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
This article first appeared
in the Forbes publication in May, 2009. Their website
can be found at www.Forbes.com.
Music without words means leaving behind the mind. And leaving behind the mind is meditation.
Meditation returns you to the source. And the source of all is sound. — Kabir
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