The Costanzo family makes a special delivery to the NICU’s Brigham Baby Academy program.

Anthony Costanzo is a happy, healthy 3 year old who loves toy trucks and the children’s book Goodnight, Goodnight, Construction Site. Every time his father, Joe Costanzo, thinks of the book, he is reminded of the long days the Costanzo family spent in the Brigham’s Neonatal Intensive Care Unit (NICU) reading the story to a tiny, newborn Anthony.

Anthony was born at 24 weeks and five days gestation in May 2020, just months after the onset of the COVID-19 pandemic. Due to his very premature birth, Anthony was cared for in the NICU for four months. Joe and his wife, Adrianna Costanzo, could only visit him one at a time because of pandemic-era visitor restrictions.

During that time, the Costanzos found that regularly reading aloud to Anthony helped them bond as a family and offered a reprieve from the uncertainty that accompanies having a baby in the NICU.

“People would ask, what can we do to make it easy for you guys being there? We wanted Anthony to hear our voices, so friends and family would give us books to read to him,” Joe said.

The family recently donated over 300 books to the NICU to support the unit that did so much for them and to help other families find a similar sense of comfort.

“Reading was the way we would really connect with Anthony in times that we couldn’t hold him,” Adrianna said. “We could tell that if he was having a rough day and we came in to read with him, he would hear our voice and would calm down.”

That experience doesn’t surprise neonatologist Carmina Erdei, MD, who founded an early literacy and reading initiative at Brigham’s NICU known as the Brigham Baby Academy (BBA).

“Regular, daily reading routines since birth can help infant cognitive and language development later in childhood,” said Erdei, director of the NICU’s Growth and Development Unit.

The BBA partners with the national Reach Out and Read program to further spread the literacy message to families of infants in the NICU. The unit maintains a library of donated books that are available for use on the unit and gifted to families so they can begin reading to their babies as early as possible in life.

Given the extremely vulnerable nature of the NICU’s patient population and the initial uncertainty surrounding COVID-19 transmission in the early days of the pandemic, the BBA’s library was temporarily closed during the time of Anthony’s hospitalization. Still, the Costanzos quickly saw the value of the program’s mission as they read to Anthony during their visits with books from home.

As Anthony grew bigger and stronger, Adrianna and Joe noticed that he started looking at them and recognizing their voices while they were reading — an important and heartwarming milestone for any baby but also a “really special” moment, his parents said, after all they had been through.

Babies in the NICU have different experiences than babies who do not require such care right after birth. The sights, sounds, sensations and overall environment of a NICU can be stressful for infants. Research has shown that increased parent engagement and presence in an infant’s care not only provides tremendous comfort to babies, but it also leads to greater meaningful language exposure, which in turn is associated with improved language and cognitive skills in early childhood.

“Hearing the words from the stories that we would read to him helped Anthony come along with his speech and learn new words,” Joe said. “We’re seeing the benefits of it right now with the way he’s growing.”

These advantages go both ways, as parents also reap significant benefits from connecting with their children in this way.

“Reading with their baby can help create meaningful moments between parents and infants. It helps parents become more confident in their parenting skills and strengthens the parent-infant relationship,” Erdei said. “There is some evidence suggesting these routines can help enhance parental wellness, which is very important, particularly during a stressful time while their baby is hospitalized in the NICU.”

To help other families experience the same benefits of the reading program, Joe and Adrianna invited their friends and families to purchase children’s books for donation using an Amazon wish list the Costanzos created and shared on social media. Ultimately, the family received 332 books that they donated to the Brigham NICU on Nov. 6. Anthony, who is still an enthusiastic reader –– especially of Goodnight, Goodnight, Construction Site –– was there to help his parents drop off the books.

The Costanzos placed a sticker on the outside of each cover with a short message about their story and words of encouragement for fellow NICU families.

“As someone who’s three years on the other side of it, the journey is long, tough and emotional,” Adrianna said. “But you’ll come out the other end stronger. It’s only for a moment, and the moment will pass.”

The family hopes to make the drive an annual event and aims to double the number of books donated next year. The donation is a critical contribution to the Brigham’s BBA program, which Erdei said is working to expand so that each family can receive a new book every couple of weeks and build a “small library” by the time their baby is ready to leave the hospital.

“I hope that the parents will always remember reading that book to them –– just like I did with Goodnight, Goodnight, Construction Site,” Joe said. “When I read it now, I’ll think back to those rough times, and you look at your child, no matter what the situation is, and say, ‘Hey, my son or daughter is home with me right now, and I’m reading to them.’”