2023 Early Hearing Detection & Intervention Conference

March 5-7, 2023 • Cincinnati, OH

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10/14/2017  |   8:40 AM - 9:45 AM   |  Use of Hearing Protection with NICU Patients: A Systematic Review of the Evidence and Applications in Low Resource Facilities   |  West Ballroom at Shalala Student Services Building

Use of Hearing Protection with NICU Patients: A Systematic Review of the Evidence and Applications in Low Resource Facilities

Neonatal intensive care unit (NICU) settings present neonates with many environmental hazards, including exposure to dangerous sound intensity levels. High noise levels are ubiquitous among NICUs worldwide and overwhelmingly exceed the recommendations for safe exposure by the American Academy of Pediatrics. Environmental modifications and staff behavioral changes have proved ineffective at sufficiently reducing infant noise exposure. Often low-resource facilities rely on donations of slightly older and louder equipment, don’t have the option of single-patient rooms, and operate in areas with higher infant mortality rates. To answer the question whether earmuff use by NICU patients improves physiologic stability, behavioral response, and sleep behavior, which are markers of stress response, a systematic review of the literature was undertaken. Earmuff use in low-resource conditions may be even more critical to infant physiologic stability, improved weight gain, and reduced behavioral stress. Seven databases were searched for pertinent records using a specific search protocol. Seven studies met the review’s inclusion criteria and were examined for qualitative synthesis. Examination of the literature provides evidence that using earmuffs to reduce neonate exposure to noise in the NICU is a viable intervention for improving physiologic stability as well as sleep and behavioral response. Earmuffs are a minimally invasive, affordable, and an effective option for attempting to comply with recommended noise guidelines. Moreover, earmuff use by NICU patients should be considered as part of the routine evidence-based practices employed when implementing development centered care aimed at minimizing the over-stimulation of the infant.

  • Recognize the elevated sound pressure levels in NICUs and the potential for its harmful effects on the developing infant.
  • Evaluate the use of earmuffs on NICU patients as an approach to reduce their exposure to noise and improve infant stress responses.
  • Propose the use of earmuffs on low-resource NICU infants.

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Presenters/Authors

Nathalie Chouery (), Rush University, nathalie_chouery@rush.edu;


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Kathleen Dunckley (), Rush University, kate_dunckley@rush.edu;


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Patricia McCarthy (), Rush University, patricia_a_mccarthy@rush.edu;


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