A survey of how mothers think about and use voice with their hospitalized newborn infant

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Abstract

Short-term family-centered early intervention enhances a mother's capacity for attuned interaction with her hospitalized newborn infant which in turn impacts positively on infant neurodevelopment. This study determined the acceptability of a focus on mothers' own voices to support their hospitalized infant.

Sixty mothers of newborn surgical inpatient infants were surveyed about spontaneous vocal behavior in the NICU. Questions included age, education and first experience of parenting, contextualization of voice use relative to other nurturing behaviors, and mother's capacity to imagine or think of a reason for singing to her infant.

Sixty percent of mothers sang spontaneously in the NICU. There was strong evidence for an association (p < 0.001) between imagining singing or thinking of a reason for singing, and actually singing. There was no evidence for an association between mothers' spontaneous voice use and their age, education or experience of parenting, and musical heritage. Barriers to singing included being too embarrassed or feeling too obvious in the NICU environment.

The snapshot of mothers' beliefs, thoughts and action in using their voices is valuable in creating an efficient family empowerment model.

Introduction

Compromised neurodevelopmental outcomes for medically complex newborn infants have lead to the call for early intervention before discharge from hospital (Laing et al., 2010). Only a few studies report the family interaction with hospitalized infants other than preterm and most are within the American medical system (Brown and Talmi, 2005). Prior to an intervention study, feasibility research about the pre-existing attributes and capacities of the parents with hospitalized infants can provide culturally pertinent evidence to inform that research protocol (Bowen et al., 2009). This study presents the pre-existing attitudes and behaviors of Australian mothers in using their voice to support their hospitalized newborn full-term infants. It was the first in a series of feasibility studies to test approachability, acceptability and viability of a maternal education protocol to promote attuned interaction between mothers and their hospitalized full-term or older infants.

Section snippets

Background

Attuned interaction between mother and infant is the dynamic experience necessary for infant learning, socialization and psychological well-being (Weber et al., 2012). An Australian study of newborn surgical patients and their mothers found that the quality of mother–child interaction is compromised in children with major birth defects requiring newborn surgery (Laing et al., 2010). They recommended that early intervention should address “the lack of individualization of treatment to the

Methods

The sample of 60 participants (Burgess, 2001) was drawn from the NICU at The Royal Children's Hospital Melbourne; a non-perinatal NICU where all infants are transferred in for management of surgical or complex medical problems. Ethics approval was granted by the Institutional Review Board (HREC31068A). Mothers were eligible when their infants had been socially available for three days (i.e., no sedative medication). Eligibility was confirmed by the medical consultant-on-duty or nurse care

Results

The mean age of participants was 31.8 years (SD 5.74) (range 20–44 years). Fifty seven percent (n = 34) had completed up to year 12 high school or a community college course, while 43% (n = 26) of participants had a Bachelor's (27%) or higher degree (16%). Fifty three percent reported this to be their first experience of parenting.

All 60 participants talked to their baby, with a high proportion also whispering (96%) and using little phrases (83%), and a small proportion reading (20%) or using

Discussion

This study sought to understand the beliefs, thoughts and actions of mothers with regard to their use of voice with their infants in NICU. Findings have demonstrated that singing is an acceptable experience for this Australian cohort, with age, education and experience of parenting not providing any barriers.

In a study of hospitalized newborn infants (N = 39) Malloch et al. (2012) found that infants who were sung to by a skilled music therapist showed a significantly higher overall score at

Conclusion

The survey of mothers' spontaneous experience provides a snapshot of their beliefs, thoughts and action in using their voice, particularly singing to their medically fragile newborn infants. This information is important in translating a strategy from a therapist delivered service to a family empowerment model. It may be used to tailor the components of content-specific education and active demonstration and participation protocols needed for mothers to productively engage their infants in

Funding source

This research project was supported by the Victorian Government's Operational Infrastructure Support Program and a grant from the Murdoch Childrens Research Institute Clinical Sciences Seeding Grant Program.

Conflict of interest

The authors have no financial, consultant, institutional or other conflicts of interest to disclose.

Acknowledgements

The authors thank Dr Carol Newnham and Dr M. Kathleen Philbin for their comments on the design of this study.

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