Reading, Talking, & Singing to Preemies

Ten years ago today, our twins came home from the hospital after 78 days in the Neonatal Intensive Care Unit. At five and a half pounds and four and a half pounds, both were more than three pounds heavier than their weights at birth. They were born at 26 weeks, a full trimester too early.

The 11 weeks we spent watching our babies in the NICU, hooked up to respirators, feeding tubes, and monitors, are a blur now. But we kept careful notes, recording their vital signs, their “activities” (for lack of a better word), and their emerging personalities from the time they were four days old until the day before they came home.

In the early weeks, our opportunities to interact with our children were few and far between. They were too sick, and it often felt like there was little we could do for them. Recently, I read a description of the NICU experience in the Journal of Perinatology that captured the chaos of the early weeks:

As neonatal providers, we have become all too familiar with the overwhelming sense of powerlessness that grips every parent as soon as their infant is whisked away from the delivery room and into the neonatal intensive care unit (NICU). Despite efforts to paint the hallways with friendly mermaids and inviting underwater creatures, the inside of the NICU remains a universally intimidating world of alarms, ventilators and ominous diagnoses for families of every background.

To encourage parents to take an active role in their children’s lives, these medical providers instituted a “Babies and Books” program, which includes a lending library and mobile book cart. This program helps parents bond with their children. It also exposes children at risk of language delay to literature at an early stage and encourages literacy in the home. As the neonatal providers explain:

Perhaps neonatologists will never agree on the ideal management of a patent ductus arteriosus or the best strategy to prevent necrotizing enterocolitis. But it would be very hard for anyone on the medical team to dispute the potential benefit of encouraging parents to consistently read, talk or sing to their premature infants while they are in the hospital.

We sang and talked to our babies through the openings in their incubators (until we were allowed to hold them), but apart from a recording of my husband reading Shakespeare’s sonnets that the nurses played after visiting hours, we never read to them. At the time, most of the books we had in our apartment were textbooks from law school. We didn’t have any children’s books, not yet, and while dealing with the torment of our twins’ early arrival, we didn’t have the wherewithal to buy any.

We would have benefited from a library at the NICU, and I suspect that many of our NICU roommates would have benefited from it, too. At 26, we were among the oldest parents of children receiving the most intensive care, and we were also among the most highly educated. Our hospital was in an urban area and served a largely marginalized population. Its patients were at a greater risk of preterm birth, neonatal death, and poor long-term outcomes than patients from more affluent communities. Discrimination has a bigger impact on children’s lives than prematurity.

I’ve lost touch with many of the families we met in the NICU, but I think about them often. I hope their children are doing as well as mine are. I worry that they are not.



RE Behrman, AS Butler, editors, Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes (2007) (“Not only does poverty increase the risk of being born preterm but it also independently increases the risk of adverse outcomes.”).

K Howard, et al, Biological and Environmental Factors as Predictors of Language Skills in Very Preterm Children at 5 Years of Age, J. of Developmental & Behavioral Pediatrics. 32(3):239-249, APR 2011 (“The finding that children of caregivers with lower education qualifications had lower expressive and receptive language scores is consistent with previous studies within the preterm literature and with studies of the broader population.”)

EA Howell, et al. Differences in Morbidity and Mortality Rates in Black, White, and Hispanic Very Preterm Infants Among New York City Hospitals, JAMA Pediatr. (published online January 2, 2018) (“Although rates of death have decreased, persistent racial/ethnic neonatal mortality disparities exist, with non-Hispanic black neonates dying at more than twice the rate of non-Hispanic white neonates and Puerto Rican neonates also having an elevated risk of death.”).

LH Rubinos, et al. The Story Behind NICU Reading Programs, 36 J. of Perinatology (2016) (linked in the text).


  1. Check out my blog Life with a preemie. Just started yesterday so i have only one post but would love moms who have been through the experience for feedback and to follow my journey as a preemie mom. We are so blessed to have our warriors.

    1. Thank you! We were given good odds that they would survive (80%), but otherwise, the NICU doctors said my girls had only a 10% chance of being “normal” (that’s the word they used, unfortunately). We are very lucky.

    1. I agree. I wonder what happens in a baby’s brain when they hear their parents read to them. Is it the books themselves that matter, or the parents’ voices? I also wonder about the effects of parents reading to babies in utero.

      1. That’s a good question. I think it’s the voice that counts the most at that stage, but reading books at that time encourages literacy in the home later on. I’ll go back to the article to see if the authors touch on this.

        1. Hearing the mother’s voice and heartbeat does have major positive effects (summarized in this PBS article but also available elsewhere). I couldn’t find the study online but a different study also found that verbal communication from a caregiver is prioritized which people have drawn some interesting conclusions from for bilingual development.

    2. Agree, agree, agree. I imagine the reading also helps the parents create a bond with the children because they can also talk to the babies about the books so it gives them something to say when there may not seem like there’s anything to say.

      1. That’s a good point. It definitely would give parents something to say when it’s hard to come up with something else. It’s such a great idea.

    3. Thank you! Ten years ago was a very bleak time for us. The NICU doctors actually said my girls had a 10% chance of being “normal” (that’s the word they used, unfortunately).

    1. It was an awful experience, but I have many positive memories of that time. It’s easier to focus on the positive parts now that my children are healthy. 🙂

  2. Happy homecoming day to you and your family, first of all! Your girls are lovely and their start in life has made them – and you – strong.

    I read to E when she was in the NICU – mostly Emily of New Moon (I know you already know that was my favorite book from childhood and was the basis for her name). It comforted me to read a favorite book and I think it comforted her too. I can’t recall what else I read to her, but I know I was deep in comfort reading at the time and I probably read some Miss Read aloud too. I also spent a lot of time sitting next to her and knitting her a sweater, which felt like an act of faith that she was going to grow and come home, and telling her about her extended family while I did that. I would have loved a circulating NICU library.

    1. Thank you! There was a time when Homecoming Day was more important to me than my girls’ actual birthday (a rather painful day for the first few years). I love the connection you and Peanut have to Emily of New Moon. I can see how reading something to your daughter that you’ve loved since childhood would’ve been comforting. The few books from my childhood that I still have, including Anne of Green Gables, were in storage when my girls were in the NICU. I wish I’d had them with me!

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