title: Impact of music therapy on breast milk secretion in mothers of premature newborns.
abstract: BACKGROUND
  The promotion of breastfeeding is a simple and efficient strategy in reducing morbidity and mortality in neonates worldwide. Milk from the mother of a Preterm New Born (PTNB) infant contains a higher concentration of nutrients and energy than that produced by mothers of a full-term infant. Studies have shown that music therapy can reduce maternal anxiety, helping mothers cope with the hospitalization of their newborns in Neonatal Intensive Care Unit (NICU).
  
  
  OBJECTIVE
  To evaluate the impact of music therapy on amount of breast milk secretion among mothers of premature newborns by reducing maternal stress.
  
  
  METHODS
  Mothers of premature babies who were admitted to NICU at a tertiary health care centre were included as subjects. Mothers of premature infants were enrolled in the study once they came to NICU to express breast milk from Dec 2012 to May 2013. Each subject was assessed for 4 sessions on MT (Music Therapy) and 4 sessions on NMT (No Music Therapy) over 4 days. Breast milk was expressed using breast milk pump and quantity was measured for two sessions each day once at 11.00am and other at 4.00pm. Raga malkauns and yaman by flute was used for music therapy. MT was administered for 4 sessions in a randomized manner during the study period of 30mins (15mins prior to and 15mins during Breast milk amount). To assess the psychological stress, PSS questionnaire was administered on day 1 and day 4 of MT. Mother's saliva was collected to estimate salivary cortisol level on the last day of study during the sessions with MT and NMT.
  
  
  RESULTS
  Music therapy was associated with a significant reduction in stress level as shown by improved PSS score and reduced salivary cortisol. Subjects who received music therapy had significant increase (p-value- 0.033) in breast milk expression when compared to mothers who didn't.
  
  
  CONCLUSIONS
  Music therapy can be easily used in the breast milk expression room as a method to increase breast milk secretion in mothers who are stressed because of their neonates being admitted in NICU.
authors.affiliation: Assistant Professor, Department of Physiology, Sri Venkateshwaraa Medical College Hospital & Research Centre , Puducherry, India .
authors.forename: Jayamala
authors.initials: J
authors.lastname: Ak
authors.affiliation: Associate Professor, Department of Physiology, M S Ramaiah Medical College & Hospital , Bangalore, India .
authors.forename: Preethi Bangalore
authors.initials: PB
authors.lastname: Lakshmanagowda
authors.affiliation: Associate Professor (Neonatologist), Department of Paediatrics, M S Ramaiah Medical College & Hospital , Bangalore, India .
authors.forename: Pradeep
authors.initials: P
authors.lastname: G C M
authors.affiliation: Professor, Department of Physiology, M S Ramaiah Medical College & Hospital , Bangalore, India .
authors.forename: Jaisri
authors.initials: J
authors.lastname: Goturu
keywords: Maternal stress; Neonatal Intensive Care Unit; Salivary cortisol