Music combined with touch therapy to decrease pain response in preterm infants

INTERVENTION: After consent is obtained from parents, infants are randomly assigned to either the experimental or control group using a random numbers table. Participants in both groups undergo a range of painful procedures during their standard medical care in the NICU. Control group: Infants receive daily painful procedures without intervention Experimental group: Infants receive painful procedures as well as the combined music and touch intervention (CMT). A CD player (Philips AZ‐1103) is used for the music intervention. Audio stimulation is provided by “Smart Baby Lullaby” compact discs. The music includes lullabies and nursery rhymes, which are musically simple songs with lower pitch and slower tempo. The disc player is placed approximately 15‐20 cm above the infants’ heads, allowing for continuous play of the music from 5 minutes before the experimental procedure until 30 minutes after the procedure. The touch intervention protocol (Gentle Human Touch, GHT), starts from the beginning of procedures until 10 min after the procedure. It involves the assistant gently placing her left hand on the infant’s head with the fingertips resting immediately above the eyebrow line and the palm touching the infant’s crown. The right hand is then placed with the right thumb on the infant’s right shoulder (at midline position) with the rest of her hand and fingers on the infant’s arm above the elbow. These procedures are repeated for every painful procedure during the two weeks data collection period. CONDITION: Cortisol and ß‐endorphin levels in pre‐term infants ; Nutritional, Metabolic, Endocrine ; Cortisol and ß‐endorphin levels in pre‐term infants PRIMARY OUTCOME: Pain is measured using the premature infants’ pain profile (PIPP) at baseline and 2 weeks. SECONDARY OUTCOME: 1. Cortisol levels are measured using blood testing at baseline and 2 weeks; 2. Beta‐endorphin levels are measured using blood testing at baseline and 2 weeks INCLUSION CRITERIA: 1. Admitted within 72 hours after birth 2. Gestational age is less than 37 weeks