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The benefits of

babv massaae

Lydia Lorenz NNEB Diploma in

A scheme to improve young children's physical health and Nursery Nursing, is Sure Skirt

psychological development hy introducing hahy massage is nursery nurse

descrihed by members of a Sure Start team Karen Moyse RSCN, MSc

Community Health, is Sure Start

Over many years a number of reports have linked Sure Start - Creswell, Eangwith/Whaley Thoms and communit) children's nurse

health problems to low socio-economic status Shirebrook, is a deprived community where young Helen Surguy RGN, BSc
(Benzeval et al 1996, Townsend and Davidson 1988). children's health is below the national average. The Nursing, BA Community
Sure Start, a UK-wide initiative introduced following Sure Start team uses a variety of strategies to promote Specialist Practice (Public
the publication of Supporting Families (Home OfTice the health and development of young children - baby Health Nursing), is Sure Start
1998), is now having a positive impact upon the lives massage being one. Nursery nurses, health visitors health visitor
of deprived families. and a community children's nurse are all involved in
Each Sure Start programme focuses on strategies to promoting baby massage by leading groups and work-
meet its targets for improving young children's health ing v^ith families in the home. Several members of
and development. Sure Start believes that the physi- the team have undertaken an infant massage teacher
cal health of young children (up to four years) can be training course.
improved by supporting parents in caring for their KEY WORDS
children. One way in which young children's psycho- Benefits of baby massage Baby massage
logical development can be promoted, is by encourag- Collins (199S) defines massage as the act of rubbing Children: development
ing and supporting early bonding between parents and parts of the body to promote relaxation. From the lit- Bonding
their children. erature examined (Field 1995, Heller 1997} and practice Parenthood

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observations, baby massage appears to have a number Touch Learn (2002) recommends baby massage as
of physical and psychological benefits for babies, not an effective, very gentle means of treating infant colic.
purely relaxation. Evidence shows tbat there are also Within Sure Start we bave taugbt parents to under-
benefits for motbers and fathers (Hart et al 2003) and take gentle abdominal baby massage, following care-
an important aspect of baby massage is for parents to ful instruction from qualified practitionersw. Parents
become skilled in touching their baby in a gentle, posi- wbo reported infant colic as a problem found that
tive way. so that tbey become more sensitive to their abdominal massage successfully eased tbeir babies'
baby's needs. discomfort.
Interestingly, infant colic, although common in
Physical health western cultures, is almost unheard of in some parts
Field (1995) found tbat massaged babies slept better of the world. Heller (1997) reports that babies in some
than babies who had not received massage, and Scafidi cultures, such as the Kung of the Kalahari Desert in
et al (1986) demonstrated similar findings with pre- Africa, are given baby massage in the very early days of
mature babies. These researchers found that massaged life. Could baby massage be a preventive factor in infant
babies slept more soundly and fell asleep more quickly. colic.^ If so, perhap.s baby massage could contribute to a
We have found tliat many mothers report that following reduction in infant colic within western cultLires.

Parents have commented that baby Psychological development

Baby massage not only has physical benefits, but
massage has helped them to feel can also improve psychological development. Some
emotionally closer to their babies authors beHeve that baby massage can belp with the
developing relationship between babies and their par-
a baby massage session tbeir babies sleep particularly ents - bonding (Field 1995. Heller 1997. Hart et al
soundly and many babies have been observed falling 2003). Mother/child bonding is a concept wbicb bas
asleep in the middle ofa massage session. been explored for many decades ( Bowlby 1951, 1969.
Other studies focusing on premature babies and 1973). Contemporary approaches to this concept tend to
baby massage bave highlighted that massage can have include fathers (Sutcliffe 1994). Hart et al (2003) found
a dramatic impact upon weight gain (Field et al 1986). that baby massage strengthened the bond between par-
Field (2001), in a more recent article, points out that ents and tbeir babies. In our baby massage sessions,
studies from different research units bave produced parents have commented tbat it bas helped them to
similar findings on premature babies and increased feel emotionally closer to their babies, more so than
weight gain. The impact of baby massage on weigbt tbeir otber children at the same age. These parents did
gain may be difficult to determine as the growth of not have tbe opportunity to participate in baby massage
babies is influenced by many different factors, and. wben their other children were babies.
from our experiences within Sure Start, links with Heller (1997) believes that baby massage is an
improved weight gain have been unreliable. important means by wbicb parents and babies com-
Another important area where massage seems to municate tbrough touch. From our obsei-vations of
impact upon babies' physical health is infant colic, parents massaging their babies, it does indeed seem to
which is very common in young babies but usually communicate caring, love and warmth tbrough touch.
resolves by tbe age of four to five months (iUingworth Field (1995) found tbat massaged babies can be more
1985). The symptoms ofinfant colic have been sociable than babies who have not received massage.
described as babies drawing their legs up in discomfort, From practice experiences massaged babies do seem
passing wind (flatus), having difficulty passing stools, to be very sociable. As the sessions go by practitioners
and crying excessively, particularly during the evening bave observed babies interacting more positively witb
(Iliingworth 1985). From practice observations, when tbeir parents, sbowing obvious social pleasure in their
babies experience infant colic mothers find the symp- interactions. This may be due to parents' motivation to
toms very distressing as they often feel frustrated and communicate with tbeir babies, and massage provides
unsure of bow to help. a special medium for relaxed communication.

16 Paediatric Nursing vol 17 no 2 March 2005

Cognitive development also seems to be enhanced reluctant to come along (Mackereth 2003) because baby
through baby massage. Cigales et al (1997) demon- massage may not be seen as the thing to do. particTjlarly
strated that lower limb massage could enhance simple in a traditionally coal mining community.
learning. Babies of four months old were given eight Accessibility of classes and information about the
minutes of massage, or play, or no stimulation, before benefits of baby massage may contribute towards
a cognitive task. Babies who received massage showed improved uptake of sessions (Mackereth 2003).
better response recovery from the cognitive task than Fundamentally, the image of baby massage needs to
the babies in the other two groups. In another study. become more accepted in the wider male culture before
Field et al (1987) found that by massaging premature great strides can be achieved.
babies, they performed better on development tests.
These researchers concluded that the babies' respon- Developing parenting skills
siveness had been heightened through massage. Szyndler and Bell (1992) highlighted how parents find
Baby massage appears to have a number of psycho- groups useful for learning and sharing information
logical benefits, emotional as well as cognitive. It is our about different aspects of child rearing. Within our
Sure Start's way of helping young children's psycho- Sure Start team baby massage is undertaken on an indi-
logical development, encouraging and supporting early vidual basis within the home and in group sessions at
bonding between parents and their children. the Sure Start centre.
Group sessions certainly do seem to have the addi-
Benefits for parents tional benefit of mothers and fathers learning from
According to Field et al (1987) mothers who massaged other parents by sharing their knowledge and expe-
their babies gained more pleasure from playing with riences. This supports the work of Hart et al (2003)
them than mothers who did not massage their babies. who found that parents participating in group baby
Baby massage may have helped these mothers to feel massage sessions learnt a great deal from each other.
closer to their babies. Other work by Field (2003) has Baby massage sessions can also provide a forum
demonstrated that baby massage can improve the mood to discuss health issues (Hart et al 2003). As
of depressed mothers. Depressed mothers touching part of our Sure Start baby massage ses-
their babies through massage improved their babies' sions a specific health promotion topic
reactions towards them. Mothers, seeing their babies' is approached each week, such as infant
positive reactions felt psychologically better, thus low- colic or childhood immunisation,
ering their depression scores. In practice we have not depending upon the specific requests
worked specifically with depressed mothers to know of parents.
the impact of baby massage in this area. However, our
mothers do seem quite content and relaxed after mas- Sensitivity to behavioural cues
saging their babies. From practice observations parents'
Fathers too, can gain from the experience of baby sensitivity to the needs of their
massage. In sessions we have observed fathers han- babies can be enhanced through
dling their babies gently, and demonstrating warmth baby massage. It can teach
towards them. Our evidence would seem to correlate them to be more aware of the
with that of CuUen el al (2000), who found that fathers behavioural cues given out
who massaged their babies showed warmth towards by their babies.
them. These researchers felt that fathers massaging Babies are particu-
their babies strengthened the bond between fathers larly sensitive to touch
and their babies. - it is the most highly
In practice we have found that only a small number developed sense at birtli
of fathers participate in baby massage. This is simi- (Montague 1986). The ji
lar to the findings of other centres (Mackereth 2003). overall development of
Porliaps within Sure Start more work needs to be done babies who are touched
to actively encourage fathers to attend. Fathers may be and caressed a great

vol 17 no 2 March 2005 Paediatric Nursing 17

deal has been found to be welt advanced for their age have observed certain behavioural cues such as those
(Montague 1986). Baby massage provides a sensitive described, we point out the significance to parents.
We wish to extend our medium for touch to occur, but for it to be successful Parents may not always realise the significance of such
thanks lo Sure Start Creswell.
Lingwith/Whaley Tlioms parents must be aware of the behavioural cues given out behaviour and baby massage may help them to gain a
and Shirebrook for providing by their babies during massage, and actively respond to better understanding of their baby's needs.
us with the opportunity to
undergo tlie Toudi Leani these. Behavioural cues indicate the mood of babies, Our Sure Start team has found that baby massage
hifant and Child Massage providing important infomiation about whether to mas- can teach mothers and fathers a great deal about their
sage or not. babies. Parents positively totiching their baby during
Murray and Andrews (2000) have identified positive massage can help them to see the world from their
behavioural cues or signals given out by babies; these baby's perspective.
include the baby's gaze, contented facial expressions,
and calm body language. Negative behavioural cues are Conclusion
described as babies turning their heads away from their Baby massage seems to be beneficial within our local
parents and becoming stiff within their parents' arms. Sure Start area. Practitioners involved have found that
From practice observations, positive behavioural cues baby massage can help babies' physical health and psy-
exhibited during baby massage can include babies jig- chological development, as welt as supporting parents
gling their arms and legs, or laying contentedly soaking in the care of their babies. Other colleagues are under-
up the massage experience. Negative behavioural cues going training so more parents can have the opportu-
we have observed include babies turning their heads nity to participate.
away from their parents, or babies becoming distressed Baby massage is a fairly new experience within
or restless during massage. British health care, although many cultures have under-
Positive and negative behavioural cues can Indicate taken the practice for centuries (Heller 1997). Baby
to parents whether their baby is enjoying the mas- massage could generate a different approach to child-
sage experience or not. If the baby is not enjoying it, rearing in this country; a more sensitive approach, witli
then massage should cease. Baby massage should be fathers feeling welcoint' to join in. As practitioners, we
a pleasurable experience. When members of our team wiD watch witti interest IBISI

by massage therapy. Early Child Hart) et al (2003) Health visitor run Scafidi F et al (1986) Effects of
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Paediatric Nursing vol 17 no 2 March 2005