Most parents know that reading should begin with young children, but studies show that many parents are not aware of the benefits of reading to infants. This is especially true for preterm or sick newborns in neonatal units, who do not experience the human sound exposure they need for brain development during the early period of rapid mental growth.
UAB Medicine
Terry Saban recently visited UAB to read books to babies in the NICU.
The NICU Bookworms program has been a big success for families in the neonatal intensive care units (NICUs) at both UAB and Children’s hospitals through finding new ways to provide books and encourage shared reading. (The program is also now available at UAB St. Vincent’s NICU.) These NICU infants have a harder time reacting to sensory input while maintaining stability in bodily systems, such as keeping their heart rate steady. That can lead to overstimulation and stress. Reading provides important auditory stimulation and also helps caregivers bond with babies and recognize infant responses and cues. The NICU Bookworms program aims to increase quality word exposure through books and establish reading routines that the parents can continue at home.
UAB Medicine
The NICU Bookworms’ guidelines follow the principles of the Synactive Theory of Infant Development, a framework for understanding the behavior of premature and sick infants. The guidelines help caregivers better respond to infant cues and take active roles in their care while using books as a medium to bond. The Bookworms program aims to increase quality word exposure through books and to establish reading routines with the parents to continue at home. NICU Bookworms was founded by Viral Jain, M.D., an assistant professor in the UAB Division of Neonatology, who previously led a study investigating the importance of reading to NICU infants. He also co-wrote the children’s book Baby Bookworm (now provided to families in the neonatal units at both UAB and Children’s of Alabama), and he partnered with members of Zac Brown Band and other musicians to pen “Sweet Little Baby (NICU Lullaby),” which encourages reading to all infants starting at birth. Dr. Jain says all facets of the program are backed by research.
“In spite of the fact that babies clearly don’t comprehend what’s being read, we know from many studies that they are indeed listening,” Dr. Jain says. “After a baby reaches six months of age, language should start to get more organized; you need rhyming and more advanced words. But for infants, we tell parents it doesn’t matter what you are reading, as far as content goes. Also, for parents who may not be able to read, having a book in hand can work as a prompt to tell their own stories or just talk. We also have data that show parents will experience better bonding with babies when they read to them. NICUs can be stressful for infants and families, and we have seen how parents are sometimes less likely to hold, feed, and talk to their babies in that environment. Reading can be a key step in solving that problem.”
Reading is Rewarding
NICU Bookworms program is expanding opportunities for parents to participate. Yvonne Bolaji, a clinical research coordinator with the UAB Division of Neonatology, says the program has been helping families build their own libraries through donations. In addition to the first vending machine in the Continuing Care Nursery (CCN), There are two vending machines that offer new books through a reward system. Not only has the program expanded to include UAB St. Vincent’s, we also received a second book vending machine this year courtesy of a donor. Now, the CCN and RNICU at UAB Hospital each have their own machines.
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“Parents currently receive a folder with instructions for reading to their infants, along with the materials to construct an actual bookworm as they go,” Yvonne says. “The construction of their little bookworms is a good way to track individual progress of our families in the NICU. The vending machine in the Continuing Care Nursery holds about 250 books, and we replenish it with books we receive from donations and programs. When we see that a little bookworm construction is proceeding, we reward that parent with tokens they can use to get a new title from the machine.”
The program also benefits from book drives, local donations, and the Reach Out and Read program. Currently, NICU parents who reside in Jefferson County can receive books from Dolly Parton’s Imagination Library, a program that mails free, high-quality books to children from birth through age five. The program is now available in each of Alabama’s 67 counties. (You can sign up at imaginationlibrary.com.)
Yvonne says the program helps ease stress for parents at the neonatal units. “Not only can we increase a baby’s development, but this also helps the family feel like things are a bit more normal and calm,” she says. “That’s important because the NICU is not a normal environment. Reading also helps meet the challenge of figuring out what to say to your baby. You just read the content, and with more books, parents can increase that content. Every family we have approached with this opportunity has loved it.”
Also, Dr. Jain points out that the program has a wider application. “We want to emphasize that this program is important for all newborn babies, not just those in neonatal units,” Dr. Jain says. “On one level, it’s an excellent way to address risks of poor neurodevelopment in infants who must stay in the NICU. Beyond that, starting early with reading for infants can establish good habits for children as they grow. That’s extremely important, considering the need to increase the literacy rates in Alabama. In that context, shared reading is an activity with the lowest investment and highest return.”
If you would like to donate funds or new storybooks to help support NICU Bookworms, please email
bookworms@uabmc.edu.