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Hearing the mother’s voice reduces pain in premature babies

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The mother’s voice helps the premature baby to better bear the pain of the medical procedures.

A study conducted by The University of Geneva (UNIGE), in collaboration with the Parini Hospital in Italy and the University of Valle d’Aosta, witnessed that when the mother spoke to her baby during the medical intervention, the baby’s signs of pain reduced and his oxytocin level increased significantly, indicating that the baby was effectively managing his pain.

The findings, appeared in the journal Scientific Reports, shows the importance of parents presence with premature babies, who face intense stress from birth, a presence that has a real impact on their well-being and development.

Premature babies are taken away from their mothers as soon as they are born before 37 weeks of gestation and placed in an incubator, often in intensive care. They have to undergo daily medical treatments to maintain their survival (intubation, blood collection, and feeding tube, for example), which may have an effect on their development and pain management. 

The problem? It is not always viable to alleviate children with pharmaceutical painkillers due to the potential for substantial adverse effects on their brain development in the short and long run. Other methods include wrapping, restriction, sugar solutions, or non-nutritive sucking with a teat.

However, studies have demonstrated for several years that the presence of a mother or father has a significant soothing effect on the child, most notably through emotional modulation of the voice. This is why Didier Grandjean’s team at the Faculty of Psychology and Educational Sciences (FPSE) and at the UNIGE’s Swiss Center for Affective Sciences (CISA) is interested in the early vocal contact between the mother and the premature baby, the effect of the mother’s voice on the management of pain associated with routine activities necessary for the babies’ follow-up, and the psychological and cephalic effects of the mother’s voice.

To test this theory, the researchers monitored 20 premature infants at Italy’s Parini Hospital and requested the mother to be present during daily blood tests, which are performed by collecting a few drops of blood from the heel.

“We focused this study on the maternal voice, because in the first days of life it is more difficult for the father to be present, due to working conditions that do not always allow days off,” said Dr. Manuela Filippa, a researcher in Didier Grandjean’s group and first author of the study.

The study was conducted in three phases over three days to allow for comparison: the first injection was administered without the mothers presence, the second injection was administered with the mother interacting with the baby, and the third injection was administered with the mother singing to the baby. The order in which these conditions occurred varied randomly.

“For the study, the mother started talking or singing five minutes before the injection, during the injection and after the procedure,” says the Geneva researcher.

“We also measured the intensity of the voice, so that it would cover surrounding noise, as intensive care is often noisy due to ventilations and other medical devices.”

To begin, the research team determined whether the baby’s suffering reduced when the mother was there. They accomplished this through the use of the Preterm Infant Pain Profile (PIPP), which sets a coding grid between 0 and 21 for facial expressions and physiological indicators (heartbeat, oxygenation) indicative of the baby’s painful feelings.

“In order to code the behaviour of premature babies, we filmed each blood test and judged the videos ‘blind’, by trained personnel, without sound, so as not to know whether the mother was present or not,” noted Didier Grandjean.

The findings are significant: while the mother is absent, the PIPP is 4.5, but reduces to 3 when the mother talks to her infant.

“When the mother sings, the PIPP is 3.8. This difference with the spoken voice can be explained by the fact that the mother adapts her vocal intonations less to what she perceives in her baby when she sings, because she is in a way constrained by the the melodic structure, which is not the case when she speaks,” emphasised the Geneva professor.

The scientists then looked at what changes in the baby when it hears its mother speak.

“We quickly turned to oxytocin, the so-called attachment hormone, which previous studies have already linked to stress, separation from attachment figures and pain,” explains Dr. Manuela Filippa.

The researchers discovered that when the mother spoke or sang and after the heel prick, oxytocin levels increased from 0.8 picograms per milliliter to 1.4 picograms per milliliter.

“In terms of oxytocin, this is a significant increase,” she said.

These findings demonstrate the beneficial effect of the mother’s presence during unpleasant medical procedures on premature infants.

“We demonstrate here the importance of bringing parents and child together, especially in the delicate context of intensive care,” Manuela Filippa emphasised.

“Furthermore, parents play a protective role here and can act and feel involved in helping their child to be as well as possible, which strengthens the essential attachment bonds that are taken for granted in a full-term birth,” concluded Didier Grandjean.

Source: University of Geneva

Study: 10.1038/s41598-021-96840-4

Image Credit: iStock

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