New ways to connect with your baby
Infant Massage
Dr Pratibha N Reebye
University of British Columbia
Science off Touch Modalityy
 Pioneers
 Researchers
esea c e s
 Scientists
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Clinical Researchers : Spitz
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Attachment Species Specificity
Evolution of
pparentingg
behavior
Human species
specificity
Influence
Infl ence of
ethology
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Touch and Species Specific
Behaviors
 Role of mother
 Role of father
 Nesting
 Parenting
g ppractices
 Humans: role of skin
to skin contact
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Baby’s First Caress: Casatt
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Mother Infant Relationship
 Attachment –bonding
 Safe haven
 Secure base
 Attachment object
j
 Hierarchy of
attachment
relationships
 Cultural issues
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Types of Attachment
Secure
Insecure ambivalent
Insecure avoidant
Disorganized, disoriented
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laughing newborn.
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Voice
/
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Non Verbal Communication
Incidental( Not an exhaustive list)
Being
g there
Brushing hair
Lotioning
Stroking feet,rocking
Experience and Intuition based :
Massage
g
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Touch and Parenting Practices
 Holding
 Co-sleeping
 Breastfeeding
 Kissing
 Bathing
B thi
 Playing
 Feeding
 Toileting
 Leisure: dancing
g
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Safe and Enriching
Create a healthy cocoon around infant
Provide experience dependent maturation
Warmth
W
h through
h
h resting
i hands
h d
Facial expression, hands, skin, olfactory
channel
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Touch Brain
Touch,
Brain, Memories!
 Infant memory
 Procedural and
autobiographical
bi
hi l
memories
 Right brain left brain
 Somatic memories
 Relevance in
posttraumatic stress
and depression
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Infant Massage: Proven Benefits
Weight
Neurological and cognitive development
Physiological stability: sleep, temp
Immune
I
system
Crying and colic less
Increased opportunity for attachment
bonding
g
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Potential Benefits of Infant
Massage
Malignancy
Adjustment of circadian rhythms
Atopic dermatitis
Local
L l massage on vaccination
i i site
i
Infantile congenital myogenic torticollis
Cocaine exposed preterm neonates
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Contraindications
 Infant cues( Respect for Infant’s wishes)
 Unresponsive mother
 Angry, substance abusing parents
 Conflictual situation around infant
 Medical condition that may be exacerbated
 For example: atopic dermatitis with superadded
infection
 Overzealous parents until they understand that
massage is for the infant and not for their own
satisfaction.
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Infant Communication Cues
Engagement cues
The cue
What you should
d
do
Disengagement cues
Eyes widen and alert
Bright eyes
Smiling
Smooth limb movements
Hands open
Turning towards
caregiver
Hand to mouth
Hand-to-mouth
Normal breathing
Head raised
Hiccoughing
Averting eye contact n
caregiver
Falling asleep
Yawning
Fast breathing
Wrinkled forehead
Dull eyes
Spitting
Optimal time to interact
with
ith baby
b b by
b talking,
t lki
playing, holding, feeding
Least optimal time for
i t
interaction.
ti
R
Reduce
d
stimulation or put baby down.
Self-regulation
Sucking on fingers,
thumb or pacifier
Attentive-unattentive
y
g
cycling
Falling in and out of
sleep
Swaddling
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Holding environment
 Hold with eyes
 Hold with voice
 Hold with hands
 Hold with heart
 Hold with practice
 Hold with patience
 Hold with confidence
 Hold with love
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Container Function
Views of
 Bion
 Winnicott
 Bick
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Physical Proximity
 Intrauterine to
extrauterine journey
 Continuity of
Sound waves
touch
buoyancy
y y
movement
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Physical Proximity
 Massage cannot be
done as a remote
control high tech
procedure
 Difficult with children
diagnosed with autism
&regulatory disorder
 Comfort zone for
tactile defensive
children
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GxE
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Depressed Mothers and Infant
massage
T.Field: (1996)
Depressed
p
mothers and their infants ,15
,
minute videotaped massage for two weeks.
Codings
g for eye
y contact,, facial expressions,
p
,
vocalizations.
Mothers who massaged
g their infants also
interacted more favorably during the
face to face interactions.
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Anxious Mothers(Includes
obsessional mothers)
 No literature available
 Clinical experience: Difficult group to treat
 Focus on details of massage techniques
 Need reassurance
 Worry
W
about
b t just
j t about
b t everything
thi in
i the
th class,
l
oil,
il skin
ki
rashes, position of the baby, contact with other babies
 Group
p not appropriate
pp p
, pprobablyy two mothers maximum.
 This is the group that did not involve fathers readily
 Techniques are more important than the actual process
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Recovering Substance Users
Preterm cocaine exposed infants that were
massaged
g had fewer pphysical
y
complications, less irritability, 28% greater
daily
y weight
g ggain,, and advanced motor
activity
Ref : Wheeden, Scafidi,Field,& Ironson, 1993
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Preterm Babies and Massage(1)
Not controversial any more.
Greater weight gain
Better performance on developmental
assessments
assessments.
Premies do not like light touch
More awake and alert
Hospital
p
discharge
g sooner
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Preterm Babies and Massage(2)
Stress hormone levels decreased after
massage.
Slight decrease of temperature
Mothers of massaged
g infants reported
p
less
depression
Massage
g mayy lead to increase in food
absorption hormones, leading to wt gain.
? Growth g
gene that responds
p
to touch
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Regulatory Disorder & Infant
Massage
 Tactile sensitivity
 Fussy babies,colicky babies
 Sleep rhythms regulated
 Feeding pattern established.
 Infant affect improved( less whiney)
 Parents feel empowered
 Infants are more likely to enjoy bathing massage
techniques ,positioned on the parent’s extremities
 Ongoing need of massage when older
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Medically Ill Child
HIV Exposed infants and massage:
Weight gain++
Motor social items on Brazelton scale ++
Fewer
F
stress bbehaviors
h i than
h controll infants
i f
( Scarfidi,Field,&Schanberg,1993)
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Different Age Groups in the
Same Household
 Adjustment of techniques,schedules.
 Infants : Before bath , before sleep hygiene
 Preschoolers: During day before naptime,
at night during book reading, story-telling, singing
 Adolescents:Girls different from boys
 Anorectic girls and massage
 Boys: benefits need explanation in slang terms,
need role models to accept massage on regular
basis Example: sports related
basis.
 Young adults : Problems
with sexuality
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Fathers and Infant Massage
Inclusion of fathers in the treatment of
depressed
p
mothers beneficial
Using fathers as massage therapists is
beneficial to infants (Scholz & Samuels,
Samuels
1992)
Our bonding group experience
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Foster Parents and Infant
Massage
Infant massage should be an inherent part
of infant’s life
Foster parents who house infants in
emergency care
care, fragile infants,
infants transitional
homes, drug exposed babies, failure to
thieve babies need training
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Preadoption and Infant
Massage
No literature but clinical experience
deserves discussion
Preparation of adopted infant and
prospective parent
Mandatory course
Not
N enough
h to say three
h weeks
k visits
i i will
ill
promote bonding
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Massaging Legs
Insert
image
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Massaging Feet
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Massaging Tummy
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Massaging Chest
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Massaging Arms
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Massaging Face
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Massaging Back

up again
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Healing Touch
 Reassurance
 Holding
g
 Warmth
 Intrauterine
memories?
 Need more studies
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Concluding Remarks
Fetuses are Infants of tomorrow, and
Infants are social capital
p
of any
y society
y
Our therapeutic interventions must respect
this social capital and nurture as a societal
responsibility
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