Elsevier

Early Human Development

Volume 124, September 2018, Pages 7-10
Early Human Development

Music reduces pain perception in healthy newborns: A comparison between different music tracks and recoded heartbeat

https://doi.org/10.1016/j.earlhumdev.2018.07.006Get rights and content

Highlights

  • Physiological response of newborns undergoing painful medical procedures is modified by music and heartbeat recordings

  • Exposure to three different music interventions improves heart rate, oxygen saturation and infant pain perception over time.

  • The comparable effects displayed by all the groups may be explained by the common characteristics shared by the sound stimuli.

  • Identify specific sound properties could be helpful to replicate these positive effects with different groups of infants.

Abstract

Objectives

To assess the effect of 3 musical interventions, as compared to no music, on the physiological response of healthy newborns undergoing painful medical procedures (Guthrie test and/or intramuscular antibiotic injections).

Methods

Prospective study of 80 full-term newborns, aged 1 to 3 days, randomly allocated to exposure to Mozart's Sonata for two pianos K.448, Beethoven's Moonlight Sonata, heartbeat sound recordings (70 bpm) or no music.

Pain perception (evaluated using the Neonatal Infant Pain Scale), heart rate and oxygen saturation were measured 10 min before (T0), during (T1), 10 (T2) and 20 (T3) minutes after the interventions.

Results

Infants who were exposed to the three music interventions displayed a significant reduction in heart rate and in pain perception and an increase in oxygen saturation, as compared to the control group, which showed less modifications on stress measurements after painful medical procedures (F(3,76) = 6.40, p = .001, partial η2 = 0.20).

Conclusions

Exposure to music and heartbeat sound recordings changes short-term physiological parameters in healthy newborns undergoing potentially painful procedures. The similar effect shown by the 3 interventions might be explained by the common characteristics of the sound shared by the various tracks. Further research is needed to investigate the impact of different types of music used in intervention, in order to develop guidelines and include music as a part of evidence-based strategies to promote the outcome for neonates.

Introduction

Several studies have proven that listening to music, voices and heartbeats can positively affect physiological indicators, feeding, length of stay, and pain outcomes for newborn babies [[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]]. Listening to music and to parent-preferred lullabies can be used to objectively determine the effects of these interventions on the heart rate, oxygen saturation (O2Sat), nutritive sucking and caloric intake of premature newborns [4,5,8,10]. Music may also improve oxygen saturation in preterm infants undergoing endotracheal suctioning [11] and also reduce stress and pain in children undergoing painful medical procedures, such as intravenous injections, lumbar punctures and dental procedures [[12], [13], [14]].

Although the available literature suggests that the presence of harmonic and rhythmic sound can positively affect neonatal neurobehavioral development and reduce parental stress during neonatal intensive care unit (NICU) stays [[1], [2], [3]], the heterogeneity of study populations, interventions and outcomes precludes definitive conclusions on the efficacy of music for specific indications [1].

To date, the main criticisms from published works relates to a lack of categorisation of the impact that various types of music, different genres or variables within the music have on physiological outcomes.

This study evaluated the effects of three music interventions (compared to no intervention) on physiological parameters and pain perception in healthy newborns undergoing painful medical procedures. A comparison between the effects of each musical intervention was conducted in order to investigate the optimal characteristics of the sound stimuli to be used with healthy newborns, to avoid the risk of hyperstimulation and to best reduce procedural pain perception and stress.

Section snippets

Participants

The study was conducted in the Neonatal Intensive Care Unit of the University Hospital of Brescia, Italy.

Eighty full-term healthy infants were enrolled during a 15 month period, with Apgar score of 8 or above, breathing spontaneously and hemodynamically stable. We verified that all infants recruited to this study had normal brainstem auditory responses (a routine procedure in all infants who are discharged from our NICU). The exclusion criteria were congenital malformations, mechanical

Results

No significant differences were found at baseline in the clinical characteristics of the subjects, nor in all the selected outcome measures (Table 1).

Between T0 and T3 the mean heart rate varied from 112.35 to 110.7 bpm in the first group (Mozart's Sonata for two pianos K.448), from 119.8 to 110.8 bpm in the second group (Beethoven's Moonlight Sonata) and from 111.8 to 105.6 in the third group (heartbeat sound recordings). By contrast, the average heart rate varied from 124.2 to 128.75 in the

Discussion

There is a growing interest in the management of stress and pain in hospitalized children, and neonates constitute a population group that might benefit from the application of standardized protocols of music therapy to provide stress reduction and analgesia [2]. According to the previous literature, although there is preliminary evidence of the therapeutic benefits of music, studies investigating the effects of music in early life have produced equivocal results, probably due to the variation

Conflict of interest statement

None declared.

Acknowledgements

We are grateful to Dr. Antonella Gasparoni for her precious assistance and to all the NICU nurses for their valuable help in performing the treatment of the children included in this study.

References (24)

  • R. Amiri et al.

    Effect of lullaby music listening on SPO2 in premature infants

    J. Birjand Univ. Med. Sci.

    (2009)
  • E. Amini et al.

    Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial

    J. Neonatal-Perinatal Med.

    (2013)
  • Cited by (22)

    View all citing articles on Scopus
    View full text