The Benefits of Reading to Your Baby in the NICU

Introduction

We all know the importance of reading to our children, but did you know that reading to your baby in the NICU is also extremely beneficial? In an infant’s brain, the language and speech areas grow exponentially in the first few months of life. Unfortunately, for many babies in the NICU, they may spend the first several of those formative months amongst the stressful NICU environment rather than in a quiet atmosphere at home. Infants born prematurely lose out on months of intrauterine language exposure that promotes normal development.

So how can we expose our NICU infants to oral language to promote positive neurodevelopmental outcomes, by reading out loud to our babies! NICU infants who have been read to aloud on a daily basis have shown enhanced language and literacy outcomes at 2 years of age. Plus, for us mothers, our babies know our voice the very best, and research has shown that babies become more alert when they hear their mother speaking, singing, or reading out loud. So, it’s time to pick up your favorite book and start reading to your little one in the NICU! Learn the multitude of benefits from reading to your NICU baby as well as tips to get started!

Interested in a FREE set of books?

To jumpstart a reading routine with your NICU baby, we are offering a FREE set of books! We strongly believe in the power of reading and want to ensure you have books to get started. Click below to be entered for a chance to win a set of FREE children’s books.

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Episode 25

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The importance of the mother’s voice

Do you read to your baby in the NICU? If not, what is stopping you? 

Before birth, the mother’s voice is the most important and calming sound an infant can listen to while their hearing is developing. The mother’s voice is the sound babies hear the best in utero. Research has shown that babies learn to recognize their mother’s voice from inside the womb, and show a strong preference for it over other voices. Isn’t that amazing!?! 

Auditory Fetal Development

To understand the importance of reading to your little one in the NICU regardless of how premature they are, I think it’s important to review some fetal development. The auditory network of your fetus began to emerge as early as 16 weeks gestation and their ears are close to reaching their final position. At 18 weeks, your fetus’ ears begin to stand out on the side of his or her head and they may be able to hear sounds like the mother’s heartbeat, breathing, and even digestion. Once your fetus reaches 20 weeks gestation, he or she may start to be awakened by noises. After 23 weeks, they will be able to make out the mother’s voice, significant other’s voice, and other sounds from outside the womb. The noises they hear from inside the mother’s body are muffled, but they can hear the mother’s voice more clearly than any others. By week 25, the fetus is thought to be able to respond to familiar sounds, such as the mother’s voice. Around 26 weeks gestation, your fetus may begin to respond to the sounds they hear with autonomic responses including changes in their heart rate, rate of breathing, and movements including a startle reflex in response to loud noises. By 28-30 weeks, the necessary neural connections to recognize and react to language, music, and meaningful sounds are well-functioning. Your baby’s ears continue to form and develop up through 35 weeks gestation. 

Language and speech development

The language exposure in utero is linked to normal development of auditory processing, speech, and reading. But infants born prematurely are deprived of the normal intrauterine auditory exposure they would have experienced in the latter weeks of the pregnancy. Infants have a large amount of exponential growth in the language and speech areas of the brain in the first few months after birth. Unfortunately, for many infants in the NICU, these impressionable months are spent with a large amount of exposure to non-verbal, loud noises. Since NICU infants have minimal opportunities to experience meaningful speech sounds, it can negatively alter their brain structure therefore accounting for some of the common neurodevelopmental deficits. 

Potential neurodevelopmental delays

We also know that infants who spend time in the NICU, especially those born prematurely, are at an increased risk for neurodevelopmental delays which may adversely affect their future performance in school and throughout life. For preterm infants, language and reading delays are the most common neurodevelopmental deficits.

Now that our son has started to read in school, I can personally tell you that it has not come easy to him. He is such a hard worker and we continue to work with him consistently, but as you may know, some of the developmental delays in preterm infants do not become very apparent or are not as noticeable until the school-age years.

One of the ways parents and members of the NICU staff can enrich exposure to oral language for infants in the NICU is by reading aloud to them. Reading out loud to infants has been shown to minimize deficits and improve language and literacy outcomes especially when reading out loud is provided at an early age and frequently. 

Can your premature infant really hear your voice?

With all of that being said, it makes sense that infants born as early as 23 weeks gestation can hear all of the noises in their environment, but they especially recognize the mother’s voice and that of their significant other. Reading to your baby is one of the most beneficial things you can do for your baby’s growth and development. Research has shown that infants who are exposed regularly to language and their parent’s voice in the NICU experience enhanced brain plasticity and have higher language and cognitive scores at the age of 2. Once babies hear language and/or words, hundreds of their brain cells connect and it helps to set up brain pathways for future learning. Is that not just incredible?!?

Why is reading so important in the NICU?

With the loud environment NICU infants are often exposed to, they may respond with negative autonomic responses with their heart rate and breathing, but when listening to their mother’s voice, they have been shown to actually experience fewer cardiorespiratory events. 

Additionally, in a high stress environment, NICU parents are at an increased risk for parental role alteration which can lead to impaired infant-child bonding. Parents are unsure how to help their baby or be a parent to their NICU baby, but reading absolutely helps to promote parental involvement, bonding, and engagement. 

Many parents are unaware that there are a multitude of benefits for their NICU baby with daily reading but once they have been educated, parents have reported to have an increased sense of empowerment, a decreased amount of stress, improved bonding, and more positive interactions with their baby once they started to read to them on a regular basis. 

The American Academy of Pediatrics (AAP) recommends that parents read to their children as soon as possible after birth. They recommend 15-20 minutes of daily reading for all babies and children to help stimulate optimal patterns of brain development as well as enhance the parent-child relationship.

Parents who read to their infants, especially those in the NICU, are more able to respond to their infant’s behavioral and stress cues which is important for bonding and it helps to prepare parents for their baby’s discharge and transition to life at home. 

Tips for reading to your NICU baby

Try to read to your baby at least 15-20 minutes a day. Make it part of your routine each day when you do kangaroo care! If you are unable to visit the NICU everyday, ask your baby’s nurse to read to your baby. If you commit to making daily reading a regular part of your time with your baby early on, it will be more likely to become part of your daily routine once you bring your baby home.

So you may be wondering, are there certain books you should read to your child? Well, books with rhyming stories actually help to train young brains to learn phonemes which helps to build the blocks for later language development. But ultimately, your little one will appreciate whatever you read to them even if it’s a newspaper article! The main goal is for it to be an enjoyable and memorable experience for you and your baby. 

As a parent, I loved reading to William in the NICU. It was one of the few things that I felt I could do in a situation where I felt so powerless. I still remember some of the specific books I read to him in the NICU including, I Love You Little One and Giraffes Can’t Dance (my personal favorite) and now as a 7 year old, he is reading them to me! It is absolutely amazing!

Document your daily reading with your baby

To support your daily reading with your NICU baby, we designated an area in the daily log portion of our NICU Journal, Our NICU Roadmap so you can document what books you read to your little one each day. We believe so strongly in reading with your NICU baby each day and want it to become part of your daily routine. Months and years down the road, you will be able to look back to see what you read to him or her while they were in the NICU. It will be such a great keepsake for years to come.

When you read to your NICU baby, read to them in a calm and steady voice either while doing skin-to-skin care, while holding them swaddled, or even if they are in the isolette. Or consider singing simple lullabies or songs to your infant with a steady rhythm and tone. It is recommended to read to your infant in your preferred or primary language. But, early exposure to multiple languages has been shown to enhance children’s development and cognitive thinking. 

Understanding your infant’s behavioral cues while reading

Your infant’s immediate positive responses to your reading may be subtle and may be difficult for you to recognize, but remember, the long-term benefits are immense. You may notice your baby relax or possibly even lower their respiratory rate and/or heart rate. As your baby gets older, you will hear them coo or become more vocal as you read out loud to them. 

If you are concerned about overstimulating your baby, speak to their care team so you can learn particular signs that may indicate they are overwhelmed. A few of their stress signs may include: fast breathing, yawning, crying, changes in skin color either a pale color or if they become bright red, excessive alarming on the monitor, splayed fingers, tremors, or if your infant is placing his or her hands in front of their face. If you notice these behavioral cues, try some simple modifications and continue. 

For modifications, you can consider lowering your voice to reduce stimulation, pausing for a bit, or if it is developmentally appropriate, you may be able to swaddle your infant. Try again and if they continue to display negative behavioral cues, consider trying another time. Even if they continue to show some distress after modifications, it is not your fault, just pause and try again the next day. Do not give up! As your baby develops and gets stronger, you will notice that they become more reactive and responsive to their environment and reading. 

Reading with our son in the NICU to today

With William, as you may recall me stressing the amount of kangaroo care we did with him on a daily basis. I strongly believe all our daily kangaroo care, the daily reading we did with William, and the songs I sang to him (sorry to all of his nurses that had to endure that daily), were all so beneficial for him. When William was just a few weeks old, we would get compliments from the providers for how responsive and interactive he was. And yes, I am biased, but I promise you that you will not regret bonding with, holding, and reading to your little one! The days and nights are long and stressful in the NICU, but parents who read out loud to their infants have reported it as being a calming activity that also improves their stress level. 

I still enjoy reading with William. It brings back a lot of memories, but most importantly, reminds me of just how far he has come! I know our frequent reading helped him early on with his language skills and it continues to improve his language and reading skills. We still continue our routine and try to read every night before bed. So please consider reading to your NICU baby today if you have not started. If you have not had an opportunity to buy any books, many NICUs have donated books for you to use, so just ask!

Closing

I hope you gained some valuable insight on all of the benefits of reading out loud to your baby while they are in the NICU and for many years to come! And as I said, I can personally tell you it is incredibly rewarding! NICU parents often feel utterly helpless, and I can personally speak to that, but reading out loud to your baby is one thing you can do everyday despite how critical your baby may be. And, not only will it benefit your baby’s future, but it will also make you feel like their parent! So grab a couple of books and get started. You will not believe it now, but before you know it, they will be reading them back to you in the upcoming years! 

Remember, once empowered with knowledge, you have the ability to change the course. 

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