We write to address the concerns raised by Dr Philbin regarding the masking, measurement, and outcomes used in our randomized controlled trial in preterm infants of a pacifier-activated music player using mother’s voice.

Her first concern was inadequate masking. In our study, our NICU nurses, although not part of the research team, were masked to their patient’s group assignment. The music therapist visited all enrolled infants with the pacifier-activated lullaby (PAL) device, regardless of study assignment. Infants are cared for in single-patient rooms (or semiprivate if multiples), and the study visits, conducted behind closed doors in these rooms, were neither visible nor audible. Nursing staff rarely entered the patient room during the study visit, although they were obviously not excluded; entry was only for necessary patient care. Thus, masking of nurses to study group assignment was within the limits of standard of care. Parents in both groups received identical...

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