Music therapy during skin-breaking procedures in infants admitted to a Neonatal Intensive Care Unit or High Care ward: a non-pharmacological intervention
Admission to a neonatal intensive or high-care (HC) ward and need for repeated skin-breaking procedures
The three study arms are: 1. Care as usual (CAU) 2. Music therapy during the intervention 3. Music therapy after the intervention The intervention in this study will be a sedative music therapy session according to the Rhythm, Breath and Lullaby method. This method employs the ocean disc or guitar and voice as instruments and is specifically designed for NICU music therapy by Loewy and colleagues. The music therapists is trained to observe the infant and individualize the therapy sessions aimed at specific goals, including, for example, relaxation or parent-infant bonding. This protocol is currently standard care in the UMCG NICU but at present not used for procedural support. The UMCG NICU employs two board-certified music therapists with this additional specialization. The therapist will use the following protocol: First, the neonate’s behavioural state will be matched and mirrored using music. If the infant is fussing or agitated, a moderate to active tempo and intensity will be used. Throughout playing, the tempo is slowed gradually and intensity reduced. The music is slowed and simplified. The music is then transitioned into triple meter and further slowed and simplified so that the infant is aided to achieve a calm state. The instrumental music is faded out using toning or humming of the melody. The melody is then sustained in long notes and triple meter and repeated with a cadence. The session is closed on one tone. For the intervention, a parent-preferred lullaby (Song of Kin) will be used, which is a familiar piece of music to the neonate.
1. If the gestational age is between 33 and 42 weeks, expected length of stay >2 weeks 2. If the gestational age is <32 weeks, expected length of stay > 3 weeks (because one of our research projects has shown that starting music therapy after 7 days is more beneficial for these children than starting before 7 days of life) 3. Need for repeated skin-breaking procedures (at least three) within the study period 4. Written informed consent from parents
Inability of the parents to understand/speak Dutch