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Music May Temper Pain in Preemies
Date:5/27/2009

Analysis finds benefits, but some question results beyond soothing of infants,,,,

WEDNESDAY, May 27 (HealthDay News) -- Playing music seems to reduce pain and encourage feeding in premature infants, University of Alberta researchers report.

Music is being widely used in neonatal units across North America, but how beneficial it is to the infants remains unclear.

Lead researcher Dr. Manoj Kumar, an assistant clinical professor in the neonatal division of the pediatrics department at the university, said the study "found some evidence to suggest that music may have beneficial effects in terms of physiological parameters, behavioral states and pain reduction during painful medical procedures in the neonates."

"Music was also noted to improve oral feeding among the preterm infants who were having difficulty making transition to oral feeding," he said.

These benefits, if confirmed, have the potential to save health-care resources by using less pain medication and enabling an earlier transition to oral feeding and discharge from the hospital, he noted.

The report is published in the May 27 online edition of the Archives of Disease in Childhood.

For the study, Kumar's team analyzed data from nine trials, including six that looked at music played while infants underwent painful procedures such as circumcision or having a heel pricked to obtain blood samples. The others looked at music played for premature infants.

Measurements such as heart rate, respiratory rate, oxygen saturation and pain were used to evaluate the benefit of music.

In studies that involved circumcision, music was found to have benefits for the infants' heart rate, oxygen saturation and pain. Several studies that involved a heel prick also reported evidence that music could have a benefit in reducing pain and improve behavior. The music played ranged from classical to lullabies and nursery rhymes.

"Calmer infants, a stable condition in the child's physiologic functions such as heart rate and higher oxygen saturation, and lesser pain during the painful procedures such as circumcision and blood sampling via heal prick" were all reported, Kumar said.

"One study noted that the use of a pacifier-activated lullaby system in the preterm infants helped improve their oral feeding rates," he said. "These infants were previously documented to have difficulty in making the transition to oral feeding."

However, Dr. F. Sessions Cole, director of newborn medicine and head of the neonatal intensive care unit at St. Louis Children's Hospital, thinks the jury is still out on whether music in intensive care units works in reducing infant discomfort.

"This article provides a systematic analysis of available information concerning the possible usefulness of music for pain management among sick newborn infants who are undergoing procedures," Cole said, but he noted that "the authors indicate that the methodological problems with all of the reported studies preclude any conclusions about the efficacy of music therapy in the neonatal intensive care unit."

"I know many of us would like this music-based strategy to work to reduce use of pain medications and to improve outcomes of these fragile, high-risk infants," Cole said. "However, based on this article, evaluation of the use of music for pain relief among sick newborn infants is experimental at best and will require more carefully designed, methodologically rigorous strategies before any kind of conclusion about its usefulness can be made."

Dr. Charles R. Bauer, a professor of pediatrics, obstetrics-gynecology and psychology at the University of Miami Miller School of Medicine, noted that research on the benefit of music for infants is sketchy at best.

"The use of music as a soothing intervention for infants is well known," Bauer said. "We know that a neonatal intensive care unit is an abnormal situation. The interventions that the babies undergo are always painful and always uncomfortable, so any attempt to try to soften that environment is a positive intervention."

As an effort to improve the infant's environment, music is worthwhile, Bauer said. "But from an academic standpoint, it is considered very soft science so it's not being used widely, and this article does not advance the cause," he said.

Bauer thinks that randomized trials are needed to really show whether music therapy in such situations is beneficial or not.

More information

The Nemours Foundation has more on, visit the neonatal intensive care.



SOURCES: Manoj Kumar, M.D., assistant clinical professor, Neonatal Division, Department of Pediatrics, University of Alberta, Edmonton, Canada; F. Sessions Cole, M.D., director, newborn medicine, and head, neonatal intensive care unit, St. Louis Children's Hospital; Charles R. Bauer, M.D., professor, pediatrics, obstetrics-gynecology and psychology, University of Miami Miller School of Medicine; May 27, 2009, Archives of Disease in Childhood, online


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