In a neonatal intensive care unit, calm is hard to come by. Alarms sound, monitors beep, and babies and parents alike can feel the strain of round-the-clock medical care.
Lullaby Hour offers a gentle counterbalance. The program, run by Music in Hospitals & Care, brings professional musicians into neonatal units. They perform slow, steady songs designed to ease stress and support regulation.
In 2025 alone, the sessions reached more than 1,000 ill babies across U.K. hospitals.
First launched in 2017 and now used within the Imperial College Healthcare NHS Trust, the approach reflects growing interest in how sound shapes stress, recovery, and care – especially in the most intense medical settings.
Finding calm in intensive care begins with understanding just how overwhelming the NICU environment can be.
Lowering stress in intensive care
A neonatal intensive care unit (NICU) is a ward designed for newborns who need constant medical support, but it can also be an overwhelming place.
“The environment of a neonatal intensive care unit is, of course, quite overwhelming,” said Gail Scott-Spicer, chief executive of Imperial Health Charity.
In this setting, the approach relies on slow, predictable melodies that may help steady the autonomic nervous system, which controls heart rate and breathing automatically.
Many preterm babies, born before 37 weeks of pregnancy, have fragile sleep-wake patterns, and gentle singing may support regulation.
Lower stress can slow breathing and briefly improve oxygen saturation, the percentage of blood carrying oxygen, during short periods of calm.
Music as medical support
Music therapy – the structured use of sound to support health – is broader than this specific program, but both share the same goal: steady, predictable sound.
Live musicians adjust tempo and volume in real time, and parents often choose familiar songs to help keep babies settled.
“When I’m singing to the baby, I can literally see their heart rate calming down,” said Mica Bernard, a singer and guitarist.
Research supports those observations. A 2021 meta-analysis, which combined results from many trials, linked music therapy to lower heart rates, slower breathing, and higher feeding volumes – the amount of milk taken per feeding.
Earlier work, including a 2013 trial using live sound and parent-chosen lullabies, also reported steadier vital signs and improved feeding.
Future research on Lullaby Hour
Within this field, the approach sits beside studies that vary widely, and many interventions differ in timing and volume.
Quality ratings in the same review fell to low or very low certainty, because bias and small samples can exaggerate effects.
Clinicians also worry about overstimulation, so music therapy studies often cap sound levels and stop sessions when babies appear distressed.
Live sound over recordings
Rather than fixed playlists, the program depends on live performers who can follow a baby’s cues.
Certified therapists sometimes match rhythm to breathing, and the approach can reduce arousal by nudging breaths into slower patterns.
Staff observations during sessions often note babies stay asleep, even during procedures and diaper changes, easing routine care.
Parents benefit from Lullaby Hour
For families, the approach reaches parents who may feel powerless, and parental stress can make decision-making harder during intensive care.
Stress triggers faster breathing and tighter muscles, and calmer sound can soften that response by lowering adrenaline signals.
Researchers also track maternal anxiety, persistent worry that strains sleep and focus, because parents’ mental health shapes caregiving.
Even when babies must remain inside an incubator – a heated enclosure that controls temperature and humidity – the approach can still provide comfort.
Parents who are unable to do skin-to-skin holding can sing softly instead, allowing their baby to hear a familiar voice.
During sessions, the experience sometimes opens an emotional space for parents themselves, where they no longer feel pressure to appear strong.
“Often, if it’s the first time I’ve sung to a parent, it’s the perfect outlet,” said Bernard.
Crying can release tension, and the slower, regulated breathing that follows may help steady heart rate through the autonomic nervous system.
Guarding against overstimulation
For safety, sessions are planned around medical care, so nurses can stop the music quickly if needed.
Program evaluations report babies often fall asleep during live music, which eases worries about disrupting rest.
Musicians keep sound levels low and avoid sudden changes, because overstimulation can raise breathing effort and oxygen needs.
Lullaby Hour within hospital routines
Within hospital routines, the approach depends on clinical teams, because musicians must coordinate with rounds, procedures, and infection-control rules.
Over one year, more than 90 hours of live music reached families across UK neonatal units.
Nurses and doctors report smoother caregiving when parents appear calmer, because parents ask clearer questions and follow guidance.
Looking beyond the moment
The approach raises a difficult question: do brief moments of calm in the NICU translate into better development months or years later?
A 2024 international analysis found no clear improvements in language or motor skills by age two among children who received music therapy as newborns.
Even so, the same paper cautioned that the NICU sound environment can shape brain development, meaning careful sound design still matters.
Looking ahead, the approach is simple to deliver, but hospitals will need clear guidelines to ensure access is fair and sound levels remain safe.
Families deserve every proven comfort available in intensive care, and gentle live music may be one meaningful part of that support.
The study is published in the journal The BMJ.
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