Effects of Reading to Preterm Infants on Baby and Parents' Well Being
Phase: NA
Conditions: Parental Infant Bonding, Cardio-respiratory Stability in Preterm NICU Infants
Sponsor: Georgetown University

Effects of Reading to Preterm Infants on Baby and Parents’ Well Being 
ID:  2014-1464 
10/24/19 
Study Protocol: 
Parents of infants born between 23 and 31weeks gestationalagewhowerebetween260/7and346/7weeks 
post menstrual age cared for in the NICU were approached for enrollment into the study. All infants 
were at least 7 days or older after birth to allow successful transition to extra uterine life. Parents 
agreed to participate and to read out loud from written word as a requirement for participation in the 
study. Infants were excluded if:  they were considered too ill to participate by the primary care team, 
were on high frequency ventilation, were not expected to survive,  had chromosomal anomalies, had 
abnormalities of the midface, or had a family history of/suspected congenital hearing loss. The study 
was approved by the Georgetown University Institutional Review Board. Of 21 sets of parents 
approached, 18 consented to participate. Two sets of parents decided to participate only with live 
reading and did not make a voice recording. Parents were given a children’ s book using a rhyming 
pattern of text to read, but other materials were allowed according to parental preference. Parents were 
asked to read or create a recordinglastingaminimumof15minbutupto60minof recorded reading. 
Mothers and fathers could read to their infants individually. Recordings were made using Garage Band® 
on a study computer and exported to bedside ipods®. Recording was played via humidity resistant 
Bluetooth enabled speakers in the incubator. Recorded reading was played for infants up to twice per 
day by the bedside nurse. The primary care team could withhold any recorded or bedside reading 
exposure if an infant was deemed too unstable for that experience on any given day. Live and recorded 
reading could occur on the same day with the goal of at least 2 reading episodes per day, but because 
parents may not be available for live reading everyday, recorded and live reading episodes may occur on 
different days. Cardiorespiratory events for each reading exposure were compared to the immediate 
period before and after the reading exposure. As such the period before each reading exposure served 
as the control period for that reading exposure to mitigate the effect of reading on different days or 
time periods. All infants were being cared for in incubators on reading exposure days. For 2 infants, at 
one time period each, the infant was removed from the incubator and was being held for all comparison 
time points around that single reading exposure. Two infants had one day of data when the infant was 
held only during reading exposure. Data from those days were excluded from analysis. For all other live 
reading exposures, the infant was in the incubator with parents reading through the open portholes. 
Sound decibel levels were checked via a sound meter (Triplett SoniChek TSC-MC1 Mini Digital Sound 
Level meter) to ensure sound levels did not increase above baseline if above 45 decibels prior to reading 
exposure.  
Cardiorespiratory data, including heart rate (HR), respiratory rate (RR), oxygen saturation, apnea and 
bradycardia events, were continuously downloaded every 5 seconds directly from bedside GE monitors 
using BedMaster EX Software and exported to a spreadsheet for analysis. The data on mode of 
respiratory support and amount of supplemental oxygen needed were collected for each time period. 
Mean RR, HR, apnea and bradycardia episodes, amount of supplemental oxygen needed, mode of 
respiratory support, if any, and number of periods with oxygen saturation <85% were compared to the 
reading period at 3 time points: 3 h before reading, 1 h before reading and 1 h after reading. These time 
points were chosen to provide a variety of time periods in relation to care times and feedings, including 

day and nighttime periods. Results were compared using  Χ2test for categorical variables and student’s t 
test forcontinuous variables. P<0.05was considered as significant.