Introduction Preterm birth may disturb the typical development of the mother-infant relationship, when physical separation and emotional distress in the neonatal intensive care unit may increase maternal anxiety and create challenges for early interaction. This cluster-randomized controlled trial examined the effects of maternal singing during kangaroo care on mothers' anxiety, wellbeing, and the early mother-infant relationship after preterm birth. Method In the singing intervention group, a certified music therapist guided the mothers (n = 24) to sing or hum during daily kangaroo care during 33-40 gestational weeks (GW). In the control group, the mothers (n = 12) conducted daily kangaroo care without specific encouragement to sing. Using a convergent mixed methods design, the quantitative outcomes included the State-Trait Anxiety Inventory (STAI) at 35 GW and 40 GW to assess the change in maternal-state anxiety levels and parent diaries to examine intervention length. Post-intervention, the singing intervention mothers completed a self-report questionnaire consisting of quantitative and qualitative questions about their singing experiences. Results The mothers in the singing intervention group showed a statistically significant decrease in STAI anxiety levels compared to the control group mothers. According to the self-report questionnaire results, maternal singing relaxed both mothers and infants and supported their relationship by promoting emotional closeness and creating early interaction moments. Discussion Maternal singing can be used during neonatal hospitalization to support maternal wellbeing and early mother-infant relationship after preterm birth. However, mothers may need information, support, and privacy for singing.

Early nutritional compromise after preterm birth is shown to affect long-term neurodevelopment, however, there has been a lack of early functional measures of nutritional effects. Recent progress in computational electroencephalography (EEG) analysis has provided means to measure the early maturation of cortical activity. Our study aimed to explore whether computational metrics of early sequential EEG recordings could reflect early nutritional care measured by energy and macronutrient intake in the first week of life. A higher energy or macronutrient intake was assumed to associate with improved development of the cortical activity. We analyzed multichannel EEG recorded at 32 weeks (32.4 ± 0.7) and 36 weeks (36.6 ± 0.9) of postmenstrual age in a cohort of 28 preterm infants born before 32 weeks of postmenstrual age (range: 24.3–32 weeks). We computed several quantitative EEG measures from epochs of quiet sleep (QS): (i) spectral power; (ii) continuity; (iii) interhemispheric synchrony, as well as (iv) the recently developed estimate of maturational age. Parenteral nutritional intake from day 1 to day 7 was monitored and clinical factors collected. Lower calories and carbohydrates were found to correlate with a higher reduction of spectral amplitude in the delta band. Lower protein amount associated with higher discontinuity. Both higher proteins and lipids intake correlated with a more developmental increase in interhemispheric synchrony as well as with better progress in the estimate of EEG maturational age (EMA). Our study shows that early nutritional balance after preterm birth may influence subsequent maturation of brain activity in a way that can be observed with several intuitively reasoned and transparent computational EEG metrics. Such measures could become early functional biomarkers that hold promise for benchmarking in the future development of therapeutic interventions.

Aim To evaluate the validity of the Language Environment Analysis (LENA) system's automatic measures in two neonatal intensive care units supporting parent-infant closeness, and in two Finno-Ugric languages: Finnish and Estonian. Methods The sound environment of 70 very preterm infants was recorded for 16 h in the neonatal intensive care units with the LENA system roughly at the gestational age of 32 (+2) weeks. Of these, the recordings of 14 infants (20%, two 5-min samples with a high percentage of speech, totally 140 min) were analysed in detail and in two different ways. Parental closeness diaries were used to document the presence of the parents. Agreements between LENA system and human coder estimates were analysed. Results Findings showed a high variation in agreements. The highest agreements were found in female and adult word counts (r = 0.91 and 0.95). The agreements for child vocalisation count, conversational turns and silence were modest or low (r = -0.03 to 0.64). Conclusion Our study provides novel information on the validity of the LENA system in the neonatal intensive care unit. Findings show that the LENA system provides valid information on adult words, but LENA estimates for child vocalisations were less valid at this early age.