This is a project to encourage mothers to bond with their babies through shared music in the Neonatal Unit at Gloucester Hospital, UK

What has made this effective?

• Playing without a written score: focus of attention is on the audience, the environment and our relationships; focus on the dynamics of the room, response, baby movement; music as embodied rather than performing a piece; being able to converse and play simultaneously;
• Exploring the technical aspects of playing an instrument: Choosing a key that doesn’t clash with monitors (multiples of 500Hz, between Bb and B); the right volume not to alarm babies; the right register not to interfere with clinical conversations; measuring spacial / stereo / phase / binaural effects of a large instrument including how it sounds in an incubator; making ad-hoc ipod recordings of the music in the hospital, to help get the music at the same pace when recording at home;
• Ethical, careful approach: Resisting early publicity; gently easing into the project; finding out information at the right time; gaining experience with Opus and with other musicians in the Derby Children’s hospital; having staff with us in the initial visits; translating medical ethics into musical ones (informed choice, dignity, non-malfeasance);
• Extending the research: extensive reading of published research; developing aspects that weren’t fully researched (eg lowering of heartrate more than 30 mins after hearing live music / the importance or not of time of day in a hospital); being aware of work on the clinical effects of music, the effects on staff, the effects on parents and on the musician, and from all these groups, the assumptions / anticipations around music;
• Working in a time-based medium: noticing and responding, moment-to-moment, to the environment and audience; potential for new research around how babies gain a sense of time in an otherwise temporally undifferentiated environment;
• The impact of our presence: being there could be a statement that we value the parents; having a book which anyone (parents / nurses / consultants / us) can comment in; the impact of the music in the room and beyond, and the further recorded work and followup work with parents in early start groups; freely offered photographs from the parents and the hospital press office; comments made to us as we play; facebook post on Glos NHS Trust facebook page;
• The impact on me as musician: informing the pace and gentleness of how I play; being more responsive to the environment; creating new compositions and making them available through recordings and website; refreshing a previous idea (nametunes); recognising the professionalism of the medical staff as something that frees me from feeling emotionally involved in the babies’ progress;
• Focus on social impact: focussing on the relationships at a very testing time for parents; addressing spiritual needs of parents; encouraging medical staff to notice, enjoy and even sing / hum the music;
• Recognising clinical impact: not therapy, but helpful to people; inviting positive relationships between doctors / parents / hospital; being asked to play for procedures;
• Quality observation: project leader (Alison) has often been there to take notes during my visits; the value of an observer who might be elsewhere in the room (musical value) or hearing things I can’t (for example, difficult conversations which may happen outside the ward); my own notes written in retrospect; comments in project book; ad-hoc conversations in the ward; conversations with professional musicians / therapists around the world;
• Creating new musical audiences: creating music in places in which is not usual to people who may never have encountered a live musician; encouraging people to be musical with their babies (eg as part of Kangaroo care or more generally, after they leave the hospital);
• Challenging assumptions about music: that it’s performed from a score; inviting people to join in where they can; introducing positive qualities such as grace, kindness, time for people, stimulation; challenging the less-rigorous research such as “music making you smarter” or “Mozart is good for babies”; being willing to experiment with original music; recognising the way babies respond to a large instrument and low bass notes, and not the “tinkly” sounds people assume babies like; talking about the project to general and specialist audiences and getting a sense of where people are enthused.

Suggested new areas for clinical / musical research coming out of our experience in the NNU:

• the effect of music on patients beyond 30 mins after music finishes
• the effects of music on movement in premature babies
• the role of repetition in building a sense of time / anticipation in a temporally undifferentiated environment
• the role of measurement – including what / for what purpose – in a music project
• how best to initiate, manage, publicise and sustain a music project in a hospital
• the effect of music on hospital staff practices
• the role of music in hospitals (social / clinical / artistic)
• the role of infrasound and phase effects in live music and how babies perceive it at different ages
• how parents can be encouraged to play / sing / hum in a hospital (eg during Kangaroo care) – potentially including visual environment and other factors
• testing of babies’ responses to see how they respond to / anticipate musical phrases

ESMBH site (for parents)

And a question:

How can a musical project like this be made sustainable or even “of interest” to medical people when it’s so far outside the clinical processes of a hospital?