Noise levels in hospitals have doubled in the last thirty years, and although the recommended noise level for a NICU is 45 to 50 dB, the actual noise level inside an incubator usually ranges from 56 to 72 dB.  In addition to high levels of background noise, intermittent noises are also a serious problem because these noises cause an infant to show signs of stress such as an increased heart rate, increased blood pressure, and decreased oxygen saturation.  A loud environment in the NICU also harms infants indirectly by causing caregivers to lose focus and to become fatigued and irritable.

Noise in the NICU can be reduced in a variety of ways.  In terms of architecture, it is helpful to think about the ABC’s –  “absorbing, blocking, and covering.”  The materials used in the walls, floors, and ceilings influence how sound propagates in a space.  Physical barriers such as walls can block sound while providing privacy to patients, and background building noise can be used to cover, or mask, disruptive noises and conversations.  Equipment changes could also reduce noise levels.  Using light-based or remote alarms in place of more traditional alarms would help babies sleep more peacefully and would help reduce the anxiety of families.  Changing the material of incubators could help muffle sound inside them.  Finally, changing patterns of staff-to-staff communication, either in terms of location or equipment, could reduce noise. 

As one thinks about the NICU of the future, it is important to remember that the noise level should be not be greater than 50 dB, that wearable noise-blocking devices are not the answer, and that the noise-related needs of infants change with age.         

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