Live Music Therapy With Lullaby Singing as Affective Support During Painful Procedures: A Case Study With Microanalysis


Nordic Journal of Music Therapy




During the most vulnerable period in a child's life, preterm and sick infants are exposed to a high number of painful procedures, sometimes without the comfort and affection of their parents. Since repeated pain and frequent use of analgesic drugs may have consequences for the neurological and behaviour-oriented development of the infant, it is vital to identify effective non-pharmacological interventions with regard to procedural pain. This paper reviews the use of live lullaby singing as an adjuvant to the control of premature infant pain. The objectives of this case study were to analyse the live lullaby singing for two premature infants during venipuncture in comparison to standard care only, and the infants' physiological and affective responses emerging before, during and after this procedure. The empirical data stem from a quantitative clinical study. From this larger study, two premature infants were selected. Through microanalysis, with in-depth analysis of video footage, and pain assessment with Behavioral Indicators of Infant Pain (BIIP), painful standard care procedures with and without live lullaby singing, were analysed. The results show that live lullaby singing with premature infants is a communicative interaction which may optimize the homeostatic mechanisms of the infant during painful procedures. This case study shows the importance of predictability of the affective support, right from the start of the live singing intervention. It is important in a painful context that vocal interactions provide regular and comforting intensity, shape and temporal structures.

Music and Health Institute Terms

Behavioral Scales; Hospital Setting; Infants; Invasive Medical Procedures; Live Music Listening; Medication Use; Music Listening; Music Medicine; Newborn Infants; Pain; Premature Infants; Procedural Pain

Indexed Terms

Pain management; premature infants; infant directed singing; lullaby; microanalysis; Babies; Case studies; Singing; Neurology

Study Type

Case Study; Qualitative Methods

PubMed ID


Document Type