| 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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