Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Effects of standardized acoustic stimulation in premature infants: a randomized controlled trial



The objective of this study was to investigate the effects of recorded lullabies and taped maternal voice in premature infants.

Study design:

Sixty-two preterm infants in a stable condition with 30<37 weeks of gestation and <10 days of postnatal age were randomly assigned to hear (A) recorded lullabies or (B) taped maternal voice for 30 min each evening during 14 consecutive days or (C) receive no standardized acoustic stimulation (control group). Heart rate and respiratory rate were recorded daily before, during and after the intervention (A and B) or a comparable period with no intervention (C), whereas activity was measured on days 1, 7 and 14 of the intervention using accelerometers.


Both interventions led to a significant decrease in heart rate and respiratory rate during and after the stimulation when compared with the control group. The changes were more pronounced in infants with higher gestational ages (P=0.001). Lower activity was measured during the intervention when compared with the control group (P<0.01).


Standardized acoustic stimulation with recorded lullabies and taped maternal voice led to a decrease in heart rate and respiratory rate, and was associated with lower activity. Whether this indicates a reduced stress reaction needs to be investigated in further studies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5

Similar content being viewed by others


  1. Guimaraes H, Oliveira AM, Spratley J, Mateus M, d'Orey C, Coelho JL et al. The noise in neonatal intensive care units. Arch Pediatr 1996; 311: 1065–1068.

    Article  Google Scholar 

  2. Lasky RE, Williams AL . Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit. Pediatrics 2009; 1232: 540–546.

    Article  Google Scholar 

  3. Blackburn S . Environmental impact of the NICU on developmental outcomes. J Pediatr Nurs 1998; 135: 279–289.

    Article  Google Scholar 

  4. Zahr LK, Balian S . Responses of premature infants to routine nursing interventions and noise in the NICU. Nurs Res 1995; 443: 179–185.

    Google Scholar 

  5. Jobe AH . A risk of sensory deprivation in the neonatal intensive care unit. J Pediatr 2014; 1646: 1265–1267.

    Article  Google Scholar 

  6. Caskey M, Stephens B, Tucker R, Vohr B . Importance of parent talk on the development of preterm infant vocalizations. Pediatrics 2011; 1285: 910–916.

    Article  Google Scholar 

  7. Ullal-Gupta S, Vanden Bosch der Nederlanden CM, Tichko P, Lahav A, Hannon EE . Linking prenatal experience to the emerging musical mind. Front Syst Neurosci 2013; 7: 48.

    Article  Google Scholar 

  8. Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr 2014; 1641: 52–60.e2.

    Article  Google Scholar 

  9. Cassidy. Presentation of aural stimuli to newborns and premature infants: an audiological perspective. J Music Ther 1999; 352: 70–87.

    Google Scholar 

  10. Amini E, Rafiei P, Zarei K, Gohari M, Hamidi M . Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial. J Neonatal Perinatal Med 2013; 64: 295–301.

    Google Scholar 

  11. Chorna OD, Slaughter JC, Wang L, Stark AR, Maitre NL . A pacifier-activated music player with mother’s voice improves oral feeding in preterm infants. Pediatrics 2014; 1333: 462–468.

    Article  Google Scholar 

  12. Loewy J, Stewart K, Dassler A, Telsey A, Homel P . The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics 2013; 1315: 902–918.

    Article  Google Scholar 

  13. Arnon S, Shapsa A, Forman L, Regev R, Bauer S, Litmanovitz I et al. Live music is beneficial to preterm infants in the neonatal intensive care unit environment. Birth 2006; 332: 131–136.

    Article  Google Scholar 

  14. Kemper KJ, Hamilton C . Live harp music reduces activity and increases weight gain in stable premature infants. J Altern Complement Med 2008; 1410: 1185–1186.

    Article  Google Scholar 

  15. Malloy GB . The relationship between maternal and musical auditory stimulation and the developmental behavior of premature infants. Birth Defects Orig Artic Ser 1979; 157: 81–98.

    Google Scholar 

  16. Alipour Z, Eskandari N, Ahmari Tehran H, Eshagh Hossaini SK, Sangi S . Effects of music on physiological and behavioral responses of premature infants: a randomized controlled trial. Complement Ther Clin Pract 2013; 193: 128–132.

    Article  Google Scholar 

  17. Graven SN . Sound and the developing infant in the NICU: conclusions and recommendations for care. J Perinatol 2000; 208 (Pt 2): 88–93.

    Article  Google Scholar 

  18. Standley JM, Moore RS . Therapeutic effects of music and mother’s voice on premature infants. Pediatr Nurs 1995; 216: 509–512.

    Google Scholar 

  19. Johnston CC, Filion F, Campbell-Yeo M, Goulet C, Bell L, McNaughton K et al. Enhanced kangaroo mother care for heel lance in preterm neonates: a crossover trial. J Perinatol 2009; 291: 51–56.

    Article  Google Scholar 

  20. Krueger C . Exposure to maternal voice in preterm infants: a review. Adv Neonatal Care 2010; 101: 13–18.

    Article  Google Scholar 

  21. Doheny L, Hurwitz S, Insoft R, Ringer S, Lahav A . Exposure to biological maternal sounds improves cardiorespiratory regulation in extremely preterm infants. J Matern Fetal Neonatal Med 2012; 259: 1591–1594.

    Article  Google Scholar 

  22. Bowden V, Greenberg C, Donaldson N . Developmental care of the newborn. Online J Clin Innovat 2000; 157: 1–77.

    Google Scholar 

  23. Standley JM . The effect of music and multimodal stimulation on responses of premature infants in neonatal intensive care. Pediatr Nurs 1998; 246: 532–538.

    Google Scholar 

  24. Keidar HR, Mandel D, Mimouni FB, Lubetzky R . Bach music in preterm infants: no ‘Mozart effect’ on resting energy expenditure. J Perinatol 2014; 342: 153–155.

    Article  Google Scholar 

  25. Philbin MK, Klaas P . Hearing and behavioral responses to sound in full-term newborns. J Perinatol 2000; Pt 2: 68–76.

    Article  Google Scholar 

Download references


We thank the parents for allowing us to include their preterm infants. We also thank Marc Hirdes and the nurses for their help, and KIM e.V., Marburg, Germany, for financial support.

Author information

Authors and Affiliations


Corresponding author

Correspondence to L Wirth.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wirth, L., Dorn, F., Wege, M. et al. Effects of standardized acoustic stimulation in premature infants: a randomized controlled trial. J Perinatol 36, 486–492 (2016).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links