As musician Alana Wilkinson cuddled and sang to her premature baby son in hospital, the machines he was hooked up to showed his tiny heart responding to her music – and touch.
Rafferty Thomas Robb was born 16 weeks early at the Mater Mothers' Hospital in Brisbane last October. He was among the smallest babies delivered there in 2021.
On the eve of his birth, mum Alana and dad Angus Robb were told babies born at 24 weeks' gestation had about a 60 per cent chance of survival.
More than seven months on, although Rafferty still requires supplemental oxygen, his devoted mum describes him as "pretty happy".
He's been listening to music all his life, his mother singing to him and playing the ukulele while he was still in the womb.
And after his birth at 2:04am on October 24, health workers sang happy birthday before he was taken to the Mater's neonatal intensive care unit (NICU).
Ms Wilkinson, 31, continued to sing to him during his three-month stay in hospital, convinced in the healing power of music.
She would cradle Rafferty skin to skin, accompanying herself on the ukulele as she sang songs, such as Somewhere Over the Rainbow, and music she composed herself.
"I just found that as soon as we picked him up and put him skin to skin … sitting there with my ukulele and singing to him, you could just see how much that really made a difference, seeing it reflected in the machines that monitor heart rate and breathing."
Ms Wilkinson said some of the other mothers with extremely premature babies in the NICU at the same time stopped her in the hallways, or wrote her notes, to thank her for her music at such a difficult time in their lives.
"One woman said to me that she could just feel the love," Ms Wilkinson recalled.
"She just said that to walk into the NICU feeling so much trauma and then to hear the ukulele playing – I think I was singing You Are My Sunshine or something — she was just crying in the halls and said that had just changed her entire experience.
"That was so special because for me, music is my way of dealing with things. It's my form of therapy. To hear that other people had benefited from that in this same situation was really magical. I think it lifted the heaviness for them."
Time spent outside humidicribs vital
Mater director of neonatology Pita Birch said hearing parents' voices was very important to a baby's development, prompting the Mater to set up reading shelves with children's books inside the NICU.
Dr Birch said parents were encouraged to read the books to their babies to help develop the language part of the brain.
"There have been concerns around environments where babies are not exposed to hearing the spoken word," he said.
"Some MRI findings suggest the language part of the brain becomes under-developed.
"Reading and singing and speaking to your baby is a really important part of that development. It's also an important part of bonding, it's part of knowing your baby."
Dr Birch said time outside humidicribs for premature babies to have skin-to-skin contact with their parents was extremely beneficial, improving breathing and heart rate.
"It used to be the case where our nursing staff would say to families: 'I'm sorry, your baby's too unstable at the moment for you to bring the baby out for a cuddle'," he said.
"Now, we're saying to families: 'Look, your baby's having a bit of a rough time, or is a bit unstable at the moment, do you want to get him out for a cuddle to help calm him down or to help make him a bit more stable?'
"We're just trying to rephrase the way we approach these kinds of episodes of care because we recognise having babies being held by their parents, particularly skin to skin, infers benefit and stability rather than worrying that we shouldn't be doing it when babies are not well.
"We can get a baby that's born at 24 weeks, extremely premature, on the borderline of survival, having a cuddle with its mum on the first day of life. That would never have happened five years ago."
Kangaroo cuddles and a NICU wedding
Ms Wilkinson, who had planned a home birth in a northern NSW rainforest cabin, was driven from Lismore Hospital in an ambulance after presenting with bleeding and cramping.
She gave birth to Rafferty at the Mater Mothers' Hospital in Brisbane three days later.
The first-time mum was able to hold her son for her first precious "kangaroo cuddle" — when parents hold their babies to their bare chests — five hours after his birth.
"My partner puts his two fists together, thumb to thumb, side by side, and that was the size of Raff's body all tucked up," she said.
"It's really confronting to see a baby that small and really confronting to see how much they have to go through in order to grow on the outside when they're meant to still be on the inside.
"I just had no idea around the world of premature babies. I didn't know anyone who had had a premature baby before."
Exactly a month after Rafferty's birth, his parents decided to marry beside his incubator in the NICU, keen to make their first born a part of the ceremony.
"There were no guarantees that he would make it," Ms Wilkinson said, as she breastfed her son.
"I know that sounds kind of grim, but it was a reality of the situation.
"It was something that I really wanted to do so that he could be there, he could feel the love, feel our commitment and he could be part of it. It was really beautiful."
Rafferty is one of about 250-300 babies born before 32 weeks' gestation cared for by the Mater's NICU team annually.
Dr Birch said that about a third of the babies born at 24 weeks' gestation did not survive.
Of the survivors, about 25 per cent will experience a moderate to severe disability.
"Often we can tell if we think babies are going to have a severe disability because they'll have some abnormalities on some of the imaging that we do," Dr Birch said.
"We do some ultrasound scans looking at their brains."
Rafferty's scans were normal.
He's living on an avocado farm at Goonengerry, in the Northern Rivers region of NSW, with his parents.
"Through all of this stress and the worry and all of the turmoil, we really have had so much joy just singing and dancing," Ms Wilkinson said.
"We want him to feel safe and loved and jolly. That has been our priority."
