What peace sounds like: Music therapy continues to transform the NICU at PeaceHealth

PeaceHealth Southwest Medical Center expanding and progressing music therapy for infants, families and nurses

VANCOUVER — He’s no bigger than a book cover. He was born 10 weeks early. His name is Silas, and while he perseveres through his daily checkup, he listens to the gentle humming of someone at his bedside. The sound brings peace.

Each week, babies are born into the community and new parents celebrate the momentous accomplishment of starting, or growing a family. 

For many, it’s a day or two of joy and happy tears, followed by a drive home. For others, the parenting journey begins unexpectedly with a battle for their child’s life.  

Baby Silas sleeps in the PeaceHealth Southwest NICU while Susan Bakouros hums gently to him as part of the music therapy program. Photo by Jacob Granneman

The Neonatal Intensive Care Unit (NICU) often becomes a second home for parents who find themselves in such a battle. Infants with special medical needs are cared for 24/7 within the NICU; nearly always being born premature.

The environment can be stressful and anxiety ridden for parents, nurses and neonates. In one Clark County NICU, music therapy is combating stress and anxiety by ushering in an atmosphere of calm.  

PeaceHealth Southwest Medical Center in Vancouver, runs a state-of-the-art NICU, within their Holtzman Twins Special Care Nursery. In 2016, the hospital’s music therapy program was founded and began being used to help care for babies in the NICU, as well as playing environmental music for the parents and hospital staff. 

Susan Bakouros, MA, MT-BC Photo by Jacob Granneman

Susan Bakouros, MA, MT-BC Photo by Jacob Granneman

“The first sound a baby hears is mom’s heartbeat, and that’s rhythm. Our brains are actually wired for rhythm,” said Susan Bakouros, MA, MT-BC, and the program director for PeaceHealth’s music therapy. “[Music] can be an extremely vital intervention to use to help their brains develop.”  

The program, which is the only of its kind in the area, continues to grow in goals and methodology; working with infants during everything from uncomfortable procedures, to stressful moments, to simple, everyday care times.

NICU babies may need to be in the unit for a few weeks, up to as long as 120 days. The length of the stay interrupts the lives of the parents, especially if they have other children at home. The importance of music can be felt throughout the program, and long after for parents and child. 

“It’s really nice to feel like there’s something you can do,” said Cara Ellis, who’s daughter Rhona stayed in PeaceHealth’s NICU for several weeks after being born. “My husband plays the guitar, and so he was able to play one of the guitars here to her. I think that really helped him bond with her, and it was so nice to feel like, ‘There’s something we can do to connect with you … to help you.’”

Cara Ellis (left) visits the NICU at PeaceHealth Southwest Medical Center with her daughter Rhona, and music therapist Susan Bakouros (right). Rhona was once a patient in the NICU and was in the music therapy program. Photo by Jacob Granneman

Cara Ellis (left) visits the NICU at PeaceHealth Southwest Medical Center with her daughter Rhona, and music therapist Susan Bakouros (right). Rhona was once a patient in the NICU and was in the music therapy program. Photo by Jacob Granneman

Within an environment as hectic and often noisy as a hospital, music therapists will use existing sounds that may be tied to stress or fear, and incorporate them into the musical landscape.

“I take the sound that’s already present in the environment and I build a musical context around it,” said Whitney McCann, one of the program’s professional music therapists. “I’m building the most harmonious sound landscape for the unit that I can.”  

McCann describes one instance where the front desk phones of the NICU ring at about F-sharp on the musical note scale. Subsequently, she will often play her instrument or sing in D, which compliments the sound and makes it blend into the music rather than standout.

“Any cues I can pickup that let me know the music is working for its intended purpose, those are my favorite things,” McCann said.  

Bakouros recently finished her Master’s Degree in music therapy at the Berklee College of Music, and is working to publish her research into how music therapy in the NICU can help during procedures.

She specifically focused on eye exam procedures, which may take place as often as every week for babies in the NICU. The frequency of the exams is due to increased risk of retinopathy of prematurity; blindness caused by oxygen prohibiting eye development. 

During the exams, which can be quite uncomfortable for the baby, Bakouros looked at the pain scores for children going through the procedure without and then with music therapy. What she found was the children with the therapy had pain scores decreased by half overall.

Susan Bakouros hums gently to an infant in the NICU to help the baby remain calm during a daily checkup. Photo by Jacob Granneman

Susan Bakouros hums gently to an infant in the NICU to help the baby remain calm during a daily checkup. Photo by Jacob Granneman

“We follow the infant, and what the infant’s cues are, so everything is infant directed,” Bakouros said. “Their vitals are actually more stable in the exam when there is music therapy provided, and then if they start to cry I match them in their cry and then bring it down and they would follow me.”  

The study is the first to ever look into the scenario, and will hopefully be followed by another study looking at nurses’ perceived stress and anxiety during similar procedures with and without music therapy, Bakouros said. 

Funding for the music therapy program is generated by the PeaceHealth Southwest Medical Center Foundation, which is donor driven. Additional funding also comes through a partnership with Union High School.

Each year the school hosts a Mr. Union Pageant, from which all money raised goes to PeaceHealth’s NICU. In the past, the students have raised enough funds to purchase new eye exam cameras for neonates, as well as upgrade the entire family room within the NICU.

The music therapy program is expected to expand into other areas of the hospital, including pediatrics, hospice, oncology, and potentially the emergency room.

The PeaceHealth Holtzman Twins Special Care Nursery and NICU operates 24/7 and is funded through donations to the PeaceHealth Southwest Medical Center Foundation. Photo by Jacob Granneman

The PeaceHealth Holtzman Twins Special Care Nursery and NICU operates 24/7 and is funded through donations to the PeaceHealth Southwest Medical Center Foundation. Photo by Jacob Granneman

“Here in the NICU we’re really teaching parents how to start their journey with their infant through music,” Bakouros said. “It’s really special to be able to have this program, and I think that it makes our hospital really special too.”  

PeaceHealth’s Special Care Nursery and NICU were originally made possible through contributions from David and Patricia Nierenberg. If you would like to partner with the program or contribute to PeaceHealth’s NICU you can contact the foundation through their website.

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