Effects of Different Music Tempos on Feeding Outcomes in Preterm Infants

Music therapy is an emerging interdisciplinary field that integrates musicology, medicine, and psychology. With its core advantages of being painless and non-invasive, it has shown high acceptance and safety in fields such as pediatric medicine and child healthcare, and is widely used in interventions for chronic diseases and the care of children with special needs. Its core mechanism is based on the physical resonance properties of music: as sound waves of specific frequencies, music can resonate with the body's inherent physiological rhythms (such as heart rate, breathing, and blood pressure), coordinating organ functions and regulating neural excitation or inhibition to achieve therapeutic effects for both body and mind. For infants, especially premature babies, hearing is their primary channel for perceiving the world. Fetuses can already perceive rhythmic sounds such as the mother's heartbeat during the prenatal period. By 30-35 weeks' gestation, the hearing of all infants including premature infants is relatively mature, allowing them to distinguish different sounds and respond to rhythm and melody. The stable auditory environment in the womb \[such as the mother's heart rate of 60-100 beats per minute (beats/min) and the fetus's own heart rate of 110-160 beats/min\] forms the foundation of early auditory experiences, and appropriate musical stimulation can continue this sense of rhythm, providing crucial support for neural development.

Over the past 20 years, the application of music therapy in neonatal intensive care units (NICUs) has received widespread attention. Research has confirmed that music interventions can effectively alleviate anxiety in preterm infants, reduce heart rate and respiratory rate, improve blood oxygen saturation, increase feeding intake, shorten feeding time, and even have positive effects on cognitive and psychological development. Relevant clinical guidelines in the United States clearly recommend that music for preterm infants should be soothing and harmonious, with a steady rhythm and no sudden jumps in notes (such as lullabies sung by a female voice , piano, or guitar pieces). However, existing studies still have significant limitations: first, most research focuses on the overall effects of music interventions without exploring the independent effects of core musical elements (such as tempo, pitch, and timbre); second, there is currently no systematic research on the specific effects of music tempo on the physiological rhythms and feeding functions of preterm infants. There is a lack of comparative analyses of music at different tempos (fast, medium, slow), which prevents precise intervention parameters from being provided for clinical practice.

Addressing the research gaps, this study will focus on the effects of music therapy at different tempos on the feeding efficiency of preterm infants, with the goal of promoting their growth and development. Through a prospective randomized open-label controlled trial, it will primarily examine the differences in feeding outcomes for preterm infants exposed to music of medium tempo (60-100 beats/min, simulating maternal heart rate), fast tempo (110-160 beats/min, simulating fetal heart rate), and slow tempo (40-50 beats/min), tracking the time to achieve full enteral feeding, and providing empirical evidence for the optimal clinical selection of music therapy.

The study has two major innovations: first, it will focus on the underexplored variable of "tempo," systematically comparing for the first time the intervention effects of music at different tempos (fast, medium, slow), thereby filling the gap in current research on targeted studies of core music parameters. Second, by presenting rhythmic music at standardized tempos (such as structured melodies simulating maternal and fetal heart rates) that can precisely match the physiological rhythm perception needs of preterm infants, the intervention's specificity and reproducibility will be enhanced. This design not only addresses the issue of ambiguous parameters in previous studies but also ensures the reliability of the results through a standardized approach, providing both theoretical and practical references for the clinical standardization of music therapy for preterm infants.

• Physical growth rate [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Gastrointestinal condition: 1. Daily feeding amount [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Gastrointestinal condition: 2. Gastrointestinal function indicators [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Gastrointestinal condition: 3. Calcium and phosphorus metabolism [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Gastrointestinal condition: 4. Liver and kidney function [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Gastrointestinal condition: 4. Sucking ability score [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Nervous system development assessment: 1. The Test of Infant Motor Performance. [Срок оценки: From correct gestational age from 34 weeks to 4 months.]
• Nervous system development assessment: 2. The Bayley III Infant Development Scale. [Срок оценки: From correct gestational age from 34 weeks to 18 months.]
• Nervous system development assessment: 3. Resting fMRI [Срок оценки: Corrected age at 18 months.]
• Other: 1. Length of hospitalization [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Other: 2. Discharge weight [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]
• Other: 3. Amino acids [Срок оценки: From date of hospital admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 1 year.]