Music Therapy: Supporting Breast Milk Production and Infant Physiologic Stability
When a baby is in the NICU, parents are often focused on numbers. Milliliters pumped. Oxygen levels. Heart rate. Weight gain. In the middle of all this data, it can be easy to overlook how closely a parent’s emotional state and a baby’s physiologic stability are connected.
Music therapy is one intervention that bridges this gap. Research increasingly shows that music therapy in the NICU does not only support infants. It can also reduce parental stress, support milk production, and create a calmer environment that benefits both baby and caregiver.
While much of the research has been conducted in NICU settings, the same stress-hormone pathways are present for all lactating parents. Birth trauma, emergency deliveries, sleep deprivation, anxiety about infant health, and difficulties with feeding can all activate the stress response and temporarily interfere with milk letdown, even when milk supply is otherwise adequate. Understanding how stress affects the body helps explain why interventions that promote calm and regulation can support both feeding and bonding across many early-parenting experiences.
What Is the Connection Between Stress and Milk Production?
Milk production is influenced by hormones that are highly sensitive to stress.
Cortisol, a hormone released during periods of anxiety or emotional strain, can interfere with the release of oxytocin, which plays a key role in milk letdown. Oxytocin is most effectively released when the nervous system is in a calm, regulated state.
For parents of preterm infants, stress is often unavoidable. Pumping in a hospital environment, separation from a baby, uncertainty about medical outcomes, and disrupted sleep all place additional strain on the body.
Research examining the impact of music therapy on mothers of premature infants has shown measurable benefits. In one study, mothers who participated in music therapy sessions experienced lower psychological stress and reduced cortisol levels. These changes were associated with significantly greater breast milk output compared to mothers who did not receive music therapy.
This suggests that music therapy may support milk production not by directly increasing supply, but by helping the nervous system shift into a calmer, more regulated state where milk production and milk ejection can function more effectively.
Gentle auditory input, such as predictable, soothing music or a familiar parent voice, activates the parasympathetic nervous system, often referred to as the “rest and digest” system. This state supports digestion, hormone release, and the coordinated physiologic processes involved in both milk letdown and infant feeding.
Difficulty with milk supply can feel deeply personal, but it is often a reflection of how hard the body is working under stress rather than a failure of the parent or the breast.
Can Music Therapy Affect Infant Physiologic Stability?
Music therapy has also been studied extensively in preterm infants themselves. Multiple studies and systematic reviews have shown that appropriately delivered music therapy in the NICU can support physiologic stability.
Findings across the literature include:
• decreased heart rate
• decreased respiratory rate
• improved oxygen saturation
• improved sleep quality
• reduced stress behaviors
A randomized controlled trial examining live music therapy during sleep found that preterm infants had significantly lower heart and respiratory rates and higher oxygen saturation following sessions, particularly when music therapy was delivered while infants were asleep. This is important because sleep is a critical period for brain development and physiologic regulation in early life.
Improved stability during rest and feeding can reduce energy expenditure, allowing more energy to be directed toward growth and development.
Can Music Therapy Help Improve Feeding, Growth, and Neurodevelopment?
Yes. Some studies have also found associations between music therapy and improved feeding outcomes, weight gain, and shorter length of stay in the NICU. These benefits are likely multifactorial.
When infants are more regulated, they often feed more efficiently and recover more quickly from feeds. When parents feel calmer and more supported, they may feel more confident engaging in caregiving routines such as pumping, feeding, and skin-to-skin care.
Music therapy is often integrated with other developmental care strategies, including oral motor interventions, cue-based feeding, positioning, and skin-to-skin contact. Rather than acting as a standalone treatment, it supports the overall caregiving environment and the shared regulation between parent and infant.
What Music Therapy in the NICU Actually Looks Like
Music therapy in the NICU is not the same as playing background music. Evidence-based NICU music therapy is typically provided by a trained, board-certified music therapist who carefully adapts sound, rhythm, and volume to the infant’s developmental stage and physiologic cues.
Interventions may include:
• live singing matched to the baby’s breathing or heart rate
• gentle humming or lullabies
• use of parent voice to support bonding
• timing sessions around sleep or feeding
The goal is not stimulation, but regulation. Music therapy is designed to support the immature nervous system, not overwhelm it.
A Low-Risk, High-Impact Support
One of the strengths of music therapy is that it is considered a low-risk intervention with potential high-impact benefits. It does not replace medical care, lactation support, or feeding therapy. Instead, it works alongside them.
Music therapy functions best as part of a broader regulation toolkit that may include skin-to-skin care, dim lighting, gentle touch, responsive feeding, and predictable routines.
For families navigating the NICU or the early postpartum period, music-based regulation strategies may:
• help parents feel more connected to their baby
• reduce stress during pumping or feeding
• support milk production through stress reduction
• improve infant stability and sleep
• support early bonding experiences
A Gentle Perspective for Parents
If music therapy is offered to you or your baby, it means your care team is looking for ways to support regulation, connection, and development during a challenging time.
And if formal music therapy is not available, simple practices at home may still offer emotional and physiologic benefits when used safely and with medical guidance. These may include:
• quiet humming or soft singing during feeding or skin-to-skin time
• choosing slow-tempo, low-volume music during pumping
• pairing a familiar song with calming routines to help the body associate sound with relaxation
• using recordings of a parent’s voice when separation is unavoidable
Always speak with your care team before introducing sound near medically fragile infants to ensure it aligns with your baby’s needs.
Small moments of calm matter. For your nervous system. For your baby’s nervous system. And for the relationship growing between you.
References
Kobus, S., Diezel, M., Dewan, M. V., Huening, B., Dathe, A. K., Felderhoff-Mueser, U., & Bruns, N. (2021). Music therapy is effective during sleep in preterm infants: A randomized controlled trial. International Journal of Environmental Research and Public Health, 18(16), 8245. https://doi.org/10.3390/ijerph18168245
Mirkin, A. (2018). The effects of music therapy on preterm infants in the NICU: A systematic review. Journal of Neonatal Nursing, 24(4), 177–184.
Singh, B. (2018). Impact of music therapy on amount of breast milk secretion among mothers of premature newborns. International Journal of Nursing Education, 10(3), 45–50.
Albino, T., Arrington, K., Monroy, N., Naik-Santana, K., & Wagner, S. (2020). Healing harmonies: Music therapy’s impact on NICU neonates. Texas A&M University Nursing Evidence-Based Practice Projects. https://oaktrust.library.tamu.edu
Standley, J. M. (2012). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network, 31(5), 311–316.