Pain in full term newborns submitted to music and swaddling during venipunctures

Keywords: Infant, Newborn; Rooming-in Care; Pain; Music.


Objective: to compare pain scores in term newborns submitted to music and swaddling interventions during venipuncture. Methods: pilot study of a clinical trial, carried out with 11 newborns in rooming-in care who received venipunctures. The newborns were randomly allocated into two groups: Experimental (20 minutes of music + swaddling) and Control (swaddling). Newborns were filmed and pain was assessed by the Neonatal Facial Coding System at baseline, procedure, and initial recovery phases. Results: the Experimental Group at baseline, procedure (antisepsis, puncture, and milking), and recovery showed less pain reactions and lower heart rate mean and variation (p<0.05) than the Control Group. Conclusion: newborns who received the intervention of music combined with swaddling had less pain reactions and less variations in heart rate during venipuncture. Brazilian Clinical Trial Registry: RBR-8x8v2r.


Williams MD, Lascelles BDX. Early Neonatal Pain-A Review of Clinical and Experimental Implications on Painful Conditions Later in Life. Front Pediatr. 2020; 8:30. doi:

Witt N, Coynor S, Edwards C, Bradshaw H. A Guide to Pain Assessment and Management in the Neonate. Curr Emerg Hosp Med Rep. 2016; 4:1-10. doi:

Guinsburg R, Cuenca MC. A linguagem da dor no recém-nascido. São Paulo: Sociedade Brasileira de Pediatria; 2010.

Pinheiro IO, Lima FET, Magalhães FJ, Farias LM, Sherlock MSM. Pain evaluation in newborns using the Neonatal Facial Activity Coding scale during blood gases analysis. Rev Dor. 2015; 16(3):176-80. doi:

Morais APS, Façanha SMA, Rabelo SN, Silva AVS, Queiroz MVO, Chaves EMC. Non-pharmacological measures in the pain management in newborns: nursing care. Rev Rene. 2016; 17(3):435-42. doi:

Sposito NPB, Rossato LM, Bueno M, Kimura AF, Costa T, Guedes DMB. Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study. Rev Latino-Am Enfermagem. 2017; 25:e2931. doi:

Melo GM, Cardoso MVLML. Non-pharmacological measures in preterm newborns submitted to arterial puncture. Rev Bras Enferm. 2017; 70(2):317-25. doi:

Fialho FA, Dias IMAV, Silva LR, Santos RS, Salvador M. Tecnologias aplicadas pela Enfermagem no cuidado neonatal. Rev Baiana Enferm. 2015; 29(1):23-32. doi:

Rossi A, Molinaro A, Savi E, Micheletti S, Galli J, Chirico G, et al. Music reduces pain perception in healthy newborns: A comparison between different music tracks and recoded heartbeat. Early Hum Dev. 2018; 124:7-10. doi:

Querido DL, Christoffel MM, Almeida VS, Esteves APVS, Andrade M, Amim Jr J. Assistance flowchartfor pain management in a Neonatal Intensive Care Unit. Rev Bras Enferm. 2018; 71(Suppl 3):1281-9. doi:

Grunau RE, Craig KD. Neonatal facial coding system revised: training manual. Vancouver: Early Human Experience Unit; 2010.

Christoffel MM, Castral TC, Daré MF, Montanholi LL, Gomes ALM, Scochi CGS. Attitudes of healthcare professionals regarding the assessment and treatment of neonatal pain. Esc Anna Nery. 2017; 21(1):e20170018. doi:

Qiu J, Jiang Y, Li F, Tong Q, Rong H, Cheng R. Effect of combined music and touch intervention on pain response and β-endorphin and cortisol concentrations in late preterm infants. BMC Pediatr. 2017; 17:38. doi:

Roué J, Rioualen, S, Gendras J, Misery L, Gouillion M, Sizun J. Multi-modal pain assessment: are near-infrared spectroscopy, skin conductance, salivary cortisol, physiologic parameters, and Neonatal Facial Coding System interrelated during venipuncture in healthy, term neonates? J Pain Res. 2018; 11:2257-67. doi:

Melo GM, Cardoso MVLML. Pain in preterm newborns submitted to music and 25% glucose intervention. Rev Rene. 2017; 18(1):3-10. doi:

Ullsten A, Hugoson P, Forsberg M, Forzelius L, Klassbo M, Olsson E, et al. Efficacy of live lullaby singing during procedural pain in preterm and term neonates. Music Med Interdiscipl J [Internet]. 2017 [cited Apr 23, 2020]; 9(2). Available from:

Nelson AM. Risks and benefits of swaddling healthy infants: an integrative review. MCN Am J Mater Child Nurs. 2017; 42(4):216-25. doi:

Pancekauskaite G, Jankauskaite L. Paediatric Pain medicine: pain differences, recognition and coping acute procedural pain in paediatric emergency room. Medicina. 2018; 54(6):e94. doi:

Fitri SYR, Lusmilasari L, Juffrie M. The Indonesian version of the Premature Infant Pain Profile-Revised: translation and adaptation of a neonatal pain assessment. Int J Nurs Sci. 2019; 6(4):439-44. doi:

Research Article