Evidence on infant massage
For centuries, massage has been believed to ease childbirth, aid recovery, stimulate and soothe babies and remedy various adult ailments in many cultures of the world (Walker, 2000). Today’s standards of proof of safety and efficacy require research studies to be done on therapeutic methods; where possible, randomised controlled trials (RCTs). There are a few studies of infants and neurological conditions.
A systematic review of all the known evidence on massage with preterm infants still in hospital, found benefits of weight gain and shorter stay in hospital (Vickers, 1998-2004). The reviewers felt that this was not strong enough evidence to warrant wider use of massage, but it is used and taught to new parents in a wide range of hospital and community healthcare settings. Nursing researchers suggest that for preterm infants still in hospital, "the significant benefits of infant massage therapy far outweigh the minimal risks" (Beachy, 2003).
Another systematic review, of infants in general aged under 6 months, also concluded that there was not enough evidence to warrant universal use. However, it found some benefits on mother-infant interaction, sleeping and crying, and hormones influencing stress levels (Underdown, 2006).
A Training and Support Programme (TSP) based at Coventry University, involving basic massage given by parents in classes and at home, has published some results. These include a study of the views of children with cerebral palsy who were given massage. The children said they enjoyed the relaxing aspects of the massage, and reported improved muscle relaxation, mobility and bowel movements, and reduced pain (Powell, 2009).
Further individual studies can be found by typing the words "infant massage" in Pubmed.
Suggested benefits of infant massage
Many babies are fussy, disorganised and have colic, cry a lot or sleep poorly. It is believed that massage can help with all these problems.
A pleasurable way of connecting with your baby, for example, giving them a short massage each night before bath time.
To alleviate trapped wind, constipation or colic, (evidence is limited; Lucassen 2007).
Massaging the jaw may relax a baby who has just begun to take solids.
Massaging the gums through the skin may ease the pain of teething.
Face massage may unblock a baby’s nose.
May alleviate post-natal depression, giving a mother more positive interaction with a baby.
Purposes of infant massage
For infants
to feel loved, respected and secure;
to develop body, mind, awareness and co-ordination;
to reduce the discomfort of colic, wind and constipation;
to help regulate and strengthen a baby’s digestive, respiratory systems and stimulate circulatory and nervous systems;
to promote relaxation;
to reduce ‘fussiness’ and improve sleep;
to improve skin condition.
For parents
to help understand a baby’s non-verbal communication;
to enhance confidence and competence in dealing with the baby;
to help with post-natal depression;
to enable parents and baby to relax together;
to promote lactation in breastfeeding mums (by stimulating hormones);
to promote the nurturing instinct by stimulating oxytocin (Glover 2002);
to help create a confident and relaxed relationship with the child.
Massage oils
Organic grapeseed (light, scent free, inexpensive and widely available) and organic sweet almond oil (light with a mild fragrance) are widely used, and should not affect the infant in themselves.
A light massage
Before massage, ensure that:
- your hands are warm and clean;
- you keep the oil away from the baby’s face as it can blur vision if it gets into eyes;
- your baby lies on soft, clean cotton (wool combined with oil may irritate the skin);
- your baby is not too full and not hungry. Baby massage is best done between feeds.
- you move the baby in ways (s)he wants to go. Remember you are doing this with your baby, not to him/her;
- you stop if your baby becomes upset. Return to massage when (s)he is ready and willing.
If a baby is unwell or has a skin disorder, seek professional advice before massaging. After immunisation, wait 48 hours to see how (s)he is affected before massaging, avoiding the injection site until it is no longer sensitive.
Massage can be introduced once the baby is happy to be undressed and enjoys being naked (often from about six to eight weeks). Ensure you are comfortable. Keep your hands well oiled and shake out your hands from time to time to keep them relaxed. Ensure that the infant is placed where they will be safe and stable as they move. Then;
- Pull your baby’s leg through your fingers and palms, hand over hand, from thigh to foot. Give the leg a gentle shake, then repeat with the other leg.
- Now do both legs together. Place your hands on the inside thighs and pull downwards around the back of the thighs, down to the feet.
- Lay the weight of your open, relaxed hand on the baby’s tummy and, without pressing downwards, massage in a clockwise direction - your left to your right. This is in the same direction as the baby’s digestive system. (Only introduce tummy massage once the cord has healed and the baby has straightened from the foetal position.)
- Place your hands on the centre of your baby’s chest and massage upwards and outwards, over the shoulders. Draw both arms down vertically through the centre of your palms.
- Rest your hands on the front of your baby’s shoulders and draw them downwards over the chest, hips, legs and feet.
- Lay your baby on his/her tummy and stroke down the back, hand over hand.
- With a relaxed open hand, stroke clockwise around the base of the spine and buttocks.
- Now lay your hands on the back of your baby’s shoulders and stroke downwards over the back, down the back of the legs to the feet.
Training organisations and materials
International Association of Infant Massage (IAIM), tel: 020 8989 9597, www.iaim.org.uk
Guild of Infant and Child Massage (GICM), tel: 01570 481010, www.gicm.org.uk
There may also be local training available through nurses or other NHS professionals. Information and learning materials are available from our postal lending library, tel: 0800 328 1159.
References
Beachy J. 2003 May-Jun. Premature Infant Massage in the NICU. Neonatal Network 22(3):39-45.
Glover V et al. 2002 Dec. Benefits of infant massage for mothers with postnatal depression. Seminars in Neonatology 7(6):495-500.
Lucassen P. 2007. Treating infantile colic: infant massage. British Medical Journal Clinical Evidence 01 July. [Review of 2 studies published in Pediatrics, 1993 and 2000.]
Powell L. et al. 2009 Jul.26. Children’s experiences of their participation in a training and support programme involving massage. Complementary Therapies in Clinical Practice. doi:10.1016/j.ctcp.2009.06.013
Underdown A. et al. 2006 Oct.18. Massage intervention for promoting mental and physical health in infants aged under six months (Cochrane systematic review of evidence).
Vickers A. et al. 1998-2004.Massage for promoting growth and development in pre-term and/or low birth-weight infants (Cochrane systematic review of evidence).
Walker P. 2000. Baby Massage. London, Carroll & Brown Publishers Ltd.