Working with premature babies and their parents at Gloucester Hospital

The Early Start - Music by Heart programme aims to help parents bond with their babies through music, and will continue that work with those babies who go on to Early Start Baby Groups.

This project from GlosMM is currently about halfway through, but has already received very positive feedback from familes and medical staff, has led to playing to comfort babies during procedures, has suggested extensions to the existing body of peer-reviewed knowledge, and is prompting us to think about the wider question of embedding music in neonatal areas in the NHS.

Starting such a project is a gentle process - and involves two different professions (musical and medical) working in close collaboration. We are hugely grateful to Gloucester Hospital, and in particular the Neonatal Nursing team, for their positive response to our inital approach, to Opus music for their excellent "Music in Healthcare" practical workshop, and to nurses, consultants and parents for their feedback and ideas.

As well as playing gentle, traditional tunes, Mark has also been writing original music based on the babies' names. His visits are advertised on posters from which parents can also access a project website via a QR code and hear examples of the music. This really helps in gaining acceptance of the work for those who may not have had a live musician play for them. In addition, we have a simple project book that anyone (Mark, the consultants and nurses, the parents) can write in. This has been superb at suggesting other ideas, such as invitations to play for procedures.

While we have not so far been looking to clinical measures of outcomes of using music, we have read some fifty recent papers on various aspects of music in neonatal - from clinical effects, to the impact on staff, parents and the musicians themselves, and on the expectations that these various groups might have around music. We have also done some research ourselves, for example in finding out just what the acoustic is like inside an incubator (it allows music through in a very gentle way while cutting down the noise in the room). You can see our journey (complete with "baby steps"!) in the presentation below, which also includes some audio from our incubator experiment, some feedback on the Gloucester NHS trust Facebook site, and some questions which we are still exploring at this stage of this project.

To see more details about what we believe are the important aspects of this emerging work, you can see a fuller report on Mark's blog page at http://www.yourmusic.biz/?p=184

This programme is funded by Youth Music and administered and supported by  GlosMM at http://glosmm.org.uk/

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Comments

Valerie's picture

Thank you so much for sharing this with us Mark! The project sounds amazing and it obviously makes such a difference to the families.
It is particularly exciting to read how you have been able to work closely with medical professionals at the hospital, and how this has informed the project further.
The Prezi demonstrates this project really well. One of the slides notes ‘Complex relationships (staff/ parents/ patients)’ – would you be able to explain what you mean by this a bit more? I assume this refers to the necessity of getting everyone on board, but it would be really interesting to hear more about these complexities and what you have done to work with them.
Also, have you seen the Early Years Group? Maybe you would like to join: http://network.youthmusic.org.uk/groups/early-years-music-making

We could post your blog on there as well. If you have any questions about the group please let me know. Thanks again!

Mark Harmer's picture

Hi Valerie,

Thanks so much for your positive reaction! There's a lot more we could have said but the Prezi is quite a fun way to show our journey to date. The baby steps continue as we move into the latter half of the project!

Relationships are at the heart of this project: it aims / is funded to promote better relationships between the parents and these vulnerable babies. We thought long and hard about this focus on relationships - because the baby is the focus of the medical care, and yet it is the baby's relationships with his or her parent that will support the baby in the longer term. Hence rather than just focussing on babies, we are where possible playing for parents as they hold or look at their babies, and subtly offering ideas for them to connect through music. Communicating (speaking / vocalising / humming) can really help and we offer gentle encouragement and permission to do that. We are mindful of our own relationship with the parents: the fact that parents are there at all means they are likely to be under stress. I am gentle in my approach and will play in a corner of the ward first, which allows people to decide whether they'd like me to come over and play for them - essentially we translate medical ethics (informed choice) into musical ones.

The doctors, nurses and consultants are there to do a job, so there's also a relationship between music and the clinical environment. For the staff, objective measures such as heartrate and oxygen saturation are at least part of how they judge the progress of a baby, whereas music by contrast can seem like a different world. But musicians bring their own expertise - in terms of sound, rhythm, and structure - and I think in this almost constantly active place, the repetitions, rhythms and harmonies of music give these babies a sense of comfort and familiarity. The consultants were interested enough in the relaxing qualities of live music that they have asked us to play for procedures, and we have been offered some clinical data to see what the effect of the music might be. It could be that by putting numbers on the effect of music, there might be a case to support longer-term use of live music in the Neonatal areas.

The hospital element of this project also relates to followup work we will be doing in Early Start baby groups with some of these same parents, and the music which I create in the hospital will be used there as well as being available on CD / web to any parent. Indeed, the work came about thanks to contact with older children who have special needs and a conversation about premature babies.

Aside from any clinical measures, live music clearly changes the atmosphere in a hospital; just as playing there has made me more responsive to other environments I play in, equally the doctors and nurses respond to the music and are quieter, and the pace becomes gentler. I see more smiles and people walking past in the corridors stop to listen. I have found that people are even occasionally singing the familiar music, such as "Scarborough Fair" and "My Bonnie Lies over the Ocean". I played the latter one day in intensive care, and heard some distant humming, which turned out to be a mother on the far side of the ward with her hands through the two side portholes of the incubator, resting her hands on her baby and humming quietly to him. I moved the harp nearer and a nurse joined her on the other side of the incubator and put her hands through the opposite holes, and between them produced some lovely harmonies. And to answer your question about complex relationships, maybe we're simplifying them. I really love it when the nurses and doctors sing gently. It's in those moments that I think there's a real human connection going on amongst all the equipment, where the room is filled with gentle music.

Sarah Flute's picture

This project is so brilliant. Many parents- stressed or not- have forgotten (or never learned) these lovely melodies that are so soothing to babies and small children, or doubt their ability to sing them, so to have the harp there to encourage them is fantastic.
With music everything becomes easier - we know this as adults when we turn the radio on - so for babies it must be better than this horrid world of beeps and flashing lights and strange smells .
I live just 10 mins away so I shall imagine you there Mark, with your harp, helping all these people big and very small, have much better outcomes to their days.