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J Music Ther. 2005 Summer;42(2):123-39.

Effects of the pacifier activated lullaby on weight gain of premature infants.

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  • 1The University of Georgia, Georgia, USA.


Within the past 5 years there has been an increase of premature infants surviving in the neonatal intensive care unit as well as an increasing cost for each day the infant is kept there. It is important for the premature infant to acquire the feeding skills necessary for weight gain, which lead to discharge from the hospital, and recent advancements have indicated the effectiveness in using contingent music to teach sucking skills to premature infants. The purpose of the first analysis in this study was to determine the effects of Pacifier Activated Lullaby (PAL) trials on weight gain of premature infants. During a 2-year time period, 62 infants from a sample of 188 met criteria for analysis. A one-way analysis of variance showed no significance in daily weight gain for the number of PAL trials completed. The mean weight gains for infants with 1 PAL trial = 13.85 grams, 2 trials = 26.67, 3 trials = 29.64, and 4 or more = 22.89. The Pearson product-moment correlation between the mean percent of music earned via nonnutritive sucking (NNS) and mean weight gain of all trials approached significance (p = .077, r = 0.18). In a second analysis, weight gained prior to use of PAL, during use of PAL, and post use of PAL was analyzed. Results indicated no significant difference between weight gain 1 day prior to use of PAL, the day of PAL trial, and 1 day post use of PAL. Mean weight gain for those infants who participated in 1 PAL trial was 8.49 grams for 1 day prior to use of PAL, 18.73 the day of PAL trial, and 24.81 for 1 day post use of PAL. Mean weight gain for 3 days prior to using the PAL was 10.78, 11.30 on the day of PAL trial, and 24.78 grams for 3 days post PAL use. The analyses show definite trends of greater weight gain with PAL use; however, individual variability within groups was greater than group differences leading to no significance in statistical analysis. In the third analysis the effect of proximity between premature infants' feeding schedule and PAL trial on amount of time the infant received contingent music via NNS was examined; the infants' feeding and sleep schedules were divided into 5 blocks of time. Results indicated no statistical significance among the amount of time premature infants sucked/received music according to their schedule, although there were noticeable differences in the average percent of music reinforcement received according to assigned block. Infants who participated in PAL trials 30 minutes prior to feeding scored the highest average at 77.25 %, followed by 71% for infants who participated in PAL trials during feeding. Other times, primarily after the infants' feeding, resulted in averages of 59% and 54.5%; these infants often fell asleep after their feeding and did not complete the full 15-minute trial. Based on this research and previous research on NNS, it seems beneficial for premature infants to participate in PAL opportunities 30 minutes prior to feeding.

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