Noise in the NICU: How sound affects premature babies - Caregiver’s hand rests on premature baby in the NICU — Noise in the NICU: How sound affects premature babies
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Noise matters for a neurosupportive environment

We understand that premature babies are exposed to a variety of stress inducers within the neonatal unit, one of these could be noise. The challenge is then to protect the baby from excessive noise levels but also to allow opportunities for positive sound stimulation. This is a delicate balance.

So, when is too loud? What is noise and what is a healthy stimulus? How does this contribute to the neurosupportive environment that these preemies need? As Specialists in Acute Care, we've spoken with experts from around the world to cover all aspects of this topic. Learn more about sound, how noise impacts preemies and everyone in the NICU and what can be done to make the changes needed to improve the auditory environment and babies’ outcomes.

Discover what infants hear

If we can better understand sound, we can create a better sound environment for preemies. Discover our infographic to get an overview of decibels, perceived loudness, what infants hear in the incubator and the effects of loud noises on these infants.

Download complete infographic

Understand sound

Do you understand sound physically? Watch our video series with Prof. Dr. rer. nat. Juergen Tchorz and learn more about the feeling of a decibel, a-weighting, how sound moves through various mediums and what this means for infants.

Prof. Tchorz explains what sound is physically. He talks about the hearing threshold and what a decibel is. The goal is to better understand sound so we can create a better sound environment for preemies in the NICU.

Understanding Frequency & dB(A) – Prof. Tchorz

Prof. Tchorz explains the role frequency plays in sound and why the a-weighting scale is developed and used. So when we see dB and dB(A), we understand the difference. The goal is to better understand sound so we can create a better sound environment for preemies in the NICU.

Sound in Different Mediums – Prof. Tchorz

Prof. Tchorz explains how sound travels through different mediums or even more specifically what happens when sound travels from air to water or a solid. This is especially important when thinking of the natural environment in the womb compared to the environment in the NICU. The goal is to better understand sound so we can create a better sound environment for preemies in the NICU.

Prof. Tchorz explains how different decibel levels feel with some relatable examples. The goal is to better understand sound and more specifically decibel levels so we can create a better sound environment for preemies in the NICU.

Auditory Orientation & Language – Prof. Tchorz

Prof. Tchorz explains how sound influences our development when it comes to our orientation and language skills. This is especially important when we think about what the preemie is exposed to in the NICU. The goal is to better understand sound so we can create a better sound environment for preemies in the NICU.

Incorporate positive sounds

The NICU has evolved in the past 30 years. How are we thinking about noise now? How is noise affecting you and the parents in your unit? What about positive sound stimulation?

Listen to the expert Carole Kenner, PhD, RN and learn more:

Carole Kenner - Evolution of NICU Culture

Carole Kenner discusses how the NICU culture has evolved in the past 30 years. She remembers the first NICU she worked in and talks about how different the environment was then. She reminds us that developmental care practices are just as important as other therapies and training should also be focused in this area.

Carole Kenner - Noise Affects Staff and Parents Too

Carole Kenner talks about how staff and parents can be affected by a noisy NICU environment. She explains how it has affected her personally and how she has seen it affect parents.

Carole Kenner - Positive Sound Stimulation

Carole Kenner addresses sound stimulation and how different units around the world incorporate this topic into their daily practices. She reminds us that there are many ways to introduce sound stimuli but we always need to monitor the baby to see how she or she is responding to it as they are the best indicators for when it is working or not.

Reduce & monitor noise with the right NICU design

What are the 3 things you must consider when it comes to noise control and NICU design? Are you monitoring noise in your NICU? Where should we be monitoring?

Listen to the expert Dr. Robert White, MD and learn more:

NICU Design and Noise Control - Dr. White

Dr. Robert White talks about the three things you must consider when it comes to noise control and NICU design. As he and his team just realised a brand new unit in South Bend, he is able to discuss their thought process and the challenges they faced as well.

Dr. White - Monitoring Sound… in the Incubator Compartment

Are you monitoring noise in your NICU? Where should we be monitoring? Dr. White discusses the importance of monitoring and more specifically exactly where we should be monitoring to best care for the babies' sound environment.

Create a developmental friendly NICU

How do we know the infant is experiencing noise stress? How might this affect them later? Hear about some noise reduction best practices and how to get your hospital on board!

Listen to the expert Mary Coughlin, RN, MS, NNP and learn more:

Mary Coughlin - Noise and the developing brain

Mary Coughlin talks about brain development and how we know the infant is experiencing noise stress. She goes further to how might this stress could affect these infants later on in life.

Mary Coughlin - Noise Reduction - A Group Effort

Mary Coughlin talks about the importance of getting everyone on board before implementing a noise reduction program or any other developmental care focused program. Everyone from the person at the front desk to the nursing staff to the neonatologists to the management level needs to be on board to be successful.

Mary Coughlin - Noise Reduction - Belgium

Mary Coughlin talks about a best practice case in Belgium. Everything from their goals, how they implemented their program and their results. While it is only one example, and needs to be replicated, the results they were able to achieve just by starting with improving the auditory environment are worth a look.

Mary Coughlin Quiet Time Initiative - Atlanta

Mary Coughlin talks about a best practice case in Atlanta where they fully wired their unit to have around the clock sound monitoring and then implemented a quiet time initiative. This means they chose two time slots a day when they would dim the lights, avoid disturbing the infants with procedures, and speak in softer voices.

Are we monitoring noise where it really matters?

Premature babies are exposed to vastly different sound environments in the NICU compared to the womb. Andres Maturana, Head of the Neonatal Care Unit in Santiago de Chile, explains how we need to be more aware of what sounds the preemies are hearing. Are we monitoring noise where it really matters? He goes further to explain how some sounds, especially the mother's voice, positively influence the development of premature infants.

Clinical studies and reviews

Discover our downloadable literature list and articles for further reading on noise in the NICU.

Implementing sound solutions

Creating a sound environment

How can we protect these babies from negative noise? What can design and technology do? Whether you are designing a brand new NICU, renovating existing space or trying to utilise your space and equipment in a new way, careful consideration to noise is important. Here we will present ideas to improve the sound environment for your tiny patients.

By incorporating glass windows and doors, monitor visibility is increased and unwanted traffic can be minimised. When the option is available, select devices, everything from monitors to incubators to phototherapy equipment, featured with elements which push sound away from the infant compartment. Utilise sound absorbing material on room surfaces, like walls and ceilings. Incorporate the Sound Ear to raise awareness for caregivers and visitors. The Sound Ear can also be used as a tool to implement quality measure programs. Furthermore, using architectural systems to mount devices can make moving devices quieter and easier.

Proper utilisation of space can help improve patient outcomes, staff efficiency, and family satisfaction. Find a design that best fits your needs while still keeping noise in mind.

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Related products

Babyleo® TN500

With a typical operating noise level of 40 dB(A), the new Babyleo is quieter than conventional devices. A sensor measures and documents the sounds in the patient compartment and thereby heightens caregivers’ awareness of noise. MP3 players can be connected to provide positive stimulation.

Noise Display SoundEar®

Monitor and display background noise levels on your ward to support a comfortable healthy and healing environment for patients, staff and visitors.

Babylog® VN800

nCPAP and HFOV are widely used ventilation therapies. Babies can be on a ventilator for weeks and we need to think about what this means for their tiny ears. When we designed Babylog VN800 and BabyFlow plus, this was already taken into account.

BiliLux

The BiliLux phototherapy light has no fan which makes it practically soundless, measured at less than 20 dBA, during operation which makes it friendly for the babies’ neuro-development as well as for staff and parents.

BabyFlow® plus

The adjustable angle allows you to fit the prongs and masks properly on the patient, thus reducing leaks and providing more stable CPAP levels. More stable CPAP levels reduce noise levels, making BabyFlow plus a low noise level respiratory support system, therefore, supporting Developmental Care practices and offering the best possible therapy for tiny patients.