It will not come as much of a surprise to any of us, that the sound of the human heartbeat (the basis of all Baby-Go-To-Sleep music therapy recordings), is a comforting and reassuring sound that calms children and adults alike. It's steady, gentle, relaxed beating reminds us of the forgotten tranquillity and untroubled repose in the womb.

Since 1985, Baby-Go-To-Sleep Heartbeat Musical Therapy Recordings have been used by medical professionals and care givers in over 8,000 hospitals and special care centres to calm patients of all ages, who are on life support during painful and frightening procedures. They have been effectively used as an alternative or supplement to reduce the need for sedation for those on life support or undergoing frightening or painful procedures.

In the late 1950s Dr. Lee Salk began investigating the effect the sound of a human heartbeat might have on the mood of newborns and babies. He found that when he played a metrominised human heartbeat (72 beats per minute) to newborns that they cried less and gained weight faster than when no heartbeat was played. A later study of 16-37 month olds who listened to his metrominised heartbeat, revealed that the babies actually fell asleep significantly faster than those who were not exposed to the sound. Salk later noted the natural tendency of mothers to hold their babies on their left shoulder/chest (closest to the heart), seemed to confirm how important the sound of a mother's heartbeat was to a baby's sense of comfort and well being.

The results of Salk's research were replicated and extended by Dr. Richard C. Reed at the United hospitals of Newark, New Jersey. Reed used the heartbeat sound with preoperative pediatric patients and found it enhanced sedation such that the children seemed more restful and relaxed in the operating room. He noted the same reaction when he used it in the recovery room.

The Baby-Go-To-Sleep recordings that were developed with nurses have been independently tested, and it is those identical recordings where are on the CDs and cassettes today.

Nurses in Newborn nursery at The Helen Keller Hospital, Newport Alabama have studied the effects on behaviour of the Baby-Go-To-Sleep music with 59 crying babies over six-weeks in 1985. 94% stopped crying or went to sleep within 2 minutes when the Heartbeat Musical Therapy recording was played, without the use of a bottle or pacifier. Not surprisingly the heartbeat tempos used in the Baby-Go-To-Sleep recordings are in the same range that Salk and Reed used just as successfully. Although not specifically tested nurses who experimented with the tapes also found that playing the tapes greatly reduced separation anxiety.

Researchers in 1999 at The Indiana University School of Nursing completed a scientifically rigorous pilot study to evaluate interventions for procedural pain in neonates. Researchers were interested in finding a musical intervention that could benefit that could benefit a newborn without irritating the adults involved in the baby's care. Baby-Go-To-Sleep tapes fitted this criteria. Researchers found that pain intensity ratings were less for newborns who were played Heartbeat Musical Therapy recordings during and after operations than for babies exposed to no music. In addition, heart rate remained stable for babies who had the music intervention resulting in higher oxygen saturation rates throughout the procedure. Heartbeat Music Therapy recordings above and beyond promoting calmness and well-being for infants, clearly have a significant role to play in the future by helping to relieve the pain and stress children are faced with within during procedural treatment.

This year, the three year Music Therapy and Sound Reduction/Quiet Time Research project concluded at The Children's Hospital medical centre of Akron Ohio. This study is the first study in America to examine both recorded music and sound reduction together. Baby-Go-To-Sleep Heartbeat Lullabies are played every day from 10.00 a. to 2.00 p.m., the NICU's busiest hours. So far parental response to their baby's expose to music in has been very encouraging. Findings on whether neonates are released from the NICU quicker and healthier when the played our recordings keep them calm will be available later this year.

To an infant, almost all sounds are strange, and are often perceived as threatening. Biologically equipped with the fight or flight response to threat, babies tend to expend a lot of calories needed for healing and growing on unnecessary agitation and crying whilst in hospital.

Researchers had long suspected that noise in hospital could be inhibiting the healing process. According to an article by Dr. Gerald Grumet in the New York Journal of Medicine in 1993 research indicates a relationship between increased noise with increased lengths of stay patients in hospital. Intrusive noise increases a newborn's heart rate and blood pressure, and decreases oxygen saturation levels. Salk himself found in his 1960 study babies kept awake and crying put on less weight in the weeks after birth.

An encouraging study by McLean and Tarnopoisky published in 1977 pointed towards a solution: hospital patients can habituate to noise by distracting their attention. Distracting involves shifting a patient's attention away from intrusive sounds through a process of masking.

Masking occurs when the background sound level is raised to a such a point that the difference between any background noise and a potentially intrusive sound is too low to provoke a startle reaction. An observation which vindicates the action of some parents who spend the early hours driving their infant around in their car because it is the only thing that will get them to drop off to sleep. Many hospitals introduce music and other sounds into the patient's environment to mask rather than block out frightening and startling sounds.

One of the most effective ways to mask sound and distract infants from noise, pain, fear and loneliness is to play music therapy recordings. The slow, simple, repetitive, predictable music and the caressing timbre of a human voice adds a nurturing element to the infant's environment and proactively calms them. In it's need for comfort and relief the infant can habituate to frightening and startling sounds and remain calm.

Reaction from professional child careers to the Baby-Go-To-Sleep recordings has indicated that they are so successful that in certain cases they have replaced the need for sedatives use during such procedures as Magnetic Resonance Scanning (MRI), CT Scans, radiological tests, endoscopies, EEG and even after heart surgery.

Perhaps the reaction amongst the nurses who have been excited to witness the beneficial effects that these simple noninvasive recordings have had on children in nurseries and intensive care units can best be summed up by the following excerpt from a presentation by Meryl Clark RN at The National Association of Neonatal nurses in San Antonio Texas, USA.

' I use music in the Neonatal Intensive Care Unit (NICU) for calming. For music to be effective it must have simplicity, repetition, predictability, structure, consistent rhythm, harmony and no surprises. I use Terry Woodford's Baby-Go-To-Sleep tape in the NICU. I have tried lots of music. I have tried some that puts infants at risk when you look at their stress cues. I use music that works, and this works really well.'

Classical music has complex melodies, structures and rhythms. They are often dynamic, unpredictable, non-repetitive, with busy instrumentation. Some have changes in mood and tempo, with dynamic fluctuations in volume. They are often full of startling or attention-grabbing surprises.

Most classical music compositions were never written with the intention of calming babies or making them more intelligent. They deliberately avoid incorporating the basic principles of relaxation and learning in the arrangements. No composer ever intended to get their audience to go to sleep.

Only a few of the classics, such as Mozart's Lullaby (better known as Twinkle, Twinkle Little Star), and Brahm's Lullaby, were intentionally written to calm a child. These composers incorporated the basic principles of relaxation and learning into these melodies and song structures.

Whether it is New Age, natural sound recordings, classical, jazz or easy listening, babies haven't yet learned how to appreciate such mathematically complex communication. Sophisticated musical arrangements can negatively stimulate and irritate a child, if played too early in its development.

Neonatal Nursing professionals in America have reported that for music to be effective at calming an agitated child it must have simplicity, repetition, predictability, symmetry, consistent rhythm, harmony and no surprises incorporated into the melody and arrangement.

Whether it is new age, natural sound recordings, classical, jazz or easy listening babies haven't yet learned how to appreciate such complex communication. Sophisticated musical arrangements can negatively stimulate and irritate a child if played too early in it's development.

The manufacturers of classical music for children in America point to a study carried out at the University of California Irvine in 1993 for support that it makes babies more intelligent. In a study there, repeated exposure to classical music increased college student's scores on subsequent IQ tests. So that's it then. Case closed. Or is it ? Frances Rausher, co-author of the original study, later said that there was no evidence that playing Mozart in the nursery was going to raise an infants IQ and that the writers of the report had never claimed it would. It's a very giant leap to think that if music has a short term effect on college students that it will produce smarter children.

Scientists around the world have unsuccessfully tried to duplicate this original research. After a much larger study at the Appalachian State University Dr. Kenneth Steele claimed to have "debunked the myth that classical music makes you smarter". (Psychological Science 1999; 10:366-369).

If you are an employer with a workforce that contains a significant number of parents with young children why not consider giving away these recordings both as an incentive or part of a ongoing support programme.

Parents deprived of sleep can cost their employers thousands of pounds every year. They cannot perform at peak efficiency, have higher absenteeism, make more mistakes, may be prone to accidents and injury, are more susceptible to illness and any general irritability and lethargy may be detrimental to the attainment of company goals and ideals.

With American research showing that almost half of children under 5 years old keep their parents awake at night, over half of parents admit that sleep deprivation affects their ability to work.

The most often cited trigger for parental violence against children is persistent unstoppable crying. In instances where mothers and parents are prone to violence toward their babies, Baby-Go-To-Sleep has helped avoid harm coming to them because it helps stop crying.

In the last 10 years the US Military have given away over 100,000 copies of the heartbeat lullabies to employees, claiming that the tapes "directly linked to improved job performance, reduced household stress and decreased spousal abuse". (Family Practice, VOl9. No.12)

They are a cost effective and caring solution for minimizing the effects of sleep deprivation amongst employees who are balancing the conflicting demands of parenthood and work responsibilities.

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