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Talking to premature babies tied to later development

By Andrew M. Seaman

NEW YORK (Reuters Health) - Babies born prematurely may benefit from people talking to them while they are still in the hospital's intensive care unit, suggests a new study.

Researchers found that premature babies who were exposed to more talking from adults, such as their parents, in the neonatal intensive care unit (NICU), tended to score higher on development tests later on.

"This is certainly a remarkable, easy-to-implement and cost-effective intervention of informing moms of visiting their children in the intensive care unit," Dr. Betty Vohr said.

Vohr is the study's senior author from the Warren Alpert Medical School of Brown University and Women and Infants Hospital in Providence, Rhode Island.

She and her colleagues write in the journal Pediatrics that a baby still in the womb is exposed to its mother's voice, but a baby born very prematurely is kept in a NICU, where it is exposed to noises from monitors and machines but little talk.

Previous research has found that children born early are at an increased risk for language problems later on, but it's unknown whether talking to them early on will help their later scores.

For the new study, the researchers recruited families of 36 babies that were medically stable but born before 32 weeks of pregnancy and kept in the NICU.

A baby is considered "full term" if it is born between 39 and 41 weeks of pregnancy, according to the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine (see Reuters Health story of October 22, 2013 here: http://reut.rs/189Cm4Q.)

The babies in the study wore vests equipped with devices that record and analyze the conversations and background noises near the baby over 16 hours. The recordings were taken at 32 and 36 weeks of gestational age.

Overall, the babies were exposed to more talking at 36 weeks than at 32 weeks, but the actual amount of talk each baby was exposed to during the study periods varied from 144 words to over 26,000 words.

The word tallies were then compared to babies' Bayley-III scores, which measure how a baby is developing in regards to motor, language and thinking skills, at seven and 18 months of age.

The researchers found that after taking into account a child's birth weight, the amount of talking a baby was exposed to at 32 weeks accounted for 12 percent of differences in children's language scores and 20 percent of variation in their communication scores at 18 months of age.

The amount of talking a baby was exposed to at 36 weeks also accounted for about 26 percent of variation in thinking scores at seven months of age.

Overall, the researchers found that an increased amount of adult talk in the NICU was tied to higher language and thinking scores on the tests.

"To our knowledge, this is the first study showing that early exposure in the NICU of preterm infants to higher numbers of adult words is positively correlated with cognitive and language outcomes after discharge," the researchers write.

"I really think that talking to children is a really good thing to do," Dr. Heidi Feldman said. "Some of us start when our children are in utero. Sometimes our children come when they should still be in utero."

Feldman is the author of "Redesigning Health Care for Children with Disabilities" and an expert in child development at the Stanford University School of Medicine in Palo Alto, California. She was not involved with the new study.

She said it's important to understand why children exposed to more talking did better.

"I think we should pay attention to it, and try to understand it a little bit better and figure out what the causal mechanisms are," Feldman told Reuters Health.

Vohr said her team is currently working on a larger, more rigorous study to confirm the results.

"With a very sick infant on a ventilator or off a ventilator, it's a stressful time for families . . . It's an environment that's not conducive for all moms to do a lot of talking," she said.

"Just informing moms and dads of the importance of this, I think will make a big difference," she added.

Feldman said it's important to encourage parents to be with their children when they can to talk and gently touch them in a safe spot, such as on their earlobe or between their eyebrows.

"To do those kinds of gentle maneuvers and talking softly with the babies, that would be great," she said, adding that it's also important to do that when babies are brought home.

"Life is really, really complicated," she said. "If families are unable to provide for this rich verbal environment in the NICU, there are still plenty of opportunities to provide that when they come home."

SOURCE: http://bit.ly/1om1wZo Pediatrics, online February 10, 2014.

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