Neonatal health workers across Wales strongly believe that noise is a significant threat to newborns, which could affect infants with fetal and neonatal alloimmune thrombocytopenia (FNAIT) treated in these settings and directly and indirectly raise the risk of serious complications, according to results of a survey published recently in BMJ Paediatrics Open.
In this large survey, 92% of staff said that noise harms infants, while 76% linked it to errors in care caused by distracted or overwhelmed clinicians. This survey, which ran from April 21 to July 11, 2024, gathered 405 valid responses across all nine neonatal units in Wales.
Nearly half of all neonatal nurses and doctors in the country participated, along with 19 allied health professionals. Respondents described noise as a stressor that undermines both babies’ health and staff’s ability to focus, which could destabilize newborns with conditions such as FNAIT that can demand urgent medical attention.
“These findings strongly indicate that noise-reduction interventions should be framed not merely as a quality-of-care issue, but as a crucial component of patient safety, with systemic changes needed to support a meaningful and lasting progress in this area,” explained the authors of this study.
Read more about causes and risk factors for FNAIT
Doctors and nurses were especially worried about noise contributing to life-threatening complications. Nearly half of doctors and more than one-third of nurses tied it to sepsis, intraventricular hemorrhage and necrotizing enterocolitis. Some said that noise interferes with prescribing medication, communication and teamwork, raising the potential for harmful mistakes. In total, 81% believed noise can cause major errors in patient care, though only about one in five said they had witnessed such mistakes firsthand.
Staff also reported that babies fare worse in loud environments, showing more instability in vital signs, stress and poor sleep. Many emphasized that parents also felt heightened stress when visiting noisy units. Parents of infants exposed to persistent noise face additional anxiety while their babies are already vulnerable.
Despite widespread concern, only 30% of staff knew of any official policies to control noise in their units, and most of those doubted the rules were effective. Although individual strategies were common, such as seeking quiet spaces or adjusting alarm settings, staff said systemic change is lacking. They called for guidelines, education and physical improvements such as soundproofing to protect babies.
These results reinforce the idea that noise should be treated as a modifiable medical risk factor, not a background inconvenience. For parents of fragile newborns, such as those with FNAIT, this may mean future care will place greater emphasis on quiet, healing environments.
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