Massage for promoting growth and development of preterm and/or low birth-weight infants

Abstract

BackgroundIt has been argued that infants in Neonatal Intensive Care Units are subject both to a highly stressful environment -continuous, highintensity noise and bright light -and to a lack of the tactile stimulation that they would otherwise experience in the womb or in general mothering care. As massage seems to both decrease stress and provide tactile stimulation, it has been recommended as an intervention to promote growth and development of preterm and low-birth weight infants. ObjectivesTo determine whether preterm and/or low birth-weight infants exposed to massage experience improved weight gain and earlier discharge compared to infants receiving standard care; to determine whether massage has any other beneficial or harmful e ects on this population. Search methodsThe following databases were searched: the specialized register of the Cochrane Neonatal Review Group and that of the Cochrane Complementary Medicine Field. Searches were also undertaken of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2003), MEDLINE, EMBASE, Psychlit, CINAHL and Dissertation Abstracts International (up to July 1, 2003). Further references were obtained by citation tracking, checking personal files and by correspondence with appropriate experts. Data provided in published reports was supplemented by information obtained by correspondence with authors. There were no language restrictions. Selection criteriaRandomised trials in which infants with gestational age at birth <37 weeks or weight at birth <2500g received systematic tactile stimulation by human hands. At least one outcome assessing weight gain, length of stay, behaviour or development must be reported. Data collection and analysisData extracted from each trial were baseline characteristics of sample, weight gain, length of stay and behavioural and developmental outcomes. Physiological and biochemical outcomes were not recorded. Data were extracted by three reviewers independently. Statistical analysis was conducted using the standard Cochrane Collaboration methods. Main resultsMassage interventions improved daily weight gain by 5.1g (95% CI 3.5, 6.7g). There is no evidence that gentle, still touch is of benefit (increase in daily weight gain 0.2g; 95% CI -1.2, 1.6g). Massage interventions also appeared to reduce length of stay by 4.5 days (95% Massage for promoting growth and development of preterm and/or low birth-weight infants (Review)

Massage with kinesthetic stimulation improves weight gain in preterm infants

“…However, there is inconsistency of these findings across studies and methodological concerns with previous trials have led some authors to caution widespread and routine use of preterm infant massage. 11 Previous studies have also varied in the type of intervention used, ranging from gentle 'still touch' to programs including physical activity. It has not been distinguished whether potential benefits are associated with massage alone or the combination of massage and KS or exercise.…”

Massage therapy improves the development of HIV-exposed infants living in a low socio-economic, peri-urban community of South Africa

“…Massage of premature (<37 weeks) and low birth weight (<2500 g) infants has however, shown improvements in daily weight gain by 5.1 g (95% CI 3.5, 6.7 g) and a shortened length of hospital stay by 4.5 days (95% CI 2.4, 6.5 days) as well as effects on weight at 4-6 months (Vickers et al, 2004). The increase in weight gain is thought to result from increased vagal activity leading to increased gastric motility, the release of insulin and gastrin secretion and improvements in the absorption of food (Uvnas-Moberg, Widstrom, Marchini, & Windberg, 1987).…”

“…While, a systematic review provides evidence to support the increased weight gain and shortened hospital stay in premature and low birth infants who were massaged, the authors of the review raised concerns about the methodological quality and the selective reporting of certain studies that were included in their analyses (Vickers, Ohlsson, Lacy, & Horsley, 2004). In another systematic review to assess the impact of massage on the mental and physical outcomes in healthy infants under-6 months of age, massage therapy showed beneficial effects in mother-infant interaction, improved sleep, less crying and a reduction in stress hormones.…”

Prophylactic Role for Complementary and Alternative Medicine in Perinatal Programming of Adult Health

“…Pregnancies and Babies CAM has been suggested to be effective in reducing stress in mothers and infants [43,44], with the potential to reduce the impact of adverse perinatal programming on adult health. Consumers have reported high satisfaction with the use of CAM and at the same time have shown high compliance [45].…”

“…To date, there are many publications, including non-systematic reviews, suggesting there are positive outcomes associated with the use of CAM in reducing perinatal stress in mothers and infants. A number of systematic reviews exist on massage intervention in relation to anxiety and depression of mothers and in relation to the health of infants [e.g., 44,50], however, systematic reviews on other forms of CAM are lacking. This appears to be due to the lack of randomized clinical trials and research of rigorous quality, which aims to address the effectiveness and safety of other CAM therapies.…”