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      Maternal voice and preterm infants development

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      1 , , 1
      Italian Journal of Pediatrics
      BioMed Central
      XXI Congress of the Italian Society of Neonatology
      24-26 September 2015

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          Abstract

          Mother's voice seems to have an important role in neurological development of the fetus and the newborn. Numerous studies have shown that the fetus perceives sounds and reacts to them since 26th–28th week of gestation and that he has the ability to discriminate between the maternal voice and other voices, showing a marked preference to the first [1,2]. The fetus within the uterus is in a sound environment, called “noise floor”, resulting from the combination of “internal noise”, such as the sound of maternal heartbeat, breathing and gastrointestinal activity, and “external noise”, principally the mother's voice. Premature birth abruptly stops prenatal learning experiences and it causes a sudden transition from the quiet and lovely environment of the maternal womb, towards the noisy world of the NICU, often hostile and aggressive [3]. During the months in NICU, the baby is deprived of the biological maternal sounds and this could interfere with his neurodevelopment, in particular speech and language acquisition. The Developmental Care programs aim to provide an extra-uterine environment similar to the maternal womb: control of light, noise, pain, postural care, kangaroo mother care are examples. Few studies addressed the beneficial effects of the early exposure to the mother's voice and recently some researches have shown that this sound can increase cardiorespiratory stability and growth, improve deep sleep, and shorten length of hospital stay [4-8]. In 2013 Loewy [9], using several acoustic stimuli, has shown that exposure to “intrauterine” stimuli and in particular to the mother's voice, meant an increased attention span and alertness, associated with a marked reduction in heart rate, increased stability of behavioral states and sleep quality and improved nutritional behavior and caloric intake . Chorna et al. [10], using mother's voice played through a Pacifier-Activated Music player (PAM) during non-nutritive sucking, have demonstrated an improvement of the development of sucking ability and oral feeding skills in preterm infants. Finally Picciolini et al. [3] have shown that early exposure to maternal voice, administered by bone conduction, according Tomatis’ method, exerts a beneficial effect on preterm infants autonomic system and neurobehavioral development. They have found a better neurofunctional assessment score at 3 months of corrected age vs a control group. In conclusion, studies show encouraging results about mother's voice ability to promote optimal neurological development of preterm babies. We are studying the effects of the voice on mother-child attachment and its correlations with neurodevelopment outcomes.

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          Most cited references9

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          Fetal sensitivity to properties of maternal speech and language.

          Fetal speech and language abilities were examined in 104 low-risk fetuses at 33-41 weeks gestational age using a familiarization/novelty paradigm. Fetuses were familiarized with a tape recording of either their mother or a female stranger reading the same passage and subsequently presented with a novel speaker or language: Studies (1) & (2) the alternate voice, (3) the father's voice, and (4) a female stranger speaking in native English or a foreign language (Mandarin); heart rate was recorded continuously. Data analyses revealed a novelty response to the mother's voice and a novel foreign language. An offset response was observed following termination of the father's and a female stranger's voice. These findings provide evidence of fetal attention, memory, and learning of voices and language, indicating that newborn speech/language abilities have their origins before birth. They suggest that neural networks sensitive to properties of the mother's voice and native-language speech are being formed.
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            Live music is beneficial to preterm infants in the neonatal intensive care unit environment.

            Music stimulation has been shown to provide significant benefits to preterm infants. We hypothesized that live music therapy was more beneficial than recorded music and might improve physiological and behavioral parameters of stable preterm infants in the neonatal intensive care unit. Thirty-one stable infants randomly received live music, recorded music, and no music therapy over 3 consecutive days. A control of the environment noise level was imposed. Each therapy was delivered for 30 minutes. Inclusion criteria were postconceptional age > or = 32 weeks, weight > or = 1,500 g, hearing confirmed by distortion product otoacoustic emissions (DPOAEs), and no active illness or documentation of hyperresponsiveness to the music. Heart rate, respiratory rate, oxygen saturation, and a behavioral assessment were recorded, every 5 minutes, before, during, and after therapy, allowing 30 minutes for each interval. The infant's state was given a numerical score as follows: 1, deep sleep; 2, light sleep; 3, drowsy; 4, quiet awake or alert; 5, actively awake and aroused; 6, highly aroused, upset, or crying; and 7, prolonged respiratory pause > 8 seconds. The volume range of both music therapies was from 55 to 70 dB. Parents and medical personnel completed a brief questionnaire indicating the effect of the three therapies. Live music therapy had no significant effect on physiological and behavioral parameters during the 30-minute therapy; however, at the 30-minute interval after the therapy ended, it significantly reduced heart rate (150 +/- 3.3 beats/min before therapy vs 127 +/- 6.5 beats/min after therapy) and improved the behavioral score (3.1 +/- 0.8 before therapy vs 1.3 +/- 0.6 after therapy, p < 0.001). Recorded music and no music therapies had no significant effect on any of the tested parameters during all intervals. Both medical personnel and parents preferred live music therapy to recorded music and no music therapies; however, parents considered live music therapy significantly more effective than the other therapies. Compared with recorded music or no music therapy, live music therapy is associated with a reduced heart rate and a deeper sleep at 30 minutes after therapy in stable preterm infants. Both recorded and no music therapies had no significant effect on the tested physiological and behavioral parameters.
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              A pacifier-activated music player with mother's voice improves oral feeding in preterm infants.

              We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants.
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                Author and article information

                Contributors
                Conference
                Ital J Pediatr
                Ital J Pediatr
                Italian Journal of Pediatrics
                BioMed Central
                1824-7288
                2015
                24 September 2015
                : 41
                : Suppl 1
                : A14
                Affiliations
                [1 ]Neonatologia e Terapia Intensiva Neonatale, Arcispedale S. Maria Nuova - IRCCS, Reggio Emilia, Italy
                Article
                1824-7288-41-S1-A14
                10.1186/1824-7288-41-S1-A14
                4595376
                ed7b9ad4-d36a-4019-a355-bc35a42b1b4c
                Copyright © 2015 Gargano and Nuccini

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                XXI Congress of the Italian Society of Neonatology
                Palermo, Italy
                24-26 September 2015
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                Pediatrics
                Pediatrics

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