Music therapy in neonatal care reflects a growing area of interdisciplinary interest. But how exactly is best practice in neonatal music therapy characterized? Initial guidelines already exist, but the question regarding relevance they have for the Germanspeaking region remains, in light of possible specific cultural issues and clinical experiences. The Fachkreis Musiktherapie Neonatologie (FMtN), a professional circle of German speaking neonatal music therapists, has aimed to address these questions by developing an overall framework from the three approaches typical of this region: (1) recorded maternal voice, (2) live vocal and (3) live instrumental music therapy. The group has synthesized its members’ practical clinical expertise with the best available evidence, guidelines in neonatal music therapy and German guidelines for individualized developmental neonatal care. The paper presents a framework including overall objectives, (contra-) indications and methods independent of the specific approach used. It supplements existing guidelines with culturally sensitive requirements such as minimizing the music stimulation by mainly humming, in infant applications. This framework may serve as a model for music therapists to offer culturally relevant best practice interventions and to better position themselves among various related disciplines.