Touch and massage for medically fragile infants

Karen Livingston, Shay Beider, Alexis J Kant, Constance C Gallardo, Michael H Joseph, Jeffrey I Gold, Karen Livingston, Shay Beider, Alexis J Kant, Constance C Gallardo, Michael H Joseph, Jeffrey I Gold

Abstract

Research investigating the efficacy of infant massage has largely focused on premature and low birth weight infants. The majority of investigations have neglected highly acute patients in academic neonatal intensive care units (NICUs). The current study was developed with two aims: (Phase 1) to develop, implement and demonstrate the feasibility and safety of a parent-trained compassionate touch/massage program for infants with complex medical conditions and (Phase 2) to conduct a longitudinal randomized control trial (RCT) of hand containment/massage versus standard of care in a level III academic Center for Newborn and Infant Critical Care (CNICC). Certified infant massage instructors (CIMIs) taught parents to massage their hospitalized infants. Massage therapy and instruction were performed for seven consecutive days and health outcomes were collected for up to 1 month following treatment. Caregivers, nurses and certified infant massage therapists indicated moderate to high levels of satisfaction and feasibility with the implementation of hand containment/massage in a level III academic center CNICC. In addition, infant behavioral and physiological measures were within safe limits during the massage sessions. All caregivers participating in the massage group reported high levels of satisfaction 7 days into the intervention and at the 1-month follow-up with regards to their relationship with their infant, the massage program's impact on that relationship and the massage program. Due to unequal and small sample sizes, between group analyses (control versus massage) were not conducted. Descriptive infant characteristics of health outcomes are described. Preliminary data from this study indicates feasibility and safety of infant massage and satisfaction among the caregivers, CIMIs and the nurses in the CNICC. An important contribution from this study was the demonstration of the infants' safety based on physiological stability and no change in agitation/pain scores of the infants receiving massage. Massage in a tertiary urban academic NICU continues to be an area of needed study. Future studies examining infant health outcomes, such as weight gain, decreased length of hospitalization and caregiver-infant bonding, would provide greater insight into the impact of massage for medically fragile infants.

Keywords: CAM; caregiver depression; infant massage; integrative medicine; medically fragile; neonatal intensive care; pediatric psychology.

Figures

Figure 1.
Figure 1.
Infant heart rates during 20-minute touch sessions.
Figure 2.
Figure 2.
Caregiver-reported depression (control group).
Figure 3.
Figure 3.
Caregiver-reported depression (massage group).
Figure 4.
Figure 4.
Nurses’ satisfaction with massage program.
Figure 5.
Figure 5.
CIMIs’ satisfaction with massage instruction.

References

    1. Vickers A, Ohlsson A, Lacy JB, Horsley A. Massage for promoting growth and development of preterm and/or low birth-weight infants. Cochrane Database Syst Rev. 2004;2:CD000390.
    1. Ferber SG, et al. Massage therapy by mothers and trained professionals enhances weight gain in preterm infants. Early Hum Dev. 2002;67:37–45.
    1. Field T. Massage therapy. Med Clin N Am. 2002;86:63–71.
    1. Hill CF. Is massage beneficial to critically ill patients in intensive care units? A critical review. Intensive Crit Care Nurs. 1993;9:116–21.
    1. Molloy CG. Touch Therapy. Massage and Bodywork. 2001;Dec/Jan:12–22.
    1. Molloy CG. To touch or not to touch? That is the question. Perinatal Hotline of St. Lukes Hospital. 1988:;12.
    1. Liaw JJ. Tactile stimulation and preterm infants. J Perinat Neonatal Nurs. 2000;14:84–103.
    1. Lindrea KB, Stainton MC. A case study of infant massage outcomes. MCN Am J Matern Child Nurs. 2000;25:95–9.
    1. Vaughan S. The gentle touch. J Clin Nurs. 1995;4:359–68.
    1. Ward-Larson C, Horn RA, Gosnell F. The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants. MCN Am J Matern Child Nurs. 2004;29:151–156. ; Quiz 157–8.
    1. Field T, Scafidi F, Schanberg S. Massage of preterm newborns to improve growth and development. Pediatr Nurs. 1987;13:385–7.
    1. Wheeden A, Scafidi FA, Field T, Ironson G, Valdeon C, Bandstra E. Massage effects on cocaine-exposed preterm neonates. J Dev Behav Pediatr. 1993;14:318–22.
    1. White-Traut RC, et al. Developmental intervention for preterm infants diagnosed with periventricular leukomalacia. Res Nurs Health. 1999;22:131–43.
    1. Scafidi FA, Field T, Schanberg SM. Factors that predict which preterm infants benefit most from massage therapy. J Dev Behav Pediatr. 1993;14:176–80.
    1. Rose SA, Schmidt K, Riese ML, Bridger WH. Effects of prematurity and early intervention on responsivity to tactual stimuli: a comparison of preterm and full-term infants. Child Dev. 1980;51:416–25.
    1. Rice RD. The effects of the Rice infant sensorimotor stimulation treatment on the development of high-risk infants. Birth Defects Orig Artic Ser. 1979;15:7–26.
    1. White JL, Labarba RC. The effects of tactile and kinesthetic stimulation on neonatal development in the premature infant. Dev Psychobiol. 1976;9:569–77.
    1. Scafidi FA, et al. Effects of tactile/kinesthetic stimulation on the clinical course and sleep/wake behavior of preterm neonates. Infant Behav Dev. 1986;9:91–105.
    1. Sweeney JK. The high risk neonate. In: Als H, editor. Theoretical Framework: A synactive model of neonatal behavioral organization: Framework for the assessment of neurobehavioral development in the premature infant and for support of infants and parents in the neonatal intensive care environment. NY: Haworth Press; 1986. pp. 4–53.
    1. Feldman R, Eidelman A, Sirota L, Weller A. Comparison on skin-to-skin (kangaroo) and traditional care: parenting outcomes and preterm infant development. Pediatrics. 2002;110:16–26.
    1. Onozawa K, Vivette G, Adams D, Modi N, Kumar C. Infant massage improves mother-infant interaction for mothers with postnatal depression. J Affect Disord. 2001;63:202–07.
    1. Leitch D. Mother-infant interaction: achieving synchrony. Nurs Res. 1999;48:55–8.
    1. Pron A. Infant massage: preventive health care for babies. Adv Nurse Pract. 2002;10:59–60.
    1. Weber K. Massage for drug exposed infants. Massage Therapy Journal. 1991;Summer
    1. White-Traut RC, Nelson MN, Silvestri JM, Patel MK, Kilgallon D. Patterns of physiologic and behavioral response of intermediate care preterm infants to intervention. Pediatr Nurs. 1993;19:625–9.
    1. White-Traut RC, Goldman MB. Premature infant massage: is it safe? Pediatr Nurs. 1988;14:285–9.
    1. McCarthy M. The physiological and behavioral effects of a gentle human touch nursing intervention on pre-term infants. Dissert Abstracts Intl. 1993;54:1336.
    1. White-Traut RC. Rush University Chicago; 1983. Maternal-infant interaction as a function of maternal stimulation of the premature infant initiated at twenty-four hours of infant age. Unpublished Doctoral Dissertation.
    1. Solkoff N, Yaffe S, Weintraub D, Blase B. Effects of handling on the subsequent development of premature infants. Dev Psychol. 1969;1:765–8.
    1. Adamson-Macedo EN. Effects of tactile stimulation on low and very low birthweight infants during the first week of life. Curr Psychol Res Rev. 1985;4:305–08.
    1. Beider S. An ethical argument for integrated palliative care. Evid Based Complement Alternat Med. 2005;2:227–31.
    1. Beider S, Moyer CA. Randomized control trials of pediatric massage: a review. Evid Based Complement Alternat Med. 2007;4:23–34.
    1. Yaster M, Karolinsky K, Maxwell L. Opioid agonists and antagonists. In: Yaster M, Krane E, Kaplan R, Cote C, Lappe D, editors. Pediatric Pain Management and Sedation Handbook. St. Louis, MO: Mosby-Yearbook Inc.; 1997. p. 40.
    1. Hummel PA, Puchalski M, Creech SD, Weiss MG. N-PASS: neonatal pain, agitation, and sedation scale—reliability and validity.. Paper presented at the Pediatric Academic Societies’ Annual Meeting; Seattle, WA. 2003.
    1. Beck AT, Steer RA, Brown GK. Beck Depression Inventory-II Manual. San Antonio, TX: Psychological Corporation; 1996.
    1. Vitseva O, Varghese S, Chakrabarti S, Folts JD, Freedman JE. Grape seed and skin extracts inhibit platelet function and release of reactive oxygen intermediates. J Cardiovasc Pharmacol. 2005;46:445–51.
    1. McClure VS. Infant Massage: A Handbook for Loving Parents. NY: Bantam Books; 2000.
    1. Scafidi FA, Field T. Massage therapy improves behavior in neonates born to HIV-positive mothers. J Pediatr Psychol. 1996;21:889–97.
    1. Lipkin M, Schwartz MD. I can’t get no patient or practitioner satisfaction. J Gen Intern Med. 2000;15:140–1.
    1. Fan VS, Burman M, McDonell MB, Fihn SD. Continuity of care and other determinants of patient satisfaction with primary care. J Gen Intern Med. 2005;20:226–33.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi