Public Release:  Music may improve feeding, reduce pain in premature babies: U of A study

University of Alberta Faculty of Medicine & Dentistry

As long as there have been babies, adults have crooned lullabies to soothe them. But research suggests music might also help premature infants learn to suckle better and reduce their pain.

If confirmed, this would be a simple, low-cost way to help these tiny babies feed on their own faster and move them out of neonatal units sooner, says Dr. Manoj Kumar, an assistant clinical professor in the Faculty of Medicine & Dentistry's Department of Pediatrics. "If you can get them to feed earlier then you can save health-care resources," Kumar says.

Music also appears to reduce infants' pain during circumcision and some medical procedures, he says.

Music is increasingly being played in neonatal units on an informal basis because parents and caregivers have a perception that it's beneficial for the infants.

Kumar, a clinical epidemiologist who also has training in health economics - and several of his colleagues associated with the Alberta Research Centre for Child Health Evidence (ARCHE) in the Pediatrics Department - decided to conduct a rigorous, systematic review of medical literature to see what research has shown.

The results of their review are being published online ahead of print on May 28, 2009, in the London-based journal Archives of Disease in Childhood, Fetal and Neonatal Edition.

Of 180 studies the U of A team examined, nine randomly controlled trials published between 1989 and 2006 met the review criteria and were included.

These nine studies were all so different that the review team says it was not possible to reach any definitive conclusion. But the team did find much "preliminary evidence that music may have beneficial effects in terms of physiological parameters, behavioural states and pain reduction during painful medical procedures."

"Music may also improve oral feeding among premature infants," the U of A authors say.

In particular, Kumar notes one 2003 U.S. study reported that feeding rates increased significantly with use of a pacifier-activated lullaby (PAL) system in preterm infants who previously were having difficulty in making the transition to oral feeding. This result warrants further investigation, given its potential implications for health-care budgets, he says.

The PAL system consisted of a soother connected to a pressure transducer which was further connected to a tape recorder. When the baby sucked on the soother, the pressure activated recorded lullabies.

Another high-quality pilot study, conducted in the U.S. in 2001, looked at whether music could help with pain control during circumcision. It found that playing recorded lullabies and nursery rhymes lowered pain levels as measured by the babies' heart rate and oxygen saturation, and according to established pain scales that measure infants' behavioural responses.

However, the U of A review noted most trials that have been conducted to date are small in size and methodological quality is poor in many of them. It would be worthwhile for more research to be done in this area, the article says.

"Additional methodologically rigorous, randomised controlled trials are warranted to confirm and to further elucidate the benefits of music for neonates before any specific recommendation for the use of music can be made in the neonatal population," state the authors.

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*U of A authors include: Lisa Hartling, acting director, ARCHE; Lisa Tjosvold, research librarian, ARCHE; Grace Young, statistician, ARCHE; Dr. Mehaboob Shaik, Neonatal-Perinatal Medicine, Department of Pediatrics; Robin Leicht, ARCHE. Lead author: Dr Manoj Kumar, Neonatal-Perinatal Medicine, Department of Pediatrics.

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