and Julpohng Vilai, MD, FAAP
Purpose
To provide clinicians with an understanding of the relation between music and medicine in pediatrics.
Learning Objectives
Distinguish between music as an aesthetic phenomenon and music therapy; and
Identify at least one therapeutic goal of music therapy in pediatrics.
Music is a universal feature of human experience. Playing music for children, singing to infants, and using music for healing are common practices across cultures (1). As medicine has become increasingly dependent on technology for monitoring vital signs, the hospital setting has become a veritable symphony of beeps, alarms, and bells leading to alarm fatigue for staff (2) and frustration for patients and families. Technological advances have enabled incredible leaps in human health, but the ancient modality of music can help ameliorate some of the unpleasant aspects of the technological revolution. From newborns to sick children, in both in and out-patient settings, music is finding its way back into the experience of soothing and healing.
Art and music have long been incorporated into healthcare spaces for aesthetic reasons, and music is increasingly utilized therapeutically for its effects on mood, attention, stress, sleep, and learning. Indeed, one can study to become a clinical music therapist in graduate programs around the world (see MusicTherapy.org for more about music therapy). Music therapy differs from sound therapy in that the latter is referred to as vibrational therapy and includes interventions like “sound bathing” using gongs and other gentle percussives. Others consider sound therapy to be a general class of auditory and vibrational therapy with music therapy being one kind (3 pp196-197).
Nevada is home to several pioneers in using music for healing. In 1992 Nevada musicians Dr. Susan Mazer (harp) and Dallas Smith (woodwinds and percussion) created the first relaxation programming specifically for healthcare spaces offering original instrumental music over nature scenes with the goal “to improve the patient experience by creating healing environments that reduce the harmful effects of noise, enhance pain management protocols, promote privacy, and increase safety and satisfaction” (4). Feedback from practitioners as well as patients and their visitors suggest that many in the healthcare setting benefit from these visually supported soundscapes (4). Classically trained violinist and Las Vegan, Judith Pinkerton is the nation’s first licensed music therapist (5), and was integral in in the movement to have the discipline legally recognized in Nevada. Ms. Pinkerton offers therapy and classes out of Music4Life including courses for clinicians to incorporate music in their medical practice (6).
Mounting clinical evidence emerging from pediatrics shows that music beneficially influences preterm infants’ neural development and vital signs, motivates suckling reflexes thus improving oral feeding, and reduces stress in pediatric emergency rooms. Recently, a group of researchers at the University of Geneva published the first scientific evidence that playing music for preterm infants actually increases neural connectivity compared to a control group not exposed to music (7). This is particularly important for preterm infants who are at high risk of impaired brain development (8). This research was conducted after other researchers demonstrated the stabilizing effects of music in the NICU on vital signs, apnea and bradycardia, and the development of suckling reflexes, improved oral feeding, and enhanced weight gain (9,10). One of the earlier studies used pacifiers that when sucked, played music; the contingent music increased non-nutritive sucking, a precursor to nutritive sucking, a skill needed to transition babies from parenteral to total oral feeding (11).
At the University of Alberta in Canada, researchers looking at the relationship between music and stress found that music helped soothe pediatric emergency room patients (12). In the trial with 42 children ages 3 to 11, patients who listened to relaxing music while getting an IV inserted reported significantly less pain and distress, compared with patients who did not (12). Further, among the music-listening group, more than two-thirds of the providers reported that the IVs were very easy to administer (12).
Radio Lollipop, an international non-profit that has stations in hospitals all over the world, offers a different avenue for connecting sick children in hospitals to music (13). Kids help choose the music and are involved in the radio programs. Radio Lollipop maintains that while “children cannot say “no” to taking their medicine or receiving treatment, they can request their favorite songs, win prizes and hear their own voices on the radio” (13). This agency is good in-itself and likely yields therapeutic benefits.■
This video on music therapy used at the UCSF Benioff Children’s Hospital Oakland:
University of Michigan, C.S. Mott Children’s Hospital has a robust music and medicine program that is both enlightening and inspiring:
References
Mehr SA, Singh M, Knox D, et al. Universality and diversity in human song. Science. 2019;366(6468):eaax0868. doi:10.1126/science.aax0868
Bach TA, Berglund LM, Turk E. Managing alarm systems for quality and safety in the hospital setting. BMJ Open Qual. 2018;7(3):e000202. doi:10.1136/bmjoq-2017-000202
Anderson EZ. Energy Therapy. In: Complementary Therapies for Physical Therapy. Elsevier; 2008:196-205. doi:10.1016/B978-072160111-3.50019-1
Healing Healthcare Systems. C.A.R.E. Channel relaxation progamming. Accessed September 19, 2022. https://www.healinghealth.com/wp/about-healing-healthcare-systems/
Bracelin J. Las Vegas woman combines music with therapy. Las Vegas Review Journal. June 2, 2018. Accessed September 20, 2022. https://www.reviewjournal.com/life/health/las-vegas-woman-combines-music-with-therapy/
Music4Life Clinical Specialist. Thank you to Donnie Lee, III, LPMT, MT-BC for pointing us to this resource.
Lordier L, Meskaldji DE, Grouiller F, et al. Music in premature infants enhances high-level cognitive brain networks. Proc Natl Acad Sci USA. 2019;116(24):12103-12108. doi:10.1073/pnas.1817536116
Volpe J. The encephalopathy of prematurity–brain injury and brain development inextricably intertwined. Semin Pediatr Neurol. 2009;16(4):167-178. doi:10.1016/j.spen.2009.09.005
Anderson DE, Patel AD. Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact? Dev Med Child Neurol. 2018;60(3):256-266. doi:10.1111/dmcn.13663
Pineda R, Guth R, Herring A, Reynolds L, Oberle S, Smith J. Enhancing sensory experiences for very preterm infants in the NICU: an integrative review. J Perinatol. 2017;37(4):323-332. doi:10.1038/jp.2016.179
Yildiz A, Arikan D. The effects of giving pacifiers to premature infants and making them listen to lullabies on their transition period for total oral feeding and sucking success. Journal of Clinical Nursing. 2012;21(5-6):644-656. doi:10.1111/j.1365-2702.2010.03634.x
Hartling L, Newton AS, Liang Y, et al. Music to reduce pain and distress in the pediatric emergency department: a randomized clinical trial. JAMA Pediatr. 2013;167(9):826. doi:10.1001/jamapediatrics.2013.200
Radio Lollipop. The healing power of play. Accessed September 19, 2022. https://www.radiolollipop.org/