The power of human touch is unmatched and irreplaceable.  It is an innate need of every human being, especially the infant.  I recently sat down and picked the brain of an expert in the field of infant massage.  Peter Walker, a London based physical therapist, who has been working with babies, children, and their parents for over 40 years. He travels the world and has trained nearly twenty thousand or more midwives, nurses, and other health professionals through his Developmental Baby Massage and Movement program. In his words “touch is the newborn’s first language-it is her prime means of communication and plays an essential role in the forming of early parent-child relationships.”  The following are just a few of the many benefits of touch and massage to both the infant and parents.

Skin to Skin

Study after study has shown the unbelievable benefits of placing an infant skin to skin with its parent.  The power of touch is evident from the first moments after birth when the infant is placed skin to skin. Remarkably, the infant’s temperature, heart rate, breathing, and blood sugar stabilize while being comforted on their mother or father’s chest.  Touch begins here.  A bond between parent and infant begins here.

Enhanced Immunity

The simple act of skin to skin with the mother sets forth an intricate orchestration of colonization and antibody formation that is transferred from mother to baby through the breastmilk.  A study done at John Hopkins University found a significant reduction of nosocomial infections in  infants massaged daily with sunflower seed oil however a Cochrane review of this practice published in 2016 found the evidence lacking that emollient therapy would prevent invasive infections and cautioned that more research was needed..

Hormonal Influence

Done regularly, massage may reduce the level of the stress hormone, cortisol circulating in an infant’s bloodstream.  In turn, it may increase the level of endorphins, the body’s natural opiates as well as oxytocin, the love hormone.  Both leave the infant with a sense of well being and further promote attachment between parent and child.

Colic & Gas Relief

The jury is still out on the exact the cause of colic.  Colic starts as early as the few weeks after birth and results in crying for long periods of time-particularly at night.  Massage may relieve a distressed and colicky baby.  Regular tummy time and massage of the stomach may ease gas, constipation, and aid in digestion.  It is best to avoid tummy time and massage directly after a feed.

Joint Flexibility & Increased Muscle Strength

 According to Peter, developmental massage, practiced according to his program “releases ‘physiologic flexion’ imposed by the fetal position from the time the infant spends in utero.  Gentle massage together with soft stretching can allow the infant to relax and coordinate their muscles to improve the circulation to their body’s extremities, open the chest to deepen their breathing volume, relax the tummy to assist digestion and disposition, and strengthen the muscles of the head, neck and back in preparation for (upright postures and movement).”

Develops Trust & Confidence

Infants learn through touch.  The gentle, reassuring hand of a parent teaches the infant early on that his or her needs will be met.  Touch and massage further foster a deep bond between infant and parent.  The infant learns to trust and the parent develops confidence in his or her ability to care for the infant.

Benefits to Parents

A 2011 study in the Journal of Perinatal Education found “participating fathers were helped by increasing their feelings of competence, role acceptance, spousal support, attachment, and health and by decreasing feelings of isolation and depression.”  Other studies have shown that mothers that massage their infants have improved mood and decreased symptoms of depression.

Educating Parents

Nurses and midwives at the bedside have an excellent opportunity to teach the benefits of skin to skin and massage.   Early education should start right at birth by encouraging immediate and regular skin to skin contact.  In addition, parents can be taught simple techniques as seen here.  It is best to use oil for massage so the hands move nicely against the skin. For sick or unstable infants in the Neonatal Intensive Care, teaching parents and family members the importance of touch in the form of a gentle hand is essential.  By simply placing and holding a steady hand over the infant that is confined to an incubator or radiant warmer, we are still able to convey trust and reassurance.  Early massage can begin when the infant is stable and willing.

Peter sums it up perfectly, “from the very beginning, the mother should remain at the center of any “treatment” offered to her baby.  Most mothers want to hold their babies and establish skin to skin contact before the baby is removed, weighed, measured, bathed, or dressed.  From his mother’s womb into her arms, touch becomes the primal language of the newborn, and it is through holding and caressing that a baby is made to feel welcomed and loved.”

AWHONN Resources

• Healthy Mom&Baby Newborn Skin Care Zone
• Breastfeeding Support
• Duration of Uninterrupted Skin-to-Skin Contact
• Diapering That Nurtures

Additional Resources

• The Babies Website
• Effect of topical treatment with skin barrier-enhancing emollients on nosocomial infections in preterm infants in Bangladesh: a randomized controlled trial.
• Changes in plasma cortisol and catecholamine concentrations in response to massage in preterm infants
• Supporting Fathering Through Infant Massage
• Effect of massaging babies on mothers: Pilot study on the changes in mood states and salivary cortisol level
• Early skin-to-skin contact for mothers and their healthy newborn infants
• Massage Increases Oxytocin and Reduces Adrenocorticotropin Hormone in Humans

Lori is an American Neonatal Intensive Care nurse that has made her way to Sweden.  Her passion is maternal and infant education.  She incorporates her years of work in maternal and infant health with a passion for wellness through her Prenatal Yoga, Mommy & Me Yoga, and Developmental Infant Massage classes in Gothenburg, Sweden.  Follow her adventures on Instagram or through her nursing blog, Neonurse.

Having your new baby spend time in the Neonatal Intensive Care Unit (NICU) can be extremely stressful for both you and your baby. The bright lights, the random nature of nonhuman sounds such as beeps or monitors, and medical procedures can all create an uneasy or stressful environment.

This is concerning because stress can influence your baby’s brain development and how parents  interact with their babies. However, there are ways to help reduce the long-term effect of these stressors.

There are several things you can do as parents to help reduce NICU environmental stressors. Ask your nurse for help with these suggestions.

First is to reduce extra lightings and non- human sounds. Infants thrive on the mother and father’s voice.  Talking to your baby is easy to do.  Mothers and fathers instinctively raise the pitch of their voice and talk using a few words with a pause.

Another  way to help babies in the NICU  is to use a combination of procedures that can increase your understanding of and reactions to your infant’s behaviors; along with, providing your infant with positive sensory experiences. This procedure is known as Auditory, Tactile, Visual, and Vestibular Intervention (ATVV) also known as Massage Plus 30, 10, 5.

This practice helps to improve infant/parent relationships, increase infant alertness and pre-feeding behaviors, improve maternal confidence in caring for her premature infant,, and improve the baby’s ability to feed and grow.  Touch and human social interaction are important for an infant’s growth and development, and during the first few days or weeks of life babies are very sensitive to and receptive to these types of stimuli.

One mother delivered a baby born at less than 29 weeks gestation.  After she learned the ATVV and administered it for a few weeks, she stated “The ATVV made me more aware as a mother of what my child may like or dislike and to how recognize the difference.”

The ATVV procedures were developed over a 30 year period and include step by step instructions on how to introduce the sensory stimuli in a way that does not over stimulate the baby. The procedure begins with mom (or dad) talking to baby in a soothing calm voice (auditory stimulation). After 30 seconds of talking to the baby using a higher pitched voice and a few words with pauses, mom can then begin to massage the baby. Mom will massage each section of baby’s head, arms, legs, tummy and back, for 10 minutes. This is considered touch or tactile stimulation. Mom should continue to talk to baby and hold eye contact throughout the massage. Once the massage is finished mom should wrap baby up in a blanket and gently rock baby back and forth for 5 minutes (vestibular stimulation). Throughout this procedure mom should be watching for signs that baby is alert and enjoying themselves. A full instruction on how to do the ATVV protocol and tips to help understand your baby’s behavior can be found online.

Another mother had previously delivered more than three premature babies.  When she learned the ATVV for the first time on her baby who was born at 33 weeks gestation, she stated “I have never seen her so alert!”

Before starting any procedure like ATVV it is important to discuss the benefits and drawbacks with your healthcare professional, as each baby’s needs and situation is different. Work with hospital nurses, physicians, and other staff to help find ways to help reduce environmental stressors for your baby during their stay in the NICU.  They will be able to help facilitate your activities with your baby during visits such as the ATVV or skin-to-skin contact, reducing lighting and sound exposure,  and supporting non stress feedings.

No parent wants their new baby to be in the NICU in their first few days or weeks of life. However, for some with medical conditions and for those born too early, the NICU is the best place to be.  Finding ways to help reduce your baby’s stress when placed in the NICU  environment can have long lasting impacts on your baby’s development.

Rosemary C. White-Traut, PhD, RN, FAAN
Rosemary  is the director of Nursing Research at Children’s Hospital of Wisconsin. Prior to coming to the Children’s Hospital of Wisconsin, she served as professor and department head of Women, Children and Family Health Science at the University of Illinois at Chicago.