NOISE AND LIGHT EFFECTS ON PREMATURE INFANTS

Noise and Light Effects on Premature Infants in Neonatal Intensive Care Unit

Noise and Light Effects on Premature Infants in Neonatal Intensive Care Unit

Introduction

Premature infants in the NICU are often exposed to continuous loud Noise and Light despite research documenting the presence and damaging effects of Noise and Light on the preterm infant's development. Excessive auditory stimulation creates negative physiologic responses such as apnea and fluctuations in heart rate, blood pressure, and oxygen saturation. Preterm infants exposed to prolonged excessive Noise and Light are also at increased risk for hearing loss, abnormal brain and sensory development, and speech and language problems. Reducing Noise and Light levels in the NICU can improve the physiologic stability of sick neonates and therefore enlarge the potential for infant brain development. Recommendations include covering incubators with blankets, removing noisy equipment from the incubator environment, implementing a quiet hour, educating staff to raise awareness, and encouraging staff to limit conversation near infants(Stewart, 1981).

Discussion

The development of the neonatal intensive care system has had a profound effect on the survival rates of infants who would otherwise have died. The survival of very low birth weight infants (< 1,500 g) has increased from 50 percent, reported in 1981, to 85 percent, reported in 2007. With the success of neonatal intensive care since the early 1970s, the goal has changed from securing infant survival to optimizing long-term health and development.

More recent research has started to include neonatal morbidity as well as mortality, looking at the incidence of major developmental impairments among those survivors most at risk. As increasing numbers of survivors reach school age, more minor impairments cause concern; difficulties with attention, behavior, visual-motor integration, language performance, and academic skills are becoming apparent. It has been suggested that the persistence of these developmental problems may be associated with the NICU environment. One possibility is that the impairments emerging in school-age children may be the consequence of Noise and Light stimulation of the NICU environment exceeding the capacity of the preterm infant's central nervous system to cope with it.

Safe sound levels within the NICU are essential for the healthy development of preterm infants, and an understanding of recommended and actual sound levels is important for caregivers. The most recent recommendations come from the Committee to Establish Recommended Standards for Newborn ICU Design, which advises that the combination of continuous background sound and transient sound from infant bed areas, staff work areas, family areas, and spaces opening onto them should not exceed an hourly Leq of 45 dB, an hourly L10 of 50 dB, and an Lmax of 65 dB. The Leq is the average Noise and Light level over a defined period of time. The L10 is a measure of the decibel level exceeded for 10 percent of the hour. The Lmax is the highest decibel level measured for at least 1/20th of a second during the hour. Despite these recommendations, Noise and Light levels commonly exceed these ...