Music project within the neonatology department of the
Saint-Denis hospital center

    The Saint Denis neonatal resuscitation service is part of the mother-child centre. It is located within the hospital's maternity ward, which is a level III maternity ward, welcoming women with complex pathologies and at high risk of premature delivery. The maternity unit has more than 4,500 births per year.
    During 2017, we welcomed more than 470 children with various pathologies.
The department has 10 resuscitation beds, 12 intensive care beds, 5 neonatology beds and 1 mother/child room. Within the diaper suite service, we can also find a mother-child unit, called "  Kangaroo Unit  ".
    The newborns that we welcome in the service can remain hospitalized for several months. To date, to awaken these children we only have radio sets and a few early learning games, offered free of charge by volunteers.
    The objective of our project is to make the hospitalization of these children growing up in our service as less traumatic as possible. Music, the harmony of sounds, are a very interesting approach for these children, who develop in a sound environment made up of alarms of all kinds.
Besides the shock that parents can suffer when their child is born much too early, speaking, telling, singing, is often very difficult for them. The entry into our service, although we wish it and organize it benevolently, remains very impressive. Many professionals gravitate around children. The machines allowing them to pass this difficult course and to live, create a very impressive environment for the parents and in the state, appropriating their place of father and mother in this anxiety-provoking context, is not easy.
    It therefore seemed to us to be our responsibility and above all necessary to be able to make the first days, the first weeks, even quite often the first months of these children born too early, as welcoming as possible their arrival in our world. Trying to reduce the aggression of this different birth, that's what drives us. We hope through the reception of musicians in the service to alleviate the heaviness of hospitalization. Use music as a mediator to allow parents to discover their child other than through the "  care  ". Awaken children to a sound environment other than that of machines. Use the skills of the musicians so that they adapt to the needs of each child. This is it.
    1st point  : what is already done  : a small idea of the project
For ten months, a trainee in music therapy worked within the department. She was able to integrate into the team and over time, the nursing staff called on her to accompany painful or non-painful care.
    The music therapist has thus accompanied several premature babies from the intensive care unit, when they were only 26 weeks old for the smallest.
    The feedback from these few months is very positive. The introduction of music within the service, twice a week, was carried out gradually, gaining the confidence of the medical and paramedical team.
    The presence of the trainee music therapist in the resuscitation unit has always been made at the request of the medical or paramedical team.

 

His evolution in the intensive care unit and especially neonatology was more free. Throughout the hospitalization, the parents asked for the presence of "  the lady who sings and has the little iron piano  »
    2nd point  : a first adaptation to the particular conditions of the hospital.
    Although we work in a philosophy of care that aims to be the least traumatic possible, the stay in intensive care can be very painful for children who are surrounded by technology. The daily presence of a music therapist within the service is not currently considered in the budget.
    The project with the association 'Interlude' was born in 2017. At first the musicians of the association performed concerts in order to raise funds.
The entry of trained musicians into the intensive care unit being particularly complex given the cramped architecture and hygiene requirements, a different approach was considered. We are planning the production of a music disc particularly suitable for newborns, entitled "  Welcome to music  ".
    This disc is intended to be discovered by the child and his family within the service. This CD will be specific to him and the parents can take it with them when the child is transferred or when he returns home. This music, discovered during the hospitalization, will thus make a link, a sound transition,  who will accompany the child and his parents who will be able to make him listen again whenever necessary.
    3rd point  :
    The parents are not always present when the stays of their newborn must imperatively be extended in the service. From this observation and to try to recreate the familiar sound environment of the newborn, we will record the voice of his mother, his father and the family (siblings, grandparents).
    At this stage we will make recordings with the parents, of their spoken or sung voice. That's why these recordings will be so valuable. They will allow caregivers, in the absence of the parents, to be able to recreate for the child a familiar, known, reassuring sound environment.
    These recordings will be made by the musicians, made aware of the specificity of our service, in order to guide the parents around songs of their choice and free texts for their child.
    The involvement of the siblings for these recordings has a double interest, namely  : remind the hospitalized newborn of the voices he could hear in his mother's womb, but also for the big brothers/sisters, to feel involved in a relationship and a contact that they can achieve themselves to time to share with their little brother or sister.
    4th stitch  :
    The benefits of music within the service have been observed. Being able to personalize the sounds, the whispers, the songs according to the children and their experience remains our objective. The presence of a music therapist and/or trained musicians several afternoons a week to accompany the children and their parents is therefore the final objective. This presence which allows a dynamic musical adjustment which helps the mother, in the phase of the first early interactions with her premature child, to enter into a proto conversation  : the first step towards verbal communication.
    This project finds its place in a 'movement' for and towards the very young child. It is not set in stone and can be improved with the contributions of the parents already, but also those of all the professionals concerned, whatever their direct or indirect function in the care.

Elsa Viguier
Child health framework (GHT Plaine de France, CH St Denis-Neonatal intensive care unit)