Effects of three different auditory interventions on physiological and behavioral responses to neonatal heel lance

Neonatal heel lance procedures cause significant distress, requiring effective, non-pharmacological pain management strategies. This study aimed to determine the effects of white noise, classical music and mother-sung lullabies on the heel lance process, by comparing them with the control group (gentle voice).

A single-blind, four-arm, parallel randomized controlled trial (NCT06167551) was conducted in a hospital NICU between November 2023 and June 2024. A total of 100 newborns were randomly assigned to one of four groups: white noise, classical music, mother-sung lullabies, or control (gentle voice). Neonatal pain was assessed using the Neonatal Infant Pain Scale (NIPS) and the Neonatal Infant Acute Pain Assessment Scale (NIAPAS). Crying duration and physiological parameters were recorded using medical devices, and video documentation ensured consistency in assessments.

During heel lance, the mother-sung lullabies group had the lowest NIPS and NIAPAS scores, while the white noise group had the lowest scores after the procedure. The shortest crying duration occurred in the white noise, mother-sung lullabies and classical music groups, respectively. These findings were statistically and clinically significant.

These auditory interventions are accessible and easy to apply, reduced neonatal pain scores during heel lance procedures for newborns. Furthermore, even if there is no device available to play sounds to newborns, nurses can manage pain at a lower cost by having the mother sing a lullaby live.