Music for pain relief of minor procedures in term neonates

The Sound of Comfort: Neonatal Health Care Professionals' Perspectives on Music and Other Comfort Measures during Targeted Neonatal Echocardiography

This study aimed to assess health care professionals' perspectives on how implemented measures impact patient comfort during targeted neonatal echocardiography (TNE).Survey distributed to neonatal health care professionals at the Montreal Children's Hospital neonatal intensive care unit (NICU). Responses were collected for 4 weeks, anonymized, and analyzed using descriptive statistics.Of 110 respondents, most believed that scans in general disturbed infants (71%) by increasing the risk of hypothermia (75%), and lability (67%). Key comfort measures identified were warm gel (85%), bundling (80%), and a focused exam (<30 minutes; 80%). Neoclassical music recordings were valued for their calming effect on the infant (73%), parent (44%), and sonographer (39%). Respondents preferred recorded music over other forms of music delivery (53%).Health care workers generally agree that scans disturb newborns and that implementing comfort measures, such as music and the cost-efficient bundle used in our NICU, may enhance patient comfort. Further objective studies are needed to validate these findings and assess their impact on neonatal care outcomes · NICU staff surveyed on TNE comfort measures.. · Music may calm babies, parents, and workers.. · Warm gel, bundling, and focused exam highly valued.. · Care bundle is cheap and easily implementable..

The Effect of White Noise and Recorded Lullaby during Breastfeeding on Newborn Stress, Mother's Breastfeeding Success, and Comfort: A Randomized Controlled Trial

PURPOSE

The study was aimed at determining the effect of exposure to white noise and recorded lullaby during breastfeeding on newborn stress, mother's breastfeeding success, and comfort.

DESIGN AND METHODS

This single-blinded and three-parallel group randomized controlled study consisted of mothers who had given birth and whose newborns were at a hospital in Turkey. Seventy-five participants completed the study. They were assigned to white noise, lullaby, and control groups in equal numbers. Each group included 25 women. The questionnaires included descriptive characteristics of mothers, the LATCH Breastfeeding Assessment Tool, the Newborn Stress Scale, and the Visual Analog Scale. During the breastfeeding process, the newborn and mother listened to white noise and lullaby for approximately 15 min. The newborn stress and mothers' level of comfort were assessed before and after the interventions. The breastfeeding success of the mother assessed with the LATCH was completed within the first 15 min of breastfeeding.

RESULTS

The mean scores obtained from the Newborn Stress Scale by the mothers in the lullaby group and white noise group decreased significantly after the intervention. A significant difference was also observed in the control group. There were also significant differences between the changes in the mothers' comfort level of all groups. There were significant differences between the changes in the LATCH scores of the groups.

CONCLUSION

Both white noise and recorded lullaby significantly reduced newborn stress, and increased mother's comfort in the early postpartum period.

PRACTICE IMPLICATIONS

Music should be used as a nonpharmacological method to improve breastfeeding success in newborns.

Research progress of music intervention in nursing of premature infants in neonatal intensive care unit

BACKGROUND

With the continuous advancement of medical technology, the survival rate of preterm infants is gradually improving, However, due to the underdeveloped function of various organs and systems, preterm infants are often exposed to light, noise, medical as well as nursing operations and other stimuli during their hospitalization in neonatal intensive care unit (NICU); it is highly susceptible to a number of problems, such as pain, unstable vital signs, growth retardation, and sleep disruption.

OBJECTIVE

This article reviews the research progress of music intervention in nursing of premature infants in NICU with both traditional and conventional care.

METHODS

This article reviews the research background, methodology/design, and measurement/application effects of music interventions, including Chinese and Western traditional music, in the care of preterm infants in NICU. All scholarly literature retrieved from MEDLINE\PubMed, Science Citation Index Expanded, Google scholar, CNKI scholar, Scopus and PubsHub.

RESULTS

As a simple and effective non-pharmacological intervention, music intervention can effectively alleviate neonatal surgical pain, increase heart rate and oxygen saturation, promote sleep, growth and development, and improve neurological development.

CONCLUSIONS

This review provide theoretical references for clinical practice.

Exploring Pacifier-Activated Music Systems in the NICU: Improving Outcomes and Shortening Length of Stay

There is ample research discussing the benefits of a pacifier-activated music system with preterm and high-risk infants. Benefits include improving the quality of nonnutritive sucking (NNS) and increased feeding volume/attempts/endurance, which lead to decreased time to full oral feedings and shortened hospital stays. The use of pacifier-activated music systems supports a faster transition to oral feeding in preterm infants while learning to breastfeed or bottle feed in the NICU. When coupling pacifier-activated music systems with the NNS of a pacifier, the preterm infant gains efficacy in feeding strength and endurance. Benefits also include faster nipple feeding success, mother/infant stress reduction, fewer rehospitalizations, diminished length of stay, and other long-term benefits. This article will discuss how the benefits of using music in the NICU are widespread and should be implemented as a multidisciplinary approach in a variety of NICU settings. Several NICU patient populations can benefit from music using a music pacifier system dependent on the modes used.

A review and bibliometric analysis of global research on non-pharmacologic management for neonatal and infant procedural pain

Repeated and prolonged exposure to pain can impair neurodevelopmental, behavioral, and cognitive outcomes in newborns. Effective pain management of newborns is essential, but there is no comprehensive analysis of the status of neonatal pain non-pharmacologic management research. Original publications related to the non-pharmacological management of neonatal pain were obtained from the Web of Science Core Collection (WOSCC) between 1989 and 2024. CiteSpace and VOSviewer were used to extract information about countries/regions, institutions, authors, keywords, and references to identify and analyze the research hotspots and trends in this field. 1331 authors from 51 countries and 548 institutions published studies on the non-pharmacological management of neonatal pain between 1989 and 2024, with the number of publications showing an overall upward trend. Canada emerged as the leading country in terms of publication volume, with the University of Toronto and The Hospital for Sick Children identified as key research institutions. High-frequency keywords included "procedural pain," "management," "sucrose," "analgesia," and "preterm infant," resulting in 11 clusters. Keyword emergence analysis revealed that "neonatal pain," "analgesia," "oral sucrose," and "oral glucose" were research hotpots. Analysis of highly cited papers showed that the most referenced articles were published in the Clinical Journal of Pain. Researchers' interest in neonatal procedural pain has increased significantly over the past 30 years. This article can serve as a theoretical reference for future research on mild to moderate pain in neonates and infants, and it can provide ideas for exploring novel and secure pain management strategies.

Effect of music-based interventions on physiologic stability of hospitalized preterm infants. A pilot study

BACKGROUND AND OBJECTIVE

Hospitalized preterm infants experience reduced meaningful auditory exposures during a critical period of brain development. Music-based interventions (MBI) may be beneficial, though it remains unclear which stimuli optimally enhance infant stabilization. We investigated the relationship between three conceptually-different MBIs and short-term responses in hospitalized preterm infants.

STUDY DESIGN

This is a case-crossover pilot study including 21 preterm infants between 30 and 35 weeks postmenstrual age. Participants listened to three MBIs and 'no music'; each condition was provided three times in random order. We monitored physiologic and behavioral parameters around each exposure and analyzed results using linear mixed models.

RESULTS

Respiratory rates decreased after each MBI compared with 'no music' (p = 0.02). The most notable decrease occurred following exposure to a low, repetitive musical pattern resembling a lullaby (p = 0.01). We noted no significant changes for the remaining parameters.

CONCLUSION

Specific MBI characteristics may preferentially enhance physiologic stabilization in hospitalized preterm infants.

Parent-led neonatal pain management-a narrative review and update of research and practices

Introduction

Research related to parent-led neonatal pain management is increasing, as is the clinical implementation. Skin-to-skin contact, breastfeeding and parents' vocalizations are examples of pain reducing methods that give parents an opportunity to protect their infant from harm while alleviating their anxiety and developing their parenting skills.

Methods

In this paper we will provide a narrative review and describe the current research about parent-led neonatal pain management. Based on this we will discuss clinical challenges, implementation strategies and implications for future research.

Results

Parents express great readiness to embrace opportunities to increase their self-efficacy in their ability to address infant pain. Parent-led pain-reducing methods are effective, feasible, cost-effective, culturally sensitive, and can be individualized and tailored to both the parent's and infant's needs. Both barriers and facilitators of parent-led pain care have been studied in research highlighting structural, organizational, educational, and intra- and interpersonal aspects. For example, health care professionals' attitudes and beliefs on parent-led methods, and their concern that parental presence during a procedure increases staff anxiety. On the other hand, the presence of a local pain champion whose duty is to facilitate the adoption of pain control measures and actively promote parent-professional collaboration, is crucial for culture change in neonatal pain management and nurses have a key role in this change. The knowledge-to-practice gap in parent-led management of infants' procedure-related pain highlight the need for broader educational applications and collaborative professional, parental and research initiatives to facilitate practice change.

Conclusion

Parent-led neonatal pain management is more than simply a humane and compassionate thing to do. The inclusion of parent-led pain care has been scientifically proven to be one of the most effective ways to reduce pain associated with repeated painful procedures in early life and parents report a desire to participate. Focus on enablers across interprofessional, organizational and structural levels and implementation of recommended pediatric pain guidelines can support the provision of optimal evidence-based family-centered neonatal pain management.

COMFORTneo scale in preterm infants during live performed music therapy-Difference between close physical contact and hand touch contact

There is evidence that music therapy combined with physical contact to parents stabilizes the vital signs of hospitalized preterm infants. Yet, there is no evidence for the difference between simple contact by touching the infant in the incubator or cod, or close physical contact during music therapy sessions (MT). Behavioral effects of the various forms of attention toward the infant during therapy need to be elucidated. Our study aimed to quantify the effects of hand touch contact (HTC) and close physical contact (CPC) during live performed MT in preterm infants regardless of gestational age on behavioral state (assessed via COMFORTneo scale) and vital signs. A maximum of ten live music therapy sessions were delivered three to four times a week until hospital discharge to 50 stable infants. Pre-, during- and post-therapy heart rates, respiratory rates, oxygen saturations and COMFORTneo scores were recorded for each session. A total of 486 sessions was performed with 243 sessions using HTC and CPC each. The mean gestational age was 33 + 3 weeks, with 27 (54%) infants being male. We observed lower COMFORTneo scores, heart and respiratory rates and higher oxygen saturation during and after live performed music therapy independent of the kind of physical contact than before therapy. While pre-therapy values were better in the CPC group for all four variables, a higher mean response on COMFORTneo scale and vital signs was observed for HTC (COMFORTneo score -5.5, heart rate -12.4 beats per min., respiratory rate -8.9 breaths per min, oxygen saturation + 1.5%) compared to CPC (COMFORTneo score -4.6, heart rate -9.6 beats per min., respiratory rate -7.0 breaths per min, oxygen saturation + 1.1%). Nonetheless, post-therapy values were better for all four measures in the CPC group. Regression modeling with correction for individual responses within each patient also yielded attenuated effects of MT in the CPC group compared to HTC, likely caused by the improved pre-therapy values. Live performed music therapy benefits preterm infants' vital signs and behavioral state. During CPC with a parent, the absolute therapeutic effect is attenuated but resulting post-therapy values are nonetheless better for both the COMFORTneo scale and vital signs.