The Novel Idea of Reading to Infants: How an Annual Reading Program Helps NICU Babies and Caregivers

At Lucile Packard Children’s Hospital Stanford, neonatologists with the Johnson Center for Pregnancy and Newborn Services work closely with parents, the hospital’s obstetric team, and specialized pediatric services to provide high-quality care for newborns with critical, surgical, or special medical needs. But the team recognizes that nurturing newborns goes beyond meeting their medical needs: They need to be supported to thrive when they go home with their families.

So it’s no surprise that since 2017, the team has developed a harmonious reading program that can positively impact the developmental growth of newborns in the Neonatal Intensive Care Unit (NICU), along with strengthening the bonds between babies and parents.

Neonatologist Melissa Scala, MD, a clinical associate professor of pediatrics and the medical director of NICU Developmental Care, answers questions about the benefits of reading to preterm babies in the NICU, as well as the positive effects on parents and on their care teams.

Why is it important for parents/caregivers to bond with their newborn right away?

• Research has shown us how parent-infant bonding really is important because it can shape babies’ intelligence as they grow older. During bonding, oxytocin, a.k.a. the “love hormone,” is released in parents’ and infants’ brains. It strengthens the ties built between infants and parents through early contact and interaction.

• For parents of NICU infants, the bonding process is disrupted. Many of the normal activities that parents do with their newborns, like holding, talking, cooing, or reading with the baby, may be impossible due to separation, infant illness, or parental stress.

What are the benefits of parent bedside care that the reading program provides for preterm infants in the NICU?

• It makes parents feel more comfortable and allows them to have an avenue for that parent-infant bonding.

• Even infants too small or sick to hold may benefit from hearing their parents’ voices. Often parents don’t know what to say to their babies in the NICU, so reading provides some text to get them going. The program also establishes patterns of parents reading to their infants that we hope will continue after discharge.

• Reading improves infant health and neurodevelopmental outcomes. The womb is not a quiet place. It’s actually fairly loud; the fetus hears the maternal heartbeat and body noises, and also hears Mom’s voice. In this way, babies are born preferring their mother’s language to other languages and their mother’s voice to other female voices.

• While for a long time we tried to be as quiet as possible in the NICU, we now know that quiet, soft voice exposure through talking, reading, or singing is good for babies. Research has shown better cardiorespiratory strength and growth in infants exposed to parents’ voices in the NICU. Being deprived of voice exposure leads to abnormal brain development and poorer language outcomes at 18–24 months. Stanford Medicine research has shown promising early results linking improved brain maturity with NICU voice exposure. If we wait until babies are at home to expose them to language, we will miss out on important benefits for infants and parents.

• We do ask care teams to talk to babies when they interact with them. Parents can’t be at the bedside all the time, and we want infants to get the language stimulation they need.

Does language or tone play a factor when reading to a newborn?

• In general, babies prefer “motherese”—this refers to the soft singsong quality of how most people instinctively talk to babies. Since babies can hear from around 24 weeks’ gestation, we have a lot of NICU time for language exposure for our smallest infants. We try to use a quiet “library” voice to protect fragile hearing and reduce stress.

Why is the NICU Reading Program celebrated in December? How are the books chosen?

• The December reading event was inspired by the kangaroo care education we do in May, which celebrates the power of human touch for infants. I felt we needed to emphasize the importance of voice exposure, and that is how the NICU Reading Program developed. I have since heard that there are read-a-thons at other NICUs trying to do the same thing. For our care team, this event is an important time to reeducate staff and celebrate what they do in the care of NICU babies. This year, the book we chose is On the Night You Were Born, by Nancy Tillman.

• Along with our care team and staff, we are fortunate to work alongside the Family Advisory Council when it comes to choosing a book every year. And as we are focused on equitable family support at Lucile Packard Children’s Hospital Stanford, and because nearly one-third of families we serve are Spanish speaking, we make sure to have books in Spanish and in English. This is important because parents who speak a language other than English may feel less empowered or think they will receive less support in their parent role in the NICU. We want to make sure that doesn’t happen, so that all families can equally engage with their babies and gain the benefits that we know come with that care.

• The gift of a book is also in keeping with the season when we reflect on the needs of others, maybe trying to make a positive change in the world, a light in the seasonal darkness.  

With services like this, it’s no holiday surprise that Lucile Packard Children’s Hospital Stanford and the neonatology service are ranked in the top 10 in the nation by U.S. News & World Report.