Premature infants, born before the 37th week of gestation, face a range of developmental challenges. These challenges can include difficulties with attention, emotional regulation, and cognitive functioning. In response, a team of scientists at Geneva University Hospitals (HUG) has been investigating a surprising yet promising solution—music. Through over a decade of research, scientists have observed that music can play a crucial role in fostering brain development in premature infants. Now, thanks to their continued efforts, these researchers are uncovering deeper insights into how and why certain melodies seem to boost brain connectivity in preterm infants.
Premature Birth and Developmental Challenges
Babies born prematurely often have underdeveloped brains, particularly in areas related to emotional processing, sensory recognition, and attention. These regions are responsible for fundamental cognitive functions such as recognizing and responding to stimuli, making emotional connections, and interpreting the world. Without proper development of these neural networks, preterm infants are more susceptible to long-term issues, including attention disorders, challenges with emotional regulation, and even learning disabilities that can persist well into adulthood.
As part of their extensive work to identify effective interventions for preterm infants, a team led by Petra Hüppi, head of the research program at HUG, began investigating the role that music could play in improving outcomes for these vulnerable babies. They discovered that specific melodies could promote neural connectivity, enhancing the development of the very brain regions often delayed or deficient in preterm babies.
The Study and Methodology
For the past several years, Hüppi and her team have been conducting studies on premature infants, focusing on how music exposure influences brain development over time. Their most recent study, published in the journal Imaging Neuroscience, reveals some of the most significant findings to date. In this study, researchers exposed premature infants—born at an average of 29 weeks of gestation—to music in a controlled environment. The study involved 60 preterm babies, half of whom received music exposure, while the other half served as a control group, not exposed to any music. These infants were monitored over an extended period, with the key focus being on the effects of music on cerebral connectivity.
The researchers used MRI scans to track the brain development of these infants. Results showed improvements beginning at around 33 weeks of gestation, highlighting the positive impact of music on neural connections. Specifically, the team observed enhanced connectivity in the “salience network”, which plays a central role in emotional regulation, attention, and identifying the significance of stimuli such as sounds or faces. These areas of the brain are critical in forming connections between the sensory world and the brain’s emotional and cognitive centers.
The Salience Network: Key to Emotional and Sensory Processing
The salience network is a brain circuit involved in detecting and processing stimuli that may be important for emotional or cognitive responses. It helps humans to filter out irrelevant information while focusing on sounds, sights, or sensations that are either critical for survival (like hearing a sudden loud sound) or important for social connections (such as recognizing a familiar voice). For preterm infants, the development of this network is often delayed, and reduced connectivity can persist into later life, contributing to difficulties with emotional regulation and attention.
Research conducted by Hüppi’s team focused on specific regions of the brain tied to this network: the insular cortex and the anterior cingulate cortex. These areas are particularly important in how individuals process emotional significance—associating comforting sounds, like a mother’s voice, with feelings of safety and well-being, or recognizing distressing sounds, like alarms, as signals for alertness or fear. In preterm infants, this process is impaired due to underdevelopment of these regions.
One of the central findings of the study was the fact that music exposure positively affected these critical brain regions, promoting more robust development in the infants’ salience network. This suggests that music—rather than just being a simple distraction—might be serving as a tool for stimulating the brain to form vital connections that would otherwise be lacking.
Personalized Music Therapy: Not Just Any Sound Will Do
The team’s findings highlight the importance of not just “adding noise” to the neonatal intensive care unit (NICU). Given that the NICU is already full of alarms, beeping machines, and constant activity, simply playing a piece of music like Mozart would not be an effective method of brain stimulation. In fact, exposure to too much chaotic sound could even prove detrimental.
Instead, the scientists carefully selected specific musical compositions designed to align with the infants’ natural sleep-wake cycles. The music was played through headphones directly to each infant during periods of transition—moments when the baby was waking up or falling asleep. This gentle timing helped to support brain development during some of the most critical moments for neuronal activity.
To make the experience as effective as possible, the team collaborated with Andreas Vollenweider, a well-known composer from Zurich. Vollenweider crafted unique musical compositions designed to reflect the newborns’ daily rhythm with intervals of soothing, recognizable melodies. The music wasn’t meant to just be calming—it was strategically designed to be a stimulus that the infants could begin to recognize and even associate with emotional comfort, fostering the development of cognitive connections.
First Cohort’s Follow-Up: Is Music Therapy Sustainable Long-Term?
While the study demonstrated that music can boost brain connectivity in premature infants, the team is also investigating the long-term effectiveness of this approach. Music exposure led to marked improvements in brain function from 33 weeks of gestational age, but it’s still unclear whether these effects persist into later childhood. The initial cohort of infants born in 2016—approximately 20 children—are now 8 years old. For the first time, researchers are conducting follow-up studies using MRI scans, and additional cognitive and behavioral tests are being performed to gauge how well these children are progressing.
Though initial results are promising, Hüppi and her colleagues are cautious. They emphasize the slow and challenging nature of follow-up studies, particularly given the need to monitor a very young, developing population over several years. But researchers are optimistic, as the first cohort is beginning to offer invaluable insights into how music could influence a child’s developmental trajectory from infancy through childhood.
The Promise of Music in NICU Care
If the findings from the initial studies are substantiated over time, music may soon become a widespread therapeutic tool in neonatal care. The researchers hope that, in the future, musical therapy could be standardized and seamlessly integrated into neonatal intensive care units (NICUs) across the globe. Integrating this practice could provide an additional means of supporting brain development during the most vulnerable stages of life.
One of the challenges the research team faces is the practicality of individualizing music therapy in a clinical setting. Having staff members manually provide music to infants during the correct sleep-wake cycles is not feasible on a large scale. To address this, Hüppi is working in collaboration with EPFL laboratories in Lausanne to develop a way to automate the process using artificial intelligence (AI). The goal is to create a system that can automatically detect when each baby is transitioning between sleep and wakefulness—using parameters such as heart rate changes, movement, and facial features—and play the appropriate music at just the right moment.
By using AI technology, researchers aim to offer a personalized experience for each infant without relying on the hands-on involvement of staff members. This would ensure that every preterm infant, regardless of the NICU setting, could benefit from music exposure and the resulting brain development support.
Conclusion
Music’s potential to support premature infants’ cognitive and emotional development represents an exciting breakthrough in neonatal care. By improving connectivity in critical brain areas and fostering the growth of neural circuits, music may help to mitigate the developmental challenges faced by preterm infants, reducing the likelihood of attention deficits and emotional regulation issues in later life.
While research on this subject is still ongoing, the preliminary findings are compelling. The integration of personalized music therapy into NICU care could one day become the standard of care for preterm infants worldwide, offering them the best possible start in life—an opportunity to grow and thrive in ways that would have once seemed unimaginable. Through this groundbreaking research, music has proven itself to be more than just sound—it’s a potential lifeline for the brains of premature infants.
Reference: Annemijn Van Der Veek et al, Longitudinal functional brain connectivity maturation in premature newborn infants: Modulatory influence of early music enrichment, Imaging Neuroscience (2024). DOI: 10.1162/imag_a_00373