"The groundwork of all happiness is health." - Leigh Hunt

Sleeping pill or potential danger?

July 16, 2024 – After a warm bottle of milk and a sweet lullaby, many babies drift off to sleep amidst the hum of white Noise. The wide selection of sound can dampen disturbances, help babies go to sleep and keep them sleeping longer, making it a holy grail for folks of newborns.

White noise machines are sometimes listed within the “must-haves” category on baby lists, and a few parents use them throughout the night while their child continues to be young. Music streaming apps offer white noise playlists curated specifically for babies, and there are many gadgets, including white noise players, designed specifically for stroller naps. Many baby monitors even have this feature inbuilt.

But now a gaggle of medical researchers is looking for regulation of white noise machines for babies and young children after their latest evaluation concluded that long-term exposure to white noise at high volumes can harm development, with effects starting from hearing loss to learning setbacks. They warned that oldsters could unknowingly be exposing their children to the noise of a roaring subway train for a dozen hours or more a day.

Until limits and warnings are put in place, experts recommend that oldsters and caregivers measure and limit the quantity of white noise. Start by downloading a sound level meter smartphone app.

“If used incorrectly, white noise exposure 24 hours a day, or at least during children's sleep periods, which are often 10 to 12 hours, can certainly cause permanent hearing loss,” said Michelle Hu, AuD, a pediatric audiologist at San Diego State University's Speech, Language and Hearing Clinic, who was not involved within the study. “A shot next to my ear would cause the same damage as listening to white noise or music at very high volume for 3 hours.”

What the brand new study found

The researchers conducted their evaluation published in the present issue of the magazine Sleep medicineafter one in all the team members “had dinner with friends and her child's white noise machine was so loud you could hear it in the other room,” co-author Isaac Erbele, MD, a neurotologist specializing in ear and skull surgery, said in an email.

Hearing damage from noise can accumulate over a lifetime, meaning parents should take precautions against noise, corresponding to attempting to avoid exposing their child to heavy metals corresponding to lead, which can even cause increasing damage over a lifetime.

Erbele and his colleagues recommend limiting white noise for kids and babies to 60 decibels. This corresponds to the quantity of a traditional conversation.

When noises are too loud for too long, the tiny parts of the inner ear could be irreparably damaged, and the health risks will not be limited to hearing loss. Children are also exposed to other problems as a consequence of prolonged noise exposure, the researchers concluded.

“We have found animal models that also suggest delayed development of the speech and hearing centers in the brain,” Erbele said. “The cause is unclear, and the animal model studies we included focused on development rather than changes in the adult brain. Studies in adult humans have found reduced attention and increased mental workload in the presence of increased noise, and the [could] be the reason for the developmental delay.”

Commercially available white noise machines can reach volumes of 91 decibels, the researchers reported, which exceeds exposure recommendations for workers set by the National Institute for Occupational Safety and Health. White noise from a streaming playlist can certainly be played at even higher volumes depending on the capacity of the speakers, such as when the sounds are played through a cellphone, tablet or standalone external speakers.

Of particular concern is the length of time babies and young children can be exposed to white noise at high volumes, Erbele said. Some babies sleep up to 16 hours a day, and young children sleep up to 12 hours at night.

For their analysis, the researchers combined results from 20 previous studies, including data on the effects of white noise on children, adults and animals. They compared these results with the safety limits set by federal agencies to protect workers.

It's common for medical researchers to take such a piecemeal approach rather than designing a research study that could harm children by intentionally exposing them to something believed to be harmful. But the piecemeal approach limits the study's findings, which the team acknowledged, noting that “further research is required on the optimal intensity and duration of kids's exposure to white noise.”

How to use white noise safely

Erbele and other experts recommend that parents who use white noise for their children be careful to limit the volume. Fortunately, this isn't difficult to do. But it's important to spread the word.

“More people must find out about this. More and more individuals are using white noise generators, and I actually have been doing that too. When I had my first child in 2018, I definitely played the white noise louder,” said Hu, who also runs a website called Mama Hu hearswhich she describes as an online community whose mission is to “help hearing parents of deaf and hard of hearing children feel more confident in their journey.”

Hu said one day she realized she should check the volume of her white noise machine because there are standards for how much noise should be in neonatal intensive care units. Hu now limits her white noise machines to 45 decibels.

“As a desperate mother, you may think, 'It's not working. I would like to show it up. They need it up. It will calm them down if it's up.' But that's not the case,” she said.

The Recommendations The study released last year by the American Academy of Pediatrics suggests that white noise machines:

  • Place as far away from the infant as possible
  • Used at the lowest possible setting
  • The use is as short as possible.

When the AAP's recommendations on excessive noise exposure were released, lead author Sophie J. Balk, MD, said she was surprised by how many people focused on the small sections of the article discussing white noise. Balk, an attending physician at Montefiore Children's Hospital and a professor of pediatrics at Albert Einstein College of Medicine in the Bronx, N.Y., expected the response to focus on the widespread use of headphones, especially given the advent of in-ear headphones like AirPods.

Likewise, Hu said the increasing use of white noise by parents and caregivers, as well as research like the latest from Erbele and his colleagues, have led her to ask her patients about using white noise.

Hu and Erbele recommend downloading a smartphone app to measure the volume of a white noise machine, such as the one provided by the National Institute for Safety and Health at Work. According to the CDC, the app has been downloaded more than 2.5 million times. Measure the volume of the white noise where the child's head is and adjust the volume by moving the speaker farther away or turning the volume down.

Adults who use white noise while sleeping may also want to check the volume level.

“For adults, the suggestion to show down noise machines is even stronger,” says Erbele, who practices at Brooke Army Medical Center in San Antonio, Texas, and is the associate program director for otolaryngology. He is also an associate professor in the department of surgery at the Uniformed Services University of the Health Sciences.

“The link between noise and hearing loss in adults is much better established,” he said. “The biggest difference is that the majority adults can turn the noise down if it bothers them. And the danger for adults is more related to everlasting hearing loss than to brain development.”

Research has linked noise to a range of health problems, from heart and vascular problems to dementia. It's not uncommon for people to simply find noise a nuisance, but it's a public health issue, says Balk, an expert in children's environmental health and co-editor of “Pediatric Environmental Health,” the AAP's handbook for health care professionals, sometimes called “The Green Book.”

“In general, we would like to avoid high volumes for long periods of time,” she said. “Hearing is lifelong and you would like to protect anything that's lifelong. You wish to protect your heart and your lungs, you would like to protect your skin. … It's vital to place hearing health on our agenda starting in infancy.”