Gentle Touch® Parent-Child Program

Intervene Early with Infant Massage

by

Emma Miller, D.Div.

Imagine an effective high-risk intervention that could begin at or prior to birth. Imagine, too, that this intervention could also be considered a child abuse prevention. Lastly, it could even promote health and development with less vulnerable infants, toddlers and preschoolers. Infant massage is such a multi-faceted tool. To fully appreciate this, it is helpful to understand the role of touch.

Touch is the only fully developed sense by the seventh week of gestation. In the womb, the fetus is constantly stimulated by the amniotic fluid and the increasing pressure from its body on the uterus. During labor, the baby receives massive cutaneous stimulation from the uterus, which signals the life sustaining bodily systems to begin operating, and to do so properly. After birth, indeed, throughout life, being touched is significant in maintaining physical and mental health. (1)

Babies need loving touch to thrive. Once parents learn about the benefits of tactile contact and stimulation through caressing, massaging, holding, carrying, and rocking, they are more likely to integrate touch into the everyday care activities of feeding, diapering, bathing, and bedtime. Thus, more nurturing routines can be created.

One way to do this is for the parent to learn infant massage. Parents massage their infants in many cultures, and have done so for centuries. Early Intervention Specialists can refer parents and baby to a qualified instructor, or better yet, obtain training so that they themselves can teach individual families or groups of caregivers.

All babies can potentially benefit from massage. Physically, internal organs can be regulated, stimulated and strengthened. The functioning of all body systems can be improved. Respiration becomes fuller and deeper as mucous is moved and expelled and cardiac output is increased. There is faster weight gain as appetite and feeding is improved when muscles around the mouth are strengthened and digestive organs are stimulated. Circulation is enhanced as blood goes to the extremities. Gas, constipation, and colic can be relieved. Immunity is promoted. Nerve myelination is hastened for better mind-body communication. Even intellectual and language development may be enhanced by the verbal stimulation during the massage.

Babies experience stress. Massage enables them to release tension. Deep relaxation is produced and the baby learns to "cope" or self-regulate. The baby's disposition tends to improve when awake. Sleep is promoted and sleep patterns are ameliorated. (2) A foundation for healthy emotional development is laid when the infant becomes interested in the world and people. The baby feels good about herself as she expresses preferences and wishes by body language or verbal cues, and finds these respected and encouraged. Through the reciprocal interactions inherent in the bonding and attachment process, the baby learns trust and intimacy. Feeling utterly lovable results in a loving, not spoiled, child with a strong sense of self. (3)

The special populations of babies we see in early intervention can benefit from infant massage in unique ways. Cesarean-delivered infants may have not have had their skin adequately stimulated during labor, and therefore may be more susceptible to infection and disorders of the respiratory, gastrointestinal, and genitourinary systems. Massage tones these systems, as well as the peripheral and autonomic nervous systems. The situation is similar for a baby born premature.

Pre-term neonates who receive massage gain, on the average, 47% more weight per day, are more active and alert, show more mature behaviors on the Brazelton scale, and go home 6 days earlier than control infants. (4) "Kangaroo care", or skin-to-skin contact, continues to show similar beneficial results with this group. Also, these infants may be traumatized or sensitive. They can release fear and pain through the loving touch of a caring adult.

Fussy babies seem to appreciate the nurturance and consistency inherent in the massage routine. Babies who experience a change in caregivers, such as those placed into foster care, adoption, or daily group care, cling to the security of a regular, familiar activity. This also holds true when there is a change in environment, as when infants are in chaotic living situations, child care, or the hospital. With the latter, gentle touch contrasts with invasive procedures, and due to increased endorphin production, discomfort is often diminished. Pleasurable touch also communicates support, perhaps facilitating recovery.

Massage augments other therapeutic interventions and can enjoyably prepare the child with special needs for them. Handling and positioning principles can still be applied. There are specific techniques that address conditions of hyper- and hypotonicity. Body awareness is enhanced for babies with sensory impairments or congenital malformations. Again, respiration, feeding, circulation, and elimination are frequently improved.

Soothing techniques facilitate self-consoling of babies prenatally exposed to substances. Techniques that foster reaching and maintaining an alert state promote self-regulation. Gradual massage raises the stimulation threshold in these and other infants who may be hypersensitive to touch.

A hallmark of the massage is that it proceeds only after the baby's permission has been obtained through cues. The baby learns self-respect as boundaries and wishes are honored. Because infants are born with a kinesthetic sense, when they are being held, they are able to discriminate between those who care for them and those who do not. Through massage, the difference between touch that is loving and touch that is not is reinforced.

Babies who have been physically abused may benefit if massage is counselor guided, trust is established, and the child is unequivocally respected. Massage, then, is appropriate for a variety of children, from those who are well, to those who are vulnerable or high-need. Simple modifications allow for massage of toddlers and older children. Because touch is the most primal medium of communication, children need and benefit from loving messages through their skin, the largest sense organ.

Parents also benefit from infant massage. First time parents and parents who are young gain self-confidence and become more proficient in their nurturing abilities. The interaction during the massage is positive, enjoyable and fun. Parenting classes become experiential and take on the new dimension of doing something with the baby.

Breastfeeding mothers are more successful as the secretion of prolactin, essential for milk production, is enhanced. Weaning tends to go smoother if the child has the closeness that massage produces.

Parents learn relaxation techniques. They utilize them prior to the massage and begin to incorporate them into their day. Therefore, they and their baby experience less stress. This is particularly useful for parents who have experienced, or who are currently experiencing, life or relationship crises (e.g., childhood trauma, homelessness, domestic violence). Parents also sleep better because their baby's sleep is improved due to greater relaxation and a sense of well-being and security.

"Special time" alone with the baby is especially appreciated by adoptive parents, parents with older children, or parents who become separated from their child daily or periodically. Many parents report feeling empowered as massage is something they can do in times of stress, change, or ongoing therapeutic intervention.

Parents in recovery from substance abuse and those with childhood or present trauma (e.g., domestic violence) have a basic way to communicate security, caring and love. There is potential for breaking the cycle of child abuse when parents show respect by asking permission. In giving loving touch, it is possible to find emotional healing.

Massage also provides a concrete way for parents, especially those with cognitive or physical challenges, to learn about their baby. Sensitivity is developed as to how the baby is feeling, and to what pleases and what is uncomfortable. Awareness is gained regarding changes in growth, development, and health status. Developmental guidance is easy to incorporate into the instruction. As parents become more excited about their baby and derive increasing pleasure from parenting, communication is enhanced. The bonding and attachment process is promoted as the parent-baby relationship is strengthened.

Infant massage can involve the entire family. Through the nurturing of massage, fathers discern that they have a way to enjoy the same emotional fulfillment as mothers. They appreciate, too, a way to offer physical and emotional support. Siblings can both relate to the baby through their gentle touch and receive the massage with modifications. Extended family members and caregivers (e.g., foster parents, health care professionals, daycare and institution staff) can offer the massage if they have a relationship with the child. The setting can be the home, hospital, daycare or shelter. Soothing variations can be done virtually anywhere.

Ideally, infant massage instruction is for parents with their baby as it is easier for them to learn cues and soothing techniques. However, a doll can be used before birth, and after birth for parents who are separated from their infant or uncomfortable with touch. In addition, some parents may need repetition, practice, self-confidence, or emotional healing first.

Individual instruction may be best for babies with special needs or complicated family situations. On the other hand, small group classes are an excellent way for parents to share with other parents about their joys, challenges, concerns and ideas in a supportive atmosphere. In either case, encouragement, positive feedback and anticipatory guidance are offered.

Information about resources and services can be given, and referrals, if appropriate, can be made. Session length varies depending on needs. While infant massage is not a "cure-all", it may have long lasting effects on health, growth, development, and well-being. It contains all of the elements of bonding and builds trust and intimacy. Parents are better equipped to become accurate observers of their baby's cues, and sensitive responders and communicators. Mutually satisfying interaction is, therefore, more likely. The massage can become part of nurturing parenting/family routines.

There is ample room for the Early Interventionist's creativity when implementing this tool. One example is to combine massage with English as a Second Language instruction for parents. Using ethnically and culturally appropriate demonstration dolls, lullabies, and rhymes is a way to honor diversity and traditions.

Love involves respect, security, care, healing, and nurturing human potential. When we intervene early with infant massage, we promote love between caregiver and child and within families.

1. Montagu, A., Touching, The Human Significance of the Skin, New York, Harper and Row. 1986 Third Edition.
2. McClure, V., Infant Massage: A Handbook for Loving Parents, New York, Bantam Books. 1989 Revised Edition.
3. Greenspan, S. and Greenspan, N., First Feelings: Milestones in the Emotional Development of Your Baby and Child, Penguin Books. 1985. 13-39.
4. Field, T., et al. (1986, May). Tactile/kinesthetic stimulation effects on preterm neonates. Pediatrics. Vol. 77(5), 654-658.

©1993-2004, Gentle Touch Parent-Child Program, LLC

Emma Miller, D.Div., is the creator of and a trainer for the Gentle Touch® Parent-Child Program for pregnant women, infants, young children, and families. She is also the scriptwriter and co-producer of the Gentle Touch® Infant Massage Video. For more information about the video, parent/caregiver-child services, or training, please e-mail Program@GentleTouchParent-Child.com.