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NICU Noise and Neonatal Development

The neonatal intensive care unit (NICU) can be a life-saving environment but may also cause long-term physical and psychosocial complications. Although the exact relationship of long-term complications to the NICU environment has not been firmly established, there is concern that excessive noise in the NICU for a prolonged time period can significantly affect the overall health and well being of an infant. Research has shown that noise levels should not exceed standard recommendations of 65 decibels (dB), yet noise levels reported in some NICUs are as high as 93 dB (Brown, 2009). Excessive noise can cause noise induced hearing loss [NIHL] (National Institute of Health, 2011). Levy and colleagues (2003) have suggested that continuous, loud NICU noise can cause significant hearing damage in medically fragile and low birth weight infants (Brown, 2009).

Studies have shown that consistent, excessive, loud noise in the NICU can increase neonates’ heart rate, blood pressure, respiratory rate, decrease oxygen saturation and expose the infant to higher cortisol levels and increased caloric expenditure. Multiple recurring episodes of noise-induced stress reactions can result in apnea and bradycardia, which increases the risks of hypoxic episodes (Brown, 2009).

Attention Deficit Hyperactivity Disorder (ADHD) and abnormal brain development have also been documented in the literature as a consequence of excessive noise levels in the NICU, as have problems with sensory development, speech and language (Brown, 2009).

Neonatal nurses are infant advocates. In providing holistic care, attention must be given to the effect of the noisy environment on the physical and psychosocial development of the infant. Nurses can take measures to create a soothing, quiet and calm environment that is more conducive to healing, growth and development than the traditional nurseries with bright lights, audible alarms and endless activity.

Modifying the physical environment of the NICU and making small but significant changes in the delivery of nursing care can minimize disturbances to infants’ growth and development. The literature reviewed identifies simple interventions such as covering incubators with a blanket, implementing a quiet hour during each shift, dimming the lights and controlling the volume setting on audible alarms. However, the most effective intervention is educating the staff about the importance of noise control in the NICU.

References:
Brown, G (2009). NICU Noise and the Preterm Infant. Neonatal Network, 28(3), p.165-173. Retrieved from: http://www.medscape.com/viewarticle/703394
National Institute on Deafness and Other Communication Disorders [NIDCD], 2011. Noise-Induced Hearing Loss. Retrieved from: http://www.nidcd.nih.gov/health/hearing/noise.asp