title: Pain relief effect of breast feeding and music therapy during heel lance for healthy-term neonates in China: a randomized controlled trial.
abstract: OBJECTIVE
  to test the effectiveness of breast feeding (BF), music therapy (MT), and combined breast feeding and music therapy (BF+MT) on pain relief in healthy-term neonates during heel lance.
  
  
  METHODS
  randomised controlled trial.
  
  
  METHODS
  in the postpartum unit of one university-affiliated hospital in China from August 2013 to February 2014.
  
  
  METHODS
  among 288 healthy-term neonates recruited, 250 completed the trial. All neonates were undergoing heel lancing for metabolic screening, were breast fed, and had not been fed for the previous 30 minutes.
  
  
  METHODS
  all participants were randomly assigned into four groups - BF, MT, BF+MT, and no intervention - with 72 neonates in each group. Neonates in the control group received routine care. Neonates in the other three intervention groups received corresponding interventions five minutes before the heel lancing and throughout the whole procedure.
  
  
  METHODS
  Neonatal Infant Pain Scale (NIPS), latency to first cry, and duration of first crying.
  
  
  RESULTS
  mean changes in NIPS scores from baseline over time was dependent on the interventions given. Neonates in the BF and combined BF+MT groups had significantly longer latency to first cry, shorter duration of first crying, and lower pain mean score during and one minute after heel lance, compared to the other two groups. No significant difference in pain response was found between BF groups with or without music therapy. The MT group did not achieve a significantly reduced pain response in all outcome measures.
  
  
  CONCLUSIONS
  BF could significantly reduce pain response in healthy-term neonates during heel lance. MT did not enhance the effect of pain relief of BF.
  
  
  CONCLUSIONS
  healthy-term neonates should be breast fed to alleviate pain during heel lance. There is no need for the additional input of classical music on breast feeding in clinic to relieve procedural pain. Nurses should encourage breast feeding to relieve pain during heel lance.
authors.affiliation: Department of Nursing, School of Medicine, Xiamen University, Xiamen, China. Electronic address: jieminzhu@xmu.edu.cn.
authors.forename: Jiemin
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: nurhhg@nus.edu.sg.
authors.forename: He
authors.initials: H
authors.lastname: Hong-Gu
authors.affiliation: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China. Electronic address: xmszxz@163.com.
authors.forename: Xiuzhu
authors.initials: X
authors.lastname: Zhou
authors.affiliation: BSc (Nursing) Programme, Department of Nursing, School of Medicine, Xiamen University, China. Electronic address: 1538910849@qq.com.
authors.forename: Haixia
authors.initials: H
authors.lastname: Wei
authors.affiliation: BSc (Nursing) Programme, Department of Nursing, School of Medicine, Xiamen University, China. Electronic address: 1454472210@qq.com.
authors.forename: Yaru
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Nursing, School of Medicine, Xiamen University, Xiamen, China. Electronic address: benlanye@xmu.edu.cn.
authors.forename: Benlan
authors.initials: B
authors.lastname: Ye
authors.affiliation: School of Medicine, Xiamen University, Xiangan Campus, Xiamen 361102, China. Electronic address: zuguoliu@xmu.edu.cn.
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Liu
authors.affiliation: School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Australia. Electronic address: sally.chan@newcastle.edu.au.
authors.forename: Sally Wai-Chi
authors.initials: SW
authors.lastname: Chan
mesh_terms: D000698:Analgesia; D001800:Blood Specimen Collection / Q000379:methods / Q000706:statistics & numerical data; D001942:Breast Feeding; D002681:China; D005260:Female; D006365:Heel / Q000293:injuries*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis; D009147:Music Therapy; D010146:Pain / Q000517:prevention & control; D059408:Pain Management / Q000379:methods*; D011247:Pregnancy
keywords: Breast feeding; Heel lance; Music therapy; Pain relief; Randomised controlled trial