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EDITORIAL
DOI:10.1111/apa.12766
Maternal singing for preterm infants during kangaroo care comforts both
the mother and baby
Preterm birth is a major health problem worldwide. Major
advances have been made in neonatal intensive care over
the last few decades, resulting in increased survival rates of
preterm infants and a reduction in major neuromotor
impairments. However, there is now a greater awareness
of the high risk of adverse brain development among
children who are born very immature, together with the
subsequent cognitive and behavioural problems. In particular, children who are born extremely preterm have
language delay and abnormal auditory event related potentials (1). One of the factors that may contribute to the risk of
adverse brain development in preterm infants is maternal
separation while they are in the neonatal intensive care
unit.
The contact between the mother and her offspring is
essential for all mammals. Research in rodents has shown
that early maternal contact, which takes the form of sensory
stimulation through licking behaviour, has an impact on the
infants brain systems, enabling them to manage stress and
enhance their social adaptation mechanisms include fine
tuning of the hypothalamuspituitaryadrenal axis and
epigenetic modifications (2). On the other hand, prolonged
physical separation between mothers and infants exerts
lifelong negative effects on the offspring and is also known
to cause maternal stress, anxiety and depression (3).
Kangaroo care was developed in Bogota, Columbia, to
enable preterm infants to maintain body temperature
through skin-to-skin contact with the parents body (4)
and in the last few decades, it has been introduced to many
neonatal units worldwide. The technique has been associated with better autonomic functioning, sleep, reduced pain
response, improved motherinfant interaction and maternal
mood in early infancy, as reviewed by Flacking et al. (5).
Studies on the long-lasting effects on children0 s brain
development are scarce, but a recent report indicated that
10-year-old children who were born preterm and received
kangaroo care during the neonatal period showed attenuated stress responses and better sleep and executive function (6).
The mothers voice provides another important source of
sensory stimulation for the foetus and child. For example,
quail chicks that were not allowed to hear their mothers
call during late prenatal development, because of other
noise, did not recognise their mothers voice when they
hatched. Similarly, the preterm infant who is cared for in a
neonatal intensive care unit, and is often exposed to
elevated sound levels, loses significant contact with his or
her mothers voice. It has been suggested that disrupting
2014 Foundation Acta Pdiatrica. Published by John Wiley & Sons Ltd 2014 103, pp. 995996
995
Editorial
Editorial
996
Ulrika
Aden (ulrika.aden@ki.se)
Department of Woman and Child Health, Neonatology
Unit, Karolinska Institutet, Stockholm, Sweden
References
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2014 Foundation Acta Pdiatrica. Published by John Wiley & Sons Ltd 2014 103, pp. 995996