Language Nutrition in the NICU

The Neonatal Intensive Care Unit (NICU) at Lucile Packard Children’s Hospital Stanford has a special year-end tradition in which parents are given a book that they can keep at their baby’s bedside to read aloud. But it’s more than just a nice holiday gesture. NICU Fall into Reading is a developmental care event created to encourage parents to talk to their hospitalized infants and to explain to families how spoken language impacts their baby’s development.

Developmental care researchers at Packard Children’s Hospital are studying many aspects of language nutrition—a term for how language exposure feeds a baby’s growing brain. Some of their work explores the different ways that parental language exposure influences infants’ brain development, especially for those born prematurely.

“At Packard Children’s Hospital NICU, research informs our clinical practice, and it affects the day-to-day care of the babies,” says Melissa Scala, MD, clinical associate professor of pediatrics and medical director of NICU Development Care at Packard Children’s Hospital. Using the latest research findings from within and outside of Packard Children’s Hospital, Dr. Scala guides families on ways they can support their baby’s development by talking, reading, and singing to the baby. Another way she fosters a language-rich NICU environment is by engaging the medical team. For example, NICU nurses are all trained in developmental care practices, including speech. “Our nurses talk to babies even when they’re taking their temperature,” says Dr. Scala. “And I ask all of the physicians to talk directly to the babies, much to the amusement of my medical students.”

Virginia Marchman, PhD, developmental psychologist in the Department of Psychology, is helping the team at Packard Children’s Hospital to more deeply understand the connection between children’s learning environments and language outcomes, especially language-processing skills. In one of her projects, language-tracking devices were placed in both full-term and preterm babies’ clothing that continually recorded the adult words spoken to them for a full day when they were 16 and 18 months old. The researchers found that the number of words that both preterm and full-term children heard across the day predicted their skill at language processing. Dr. Marchman’s ongoing work explores the interplay between brain development and language environments and seeks to measure the effects in both English- and Spanish-speaking environments.

A third member of the team, Katherine Travis, PhD, assistant professor of pediatrics and developmental cognitive neuroscientist at Packard Children’s Hospital, is conducting the second phase of a randomized controlled trial to study the effects of playing recordings of mothers’ voices on preterm babies’ brain development. Her work builds on her previous work with Dr. Scala showing that speech is good for babies’ physical well-being in terms of their growth, but they hadn’t fully explored brain development. Using MRI scans of babies enrolled in the trial, she’s examining how the brain’s white matter brain is impacted by hearing mothers’ voices.

White matter is responsible for how cells communicate with each other and with the body, and it’s important for language development. “It’s known that premature babies are at risk for white matter injury during NICU stays, and we believe that it’s a long-term driver of neurological and developmental impairment,” Dr. Travis says. “Understanding how language plays a role will help us find ways to mitigate these effects and promote the best brain development at the earliest stages.”

The fourth annual NICU Fall into Reading event will be held on December 14, 2020. This year, families will be given Little Blue Truck in English and Spanish to keep at the bedside, along with information about why and how to encourage language exposure. The NICU team also hopes that the event kick-starts a regular reading habit when families go home, too, which would continue to strengthen parent-infant relationships and the baby’s development.