It's Official: Music can help preemies with pain

"Music may reduce pain and improve behavioral states in premature infants, researchers found."

LITTLE FALLS, N.J., May 29 -- Music may reduce pain and improve behavioral states in premature infants, researchers found.

A systematic review of nine studies investigating the effects of music on outcomes in premature babies found preliminary evidence for therapeutic benefits, Manoj Kumar, M.D., of the University of Alberta in Edmonton, and colleagues reported online in the Archives of Disease in Childhood.

But because of the methodological weaknesses of some of the studies included in the review, a meta-analysis could not be performed and the findings need to be confirmed in more rigorous trials, they said.
Music is increasingly being used in neonatal units to improve behavioral or physiological outcomes and to manage pain during common procedures. Benefits include calmer infants and parents, stable physiological parameters, higher oxygen saturation, faster weight gain, and shorter hospital stays, the researchers said.

To document such benefits, the researchers conducted a review of nine randomized trials reported between 1989 and 2006 that studied use of music on outcomes in neonates. Six studies evaluated music for painful procedures including circumcision and heel prick.

The studies used various types of music, but lullabies were the most common.

The methodological quality of the studies was generally poor, the researchers said.

One high-quality pilot study of 23 infants undergoing circumcision showed benefits of music for the outcomes of heart rate, oxygen saturation, and pain, while two low-quality studies found no difference.

Three studies evaluated the effects of music on pain from heel prick, and found it may be beneficial for measures of behavior and pain, but they were of low quality, the researchers said.

One study of music-reinforced non-nutritive sucking among 32 poorly feeding preterm infants found a significant increase in oral feeding rates compared with controls.

The researchers said it would be of particular interest to confirm the effects of using music to improve oral feeding rates, which could have the potential of "saving finite useful healthcare resources."

Another showed significant benefits in terms of heart rate and behavioral scores with recorded music versus no music in stable preterm infants.

But one methodologically strong study found no difference on the effects of recorded instrumental lullabies in 22 preterm infants with chronic lung disease compared with a no-music control group.

In general, the researchers said, the studies demonstrate that music may be beneficial in terms of behavioral states and pain, although they showed inconsistent effects overall on physiological measures.

Therefore, they said, benefits need to be confirmed in future well-designed, high quality trials.
By Kristina Fiore, Staff Writer, MedPage Today
Published: May 29, 2009
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner