INFANT MASSAGE
Field, T., Schanberg, S. M.,
Scafidi, F., Bauer, C. R., Vega Lahr, N., Garcia, R., Nystrom, J., & Kuhn,
C. M. (1986). Tactile/kinesthetic stimulation effects on preterm neonates.
Pediatrics, 77, 654 658.
¥ The stimulated neonates averaged a 47% weight gain, were more active and
alert during sleep/ wake behavior observations, and showed more habituation,
orientation, motor and range of state behavior. Their hospital stay was also
6days shorter, saving the hospital approximately $3,000 per infant.
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Infant Massage/ Rat Pups
Pauk, J., Kuhn, C., Field, T.,
& Schanberg, S. (1986). Positive effects of tactile versus kinesthetic
or vestibular stimulation on neuroendocrine and ODC activity in maternally-deprived
rat pups. Life Sciences, 39, 2081 2087.
¥ The study demonstrates that neither kinesthetic nor vestibular stimulation
effects changes associated with maternal deprivation. Results indicate that
tactile interactions between rat pups and their mothers modulate pup physiology.
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Scafidi, F., Field, T., Schanberg, S., Bauer, C., Vega Lahr, N., Garcia, R.,
Poirier, J., Nystrom, G., & Kuhn, C.M.(1986). Effects of tactile/kinesthetic
stimulation on the clinical course and sleep/wake behavior of preterm neonates.
Infant Behavior and Development, 9, 91 105.
¥ Forty preterm infants were placed in a control or treatment group. The treated
infants averaged a 47% greater weight gain per day and spent time more awake
and active during sleep/wake behavior observations. On the Brazelton scale
the treated infants showed more mature orientation, motor, habituation, and
range of state behaviors.
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Field, T., Scafidi, F., & Schanberg, S. (1987). Massage of preterm newborns
to improve growth and development. Pediatric Nursing, 13(6), 385 387.
¥ The study results show that such stimulation enhances weight gain and responsiveness,
and may affect later growth and development.
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Infant Massage/Rat Pup/ Preterm
Schanberg, S., & Field, T.
(1987). Sensory deprivation stress and supplemental stimulation in the rat
pup and preterm human neonate. Child Development, 58, 1431 1447.
¥ The data suggest that the effects of maternal deprivation in the rat pup
are regulated by a specific form of tactile stimulation; only brush stroking
of maternally deprived rat pups returned growth parameters to normal, other
forms of stimulation, including kinesthetic and vestibular stimulation, were
ineffective in restoring normal functions. Other data are presented demonstrating
that very small neonates given tactile-kinesthetic stimulation, gain more
weight per day, and show more mature habituation, orientation, motor, and
range of state behaviors on the Brazelton assessment.
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Scafidi, F.A., Field, T.M., Schanberg, S.M., Bauer, C.R., Tucci, K., Roberts,
J., Morrow, C., & Kuhn, C.M. (1990). Massage stimulates growth in preterm
infants: A replication. Infant Behavior and Development, 13, 167 188.
¥ Forty preterm infants were assigned to treatment and control groups. The
treatment infants averaged a 21% greater weight gain per day , were discharged
5 days earlier, and achieved a superior performance on the habituation cluster
items of the Brazelton scale. Treatment infants were also more active during
the stimulation sessions than during the nonstimulation observation sessions
(particularly during the tactile segments of the sessions).
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Kuhn, C., Schanberg, S., Field, T., Symanski, R., Zimmerman, E., Scafidi,
F., & Roberts, J. (1991). Tactile kinesthetic stimulation effects on sympathetic
and adrenocortical function in preterm infants. Journal of Pediatrics, 119,
434-440.
¥ Urine norepinephrine and epinephrine values increased significantly only
in the stimulated babies. Furthermore, urine dopamine and cortisol values
increased in both groups, and serum growth hormone decreased on both groups.
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Morrow, C., Field, T., Scafidi, F., Roberts, J., Eisen, L., Larson, S., Hogan,
A., & Bandstra, E. (1991). Differential effects of massage and heelstick
procedures on transcutaneous oxygen tension in preterm neonates. Infant Behavior
and Development, 14, 397-414.
¥ During the heelstick procedure, transcutaneous oxygen tension declined an
average of 14mmHg. When compared to tactile-kinesthetic massage, transcutaneous
oxygen tension during heelstick were lower than during stimulation.
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Scafidi, F., Field, T., Schanberg, S.M. (1993). Factors that predict which
preterm infants benefit most from massage therapy. Journal of Developmental
and Behavioral Pediatrics, 14(3), 176-180.
¥ Preterm infants were randomly assigned to a massage therapy or control group.
The massage therapy infants gained significantly more weight per day than
did the control infants. Seventy percent of the massage therapy infants were
classified as high weight gainers whereas only forty percent of the control
infants were classified as high weight gainers. The data suggest that the
control infants who, before the study, consumed more calories and spent less
time in intermediate care gained more weight. In contrast, for the massage
group, the pattern of greater caloric intake and more days in Intermediate
care before the study period along with more obstetric complications differentiated
the high from the low weight gainers, suggesting that the infants who had
experienced more complications before the study benefited more from the massage
therapy.
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Wheeden, A., Scafidi, F.A., Field, T., Ironson, G., Valdeon, C. & Bandstra,
E. (1993). Massage effects on cocaine-exposed preterm neonates. Journal of
Developmental and Behavioral Pediatrics, 14, 318-322.
¥ Cocaine exposed preterm neonates were randomly assigned to a control group
or massage therapy group. The massaged infants averaged 28% greater weight
gain per day although the groups did not differ in intake, showed significantly
fewer postnatal complications and stress behaviors than did control infants,
and demonstrated more mature motor behaviors on the Brazelton examination
at the end of the 10-day study period.
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Field, T. (1994). Infant Massage. The Journal of Perinatal Education, 3, 7-14.
¥ Compared to preterm infants who are not massaged, massaged infants gain
47% more weight, remain awake and active a greater percentage of the observation
time, better performance on the Brazelton scale, and are hospitalized on average
6 days fewer than control infants. Similar affects pertain to preterm infants
prenatally exposed to cocaine and HIV. Although, these infants also show reduced
stress behaviors following the study period. Depressed mothers massaging their
infants and grandparent volunteers as massage therapist also suggest that
both the infant and person giving the massage can reap benefits, such as fewer
anxiety and stress levels. These studies also suggest infantsÕ drowsiness,
quiet sleep, alertness, and tracking increases, while activity and fussiness
decreases following the massage.
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Field, T. (1995). Massage therapy for infants and children. Journal of Developmental
and Behavioral Pediatrics, 16, 105-111.
¥ Data are reviewed on the effects of message therapy on infants and children
with various medical conditions. The infants include: premature infants, cocaine-exposed
infants, HIV-exposed infants, infants parented by depressed mothers, and full
term infants without medical problems. The childhood conditions include: abuse
(sexual and physical), asthma, autism, cancer, burns, developmental delays,
dermatitis, diabetes, bulimia, juvenile rheurnatoid arthritis, posttraumatic
stress disorder, and psychiatric problems. Generally, the message therapy
has resulted in lower anxiety and stress hormones and improved clinical course.
Having grandparent volunteers and parents give the therapy enhances own wellness
and provides a cost-effective treatment for the children.
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Field, T., Grizzle, N., Scafidi, F. Abrams, S., Richardson, S., Kuhn, C.,
& Schanberg, S. (1996). Massage therapy for infants of depressed mothers.
Infant Behavior and Development, 19, 107-112.
¥ The infants who experienced massage therapy compared to infants in the rocking
control group spent more time in active alert and active awake states, cried
less, and had lower salivary cortisol levels, suggesting lower stress. Over
the 6-week period, the massage-therapy infants gained more weight, showed
greater improvement on emotionality, sociability, and soothability temperament
dimensions, and had greater decrease in urinary stress catecholamines/hormones
(norepinephrine, epinephrine, and cortisol).
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Field, T., Schanberg, S., Davalos, M., & Malphurs, J. (1996). Massage
with oil has more positive effects on normal infants. Pre and Perinatal Psychology
Journal, 11, 75-80.
¥ As compared with infants who received massage without oil, infants who received
massage with oil were less active, showed fewer stress behaviors and head
averting, and their saliva cortisol levels decreased more. Also, vagal activity
increased following massage with oil versus massage without oil.
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Cigales, M., Field, T., Lundy, B., Cuadra, A., & Hart, S. (1997). Massage
enhances recovery from habituation in normal infants. Infant Behavior and
Development, 20, 29-34.
¥ Research shows that touch stimulation can positively affect physiological,
behavioral, and social development among infants. However, empirical evidence
of the effects of touch on infantsÕ cognitive performance is lacking. In this
study, 56, 4-month-olds were given either 8 minutes of massage, play, or no
stimulation prior to an audiovisual habituation task. Infants who received
massage showed response recover from habituation during test trials, whereas
those in the other two conditions did not.
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Field, T., Schanberg, S., Davalos,
M. & Malphurs, J. (1997). Bottlefeeding with a breast-like nipple. Early
Child Development and Care, 132, 57-63.
¥ Compared mothers' and one-month-olds' behaviors during 20-minute bottlefeeding
with standard or breastlike nipple. Found that mothers' behaviors did not
differ, but infants on breastlike nipples spent less time asleep, more time
awake and active and less time fussing and crying than infants on standard
nipples; they also exhibited changes in vagal tone similar to those of breastfeeding
infants.
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Field, T. (1998). Touch therapy effects on development. International Journal
of Behavioral Development, 22, 779-797.
¥ In this review empirical data are presented on the use of touch therapy,
specifically massage therapy for improving the clinical course of several
conditions including growth and development of pre-term infants, reducing
pain, increasing attentiveness, diminishing depression, and enhancing immune
function. Potential underlying mechanisms for the massage therapy effects
are proposed for each of these conditions. The general effect appears to derive
from the stimulation of pressure receptors and the ensuing increase in vagal
activity and slowing physiology which in turn facilitates a more relaxed behavioural
state, affects a decrease in stress hormones, most particularly cortisol,
and an increase in immune function, particularly natural killer cells.
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Cullen, C., Field, T., Escalona, A. & Hartshorn, K. (2000). Father-infant
interactions are enhanced by massage therapy. Early Child Development and
Care, 164, 41-47.
¥ Infants were given massages by their fathers for 15 minutes prior to their
daily bedtime for one month. By the end of the study, the fathers who massaged
their infants were more expressive and showed more enjoyment and more warmth
during floor-play interactions with their infants.
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Field, T. (2001). Massage therapy
facilitates weight gain in preterm infants. Current Directions in Psychological
Science, 10, 51-54.
¥ Studies from several labs have documented a 31 to 47% greater weight gain
in preterm newborns receiving massage therapy (three 15-min sessions for 5–10
days) compared with standard medical treatment. Although the underlying mechanism
for this relationship between massage therapy and weight gain has not yet
been established, possibilities that have been explored in studies with both
humans and rats include (a) increased protein synthesis, (b) increased vagal
activity that releases food-absorption hormones like insulin and enhances
gastric motility, and (c) decreased cortisol levels leading to increased oxytocin.
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Field, T., & Hernandez-Reif, M., (2001). Sleep problems in infants decrease
following massage therapy. Early Child Development and Care, 168, 95-104.
¥ Infants and toddlers with sleep onset problems were given daily massages
by their parents for 15 minutes prior to bedtime for one month. Based on parent
diaries the massaged versus the control children (who were read bedtime stories)
showed fewer sleep delay behaviors and had a shorter latency to sleep onset
by the end of the study. Forty-five minute behavior observations by an independent
observer also revealed more time awake, alert and active and more positive
affect in the massaged children by the end of the study.
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Field, T., Diego, M., Hernandez-Reif,
M., Deeds, O., Figueiredo, B. & Ascencio, A.(2006). Moderate Versus Light
Pressure Massage Therapy Leads to Greater Weight Gain in Preterm Infants.
Infant Behavior and Development., 29, 574-578.
¥ Sixty-eight preterm infants were randomly assigned to a moderate or to a
light pressure massage therapy group to receive 15 massages three times per
day for 5 days. Behavior state, stress behaviors and heart rate were recorded
for 15min before and during the first 15-min therapy session. Weight gain
was recorded over the 5-day therapy period. The moderate versus light pressure
massage group gained significantly more weight per day. During the behavior
observations the moderate versus light pressure massage group showed significantly
lower increases from the pre-session to the session recording on: (1) active
sleep; (2) fussing; (3) crying; (4) movement; and (5) stress behavior (hiccupping).
They also showed a smaller decrease in deep sleep, a greater decrease in heart
rate and a greater increase in vagal tone. Thus, the moderate pressure massage
therapy group appeared to be more relaxed and less aroused than the light
pressure massage group which may have contributed to the greater weight gain
of the moderate pressure massage therapy group.
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Field, T., Hernandez-Reif, M., Feijo, L., & Freedman, J. (2006). Prenatal,
perinatal and neonatal supplemental stimulation: A survey of neonatal nurseries.
Infant Behavior and Development, 29, 24-31.
¥ A recent survey was conducted on stimulation of mothers and babies during
pregnancy and the neonatal period. The survey was responded to by 82 neonatology
staff members from Neonatal Intensive Care Units (NICUs) at hospitals in the
United States. Some forms of stimulation were extremely common including (1)
skin-to-skin following birth in the delivery room (83% of hospitals); (2)
containment (swaddling and surrounded by blanket rolls) in the NICU (86%);
(3) music in the NICU (72%); (4) rocking in the NICU (85%); (5) kangaroo care
(98%); (6) non-nutritive sucking during tubefeedings in the NICU (96%); and
(7) breastfeeding in the NICU (100%). Other forms of stimulation occurred
less frequently including (1) pregnancy massage (19%); (2) labor massage (30%);
(3) the Doula (assistant who comforts during labor and delivery) (30%); (4)
waterbeds in the NICU (23%); and (5) preterm infant massage in the NICU (38%).
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Field, T., Hernandez-Reif, M.,
& Diego, M. (2006). Newborns of depressed mothers who received moderate
versus light pressure massage during pregnancy. Infant Behavior and Development,
29, 54-8.
¥ Compared to the group of neonates whose mothers received light massage,
neonates whose mothers received moderate pressure massage spent a greater
percent of the observation time smiling and vocalizing, and they received
better scores on the orientation, motor, excitability, and depression clusters
of the Brazelton scale.
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Preterm Infants
Diego, M. A., Field, T., Hernandez-Reif,
M., Deeds, O., Ascencio, A., Begert, G. (2007). Preterm infant massage elicits
consistent increases in vagal activity and gastric motility that are associated
with greater weight gain. Acta Paediatrica, 96, 1588-91.
¥ Massaged infants exhibited consistent short-term increases in vagal activity
and gastric motility on both the first and the last days of the 5-day study
that were associated with weight gain during the 5-day treatment period.
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Hernandez-Reif, M., Diego, M. & Field, T. (2007). Preterm infants show
reduced stress behaviors and activity after 5 days of massage therapy. Infant
Behavior & Development, 30, 557-61.
¥ The preterm infants in the massage therapy group received three 15-min massages
each day for 5 consecutive days, with the massages consisting of moderate
pressure stroking to the head, shoulders, back, arms and legs and kinesthetic
exercises consisting of flexion and extension of the limbs. Preterm infants
receiving massage therapy showed fewer stress behaviors and less activity
from the first to the last day of the study.
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Diego, M. A., Field, T. & Hernandez-Reif, M. (2008). Temperature increases
in preterm infants during massage therapy. Infant Behavior & Development,
31, 149-52.
¥ A greater increase in temperature was noted for preterm infants receiving
massage therapy versus the control group; even though the incubator portholes
remained open during the 15 min massage therapy session but not for the control
group over an equivalent time period.
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Diego, M. & Field, T. (In Press) Moderate Pressure Massage Elicits a Parasympathetic
Nervous System Response. International Journal of Neuroscience.
¥ Twenty healthy adults were randomly assigned to a moderate pressure or light
pressure massage therapy group, and EKGs were recorded during a 3-minute baseline,
during the 15-minute therapy group, and EKGs were recorded during a 3-minute
baseline, during the 15-minute massage period and during a 3-minute post massage
period. EKG data were then used to derive the high frequency (LH), low frequency
(LF) components of heart variablilty and the low to high frequency ratio as
noninvasive markers of autonomic nervous system activity. The participants
who received the moderate pressure massage exhibited a parasympathic nervous
system response characterized by an increase in HF, suggesting increased vagal
efferent activity and a decrease in the LF/HF ratio, suggesting a shift from
sympathetic to parasympathetic activity that peaked during the first half
of the massage period. On the other hand, those who received the light pressure
massage exhibited a sympathetic nervous system response characterized by decreased
HF and increased LF/HF.
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Field, T., Diego, M., Hernandez-Reif, M., Dieter, J., Kumar, A., Schanberg,
S. & Kuhn, C. (In Press). Insulin and Insulin-Like Growth Factor I (IGF-1)
Increase in Preterm Infants Following Massage Therapy. Journal of Developmental
and Behavioral Pediatricts.
¥ To determine if massage therapy increased serum insulin and insulin-like
growth factor 1 (IGF-1) in preterm neonates. Forty-two preterm neonates were
randomly assigned to massage therapy (body stroking and passive limb movements
for three, 15-minute periods per day for 5 days) or a standard treatment control
group. On days 1 and 5, the serum collected by clinical heelsticks was also
assayed for insulin and insulin-like growth factor-1 (IGF-1), and weight gain
and kilocalories consumed were recorded daily. Despite similar formula intake,
the massaged preterm neonates showed greater increases during the 5 day period
in: 1) weight gain; 2) serum levels of insulin; and 3) insulin-like growth
factor-1 (IGF-1). Increased weight gain was significantly correlated with
insulin and IGF-1.
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