Preterm infant massage therapy research: a review

Abstract

In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies.

Figure 1

Trend Analyses on Vagal Tone (high frequency component of heart rate variability) and Gastric Motility (2-4 cpm EGG) 15-minutes before, during and after treatment (error bars denote +- 2 SE) in massage (moderate pressure), sham (light pressure) and control groups. Preterm infants who received massage therapy exhibited increased HF during the massage (F (1,15)=4.54, p<.05, quadratic trend for massage group only) and increased gastric activity following the massage (F (1,15)=10.66, p<.01, linear trend for massage group only).

Figure 2

Mean vagal activity and gastric motility on the first and last days of the study for preterm infants assigned to the control (closed circles) and massage group (open circles).

Figure 3

Stress behaviors on the first and last days for the massage vs. the control group. Movement on the first and last days for the massage vs. the control group.

Figure 4

A preliminary path analysis entering potential mediating variables for the massage therapy/ weight gain relationship. Corrected Model, Chi² (5)= 6.96, p=.98

Figure 5

IGF-1 levels increased from day 1 to day 5 for infants assigned to the moderate massage therapy (t (20) = 2.25, p < .05) but not the standard care control group (t (20) = 1.65, N.S.).