Promoting Preemies

“You can think of this research as the science behind mom and dad as medicine,” says Dr. Travis, an assistant professor of neuroscience in pediatrics at Weill Cornell Medicine and director of the Laboratory for Language Development and Recovery at the Burke Neurological Institute. “We’re trying to put the data behind why mom and dad are important for brain development and other outcomes, both in the NICU but also long term.”

Seeking improved outcomes in this way has become even more critical as neonatology has advanced as a field to the point where infants born at just 22 instead of 40 weeks, weighing a mere 1 pound and roughly the size of an ear of corn, can be saved — though at high risk of developmental delays and learning disabilities.

“The progress we have made in neonatology from a survival standpoint has been extraordinary,” says Dr. Camilia Martin (M.D. ’92), chief of neonatology at Weill Cornell Medicine and NewYork-Presbyterian Komansky Children’s Hospital of Children’s Hospital of New York. “Now we’re starting to learn how to correct developmental trajectories so that these children can thrive.”

The benefits of “kangaroo care”

The skin-to-skin contact that Cummings practiced in the NICU with Emma and Theo is affectionally dubbed “kangaroo care” because it mimics the marsupial pouch where tiny joeys continue their development. Research has broadly shown that the technique helps regulate premature babies’ temperature, heart rate, breathing and sleep — all factors that could potentially influence brain development, Dr. Travis says. Another major bonus for skin-to-skin contact: the bolstering of parent-child bonding, an experience that lowers stress for both mother and infant, and an interaction in very short supply for sick, premature babies compared to full-termers.

With this knowledge as motivating context, in a 2024 study, Dr. Travis and colleagues reported that preemies who received greater amounts of kangaroo care in the NICU later posted higher scores on 12-month neurodevelopmental assessments. The findings involved a cohort of almost 200 preterm children recruited through Stanford Medicine, where Dr. Travis previously worked. Those children who received an average of 20 minutes more skin-to-skin contact per day saw their scores increase by 10 points on the IQ scale-like assessment, which included visual motor tasks and auditory language skills.

“Even a little kangaroo care helped a lot,” says Dr. Travis. “With this study, we’ve gathered more evidence around the importance of this very simple and safe practice to try to up its usage ideally in NICUs.”

Cummings described her NICU experiences with Emma and Theo and the initial concern she felt navigating the various medical apparatuses. “[My babies] had wires and IV lines coming out of them, but the nurses and the doctors were fantastic in explaining, ‘OK, you can hold them, talk to them. If you’re not holding them, stick your hand through the isolette to touch them,’” recalls Cummings.

Dr. Travis and colleagues are delving deeper into the benefits of this parental proximity and tactility for developing brains. For instance, they are exploring whether there is an association between use of kangaroo care and reduced risk of autism. Preemies are prone to the neurodevelopmental condition, with the 22- to 27-week cohort facing four times the risk versus full-term babies. “There’s opportunities for this research to expand into other neurodevelopmental conditions,” says Dr. Travis.

Hearing Mother’s Voice

Another intervention Dr. Travis is investigating centers on the sound of mothers’ voices. Premature infants — defined as babies born at least three weeks early — spend nearly all their time in a hospital incubator, hearing the hissing of ventilators rather than mom’s heartbeat, digestion and voice as they would in the womb. Intriguingly, fetal hearing begins to develop fairly early during gestation, around 24 weeks, suggesting this mode of sensory input is meant to play a part in maturing the brain.

In a 2025 paper, Dr. Travis and former colleagues at Stanford and currently at the Burke Neurological Institute assessed 46 NICU patients, half of whom had only routine exposures to their mothers’ voices. For the other half, in addition to routine exposure, researchers played 10-minute audio recordings of mom reading a children’s story twice an hour overnight, adding 2 hours and 40 minutes of extra voice time per day.

Remarkably, MRI scans of the baby’s brains revealed that those who heard their mother’s voice the most showed greater structural growth in the brain region known as the left arcuate fasciculus — a tract of nerve fibers connecting areas of speech perception and production. The findings promisingly posit a method for enhancing preemie language outcomes.

“It’s been long theorized that speech input early on drives brain development at these very young ages, but it’s never been causally tested before our study,” says Dr. Travis.

Dr. Travis is now working with Dr. Mary Vernov (M.D. ’12) to launch a new, large, longitudinal study with preemie patients at Weill Cornell and Stanford Medicine to gauge if boosting hearing of mothers’ voices can prevent language delays, a common disorder for preterm children. A broader goal of the effort is to promote the well-established practice of parents talking more to their children overall, but especially in the cases of those born early, who often have ground to make up.

“Families are the backbone of what we do in caring for these patients, whether it’s language exposure or it’s kangaroo care,” says Dr. Vernov, an assistant professor of clinical pediatrics at Weill Cornell Medicine and an assistant attending pediatrician at NewYork-Presbyterian Komansky Children’s Hospital of Children’s Hospital of New York who directs the NICU’s growth and developmental support program. She emphasizes that early intervention is paramount for optimizing neurodevelopment and overall health outcomes, “so integrating developmentally appropriate interventions into the way a parent interacts with their child — not only in the NICU, but also when they go home — becomes a therapy they’re getting every single day.”

Today, Emma and Theo are flourishing. “Developmentally, they’re great,” Cummings says, and Theo has made up a lot of ground weight-wise. “He had a really hard start at it,” she says, “but he’s excelled.”

The efforts into improving preemie neurodevelopment and outcomes overall have been profoundly moving for all involved. “Parents really remember the first time that they’ve held their babies and gotten to talk to them,” says Dr. Travis. “It’s one of the most rewarding things.”