DOES A MOTHER SINGING TO HER PREMATURE BABY AFFECT FEEDING IN THE NEONATAL INTENSIVE CARE UNIT?

Blumenfeld H, Eisenfeld E. Clinical Pediatrics. 2006;45:65-70.

This is a pilot study using experimental design with a convenience sample to determine whether mothers' singing affected duration and volume of infant feeding, heart rate, and respiratory rate, as well as the effects on the culture of the neonatal intensive care unit (NICU) in Connecticut.

The authors point out that the effects of music on neonates have been a focus of attention in recent research. They note that few studies have been conducted with live singing and that, to their knowledge, this was the first study of the effects of live music on neonates in the NICU setting. If there may be improved clinical outcomes as a result of singing, then there may be economic benefits if infants can be discharged from the NICU even 1 day earlier.

Eleven infants and their mothers were included in this pilot study. At the time of the study, none had any unresolved medical problems. Mothers gave 2 consecutive feedings on 2 consecutive days. During 1 of the feedings, the mothers sang to their babies. To avoid the confounding effects of feeding order, the mothers reversed the order of singing and nonsinging feedings each day. In this way, the infants served as their own controls.

There were no statistically significant differences found in oral intake, feeding velocity, or feeding duration during singing versus nonsinging feeding. Likewise, there were no statistically significant findings regarding heart rate and respirations. However, nurses gave anecdotal support for the singing. In fact, one of the nurses was reported to have begun singing to the infants under her care when she feeds them.

The authors noted the difficulties in recruitment and retention of participating mothers. They stated that the reasons for these were that it was often difficult for mothers to be in the NICU for 2 consecutive feedings, they were anxious, or they felt too shy to sing in the NICU, where there was little privacy. The authors note that there were many factors that could not be controlled, including timing of baths, heelsticks, and other procedures. It was noted that there were no harmful effects from the singing and that further study is warranted.

THE RISK OF INFECTION FROM TOYS IN THE INTENSIVE CARE SETTING

Fleming RJ. Nursing Standard. 2006;20:50-54.

This is a descriptive study examining the growth of microorganisms on common types of toys found in a pediatric intensive care unit (PICU).

The authors relate that healthcare-associated infections are of great concern, particularly in PICUs, where children may have lower resistance to infection. Because toys are a source of comfort for children, it is vital to allow the presence of toys in the PICU. However, such toys may harbor microorganisms that could cause infection in the children, particularly if the children share the toys with one another.

A sample of 12 randomly collected toys from a PICU in England were swabbed to identify what, if any, microbial growth was present. The toys represented different types of materials and surfaces of toys commonly found in the PICU. Two groups of toys were represented: those that belonged to the children and those that belonged to the PICU.

Results showed that the children's own toys grew the most bacteria, including Staphylococcus epidermis, enterococci, gram-negative bacteria, diphtheroids, and Staphylococcus aureus. Fifty percent of communal toys in the PICU showed no growth, whereas 1 toy grew S epidermis and Bacillus species and 2 toys grew micrococci.

To prevent healthcare-associated infection, cleaning, disinfection, or sterilization may be needed. The authors point out the need for providing toys that are easily disinfected to children. Toys should not be shared between children, unless the toys are properly disinfected. The authors provide a table of guidelines on hygienic use of toys in intensive care units. Because of the study, quarterly infection control audits are now performed in the unit where the study was conducted.