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The benefits of

babv massaae

A scheme to improve young children's physical health and


psychological development hy introducing hahy massage is
descrihed by members of a Sure Start team

Lydia Lorenz NNEB Diploma in

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

(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.

Nursery Nursing, is Sure Skirt


nursery nurse
Karen Moyse RSCN, MSc
Community Health, is Sure Start

Helen Surguy RGN, BSc

KEY WORDS

improved by supporting parents in caring for their


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

vol 17 no 2 March 2005

Paediatric Nursing

15

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


massage has helped them to feel
emotionally closer to their babies

Psychological development
Baby massage not only has physical benefits, but
can also improve psychological development. Some
authors beHeve that baby massage can belp with the
developing relationship between babies and their par-

a baby massage session tbeir babies sleep particularly


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


improved weight gain have been unreliable.

16

ents - bonding (Field 1995. Heller 1997. Hart et al

Heller (1997) believes that baby massage is an


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.

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 massaging their babies.
Fathers too, can gain from the experience of baby

Sensitivity to behavioural cues


From practice observations parents'
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

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

ji

17

ACKNOWLEDGEMENTS
We wish to extend our
thanks lo Sure Start Creswell.
Lingwith/Whaley Tlioms
and Shirebrook for providing
us with the opportunity to
undergo tlie Toudi Leani
hifant and Child Massage
training

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.

medium for touch to occur, but for it to be successful

Parents may not always realise the significance of such

parents must be aware of the behavioural cues given out

behaviour and baby massage may help them to gain a

by their babies during massage, and actively respond to

better understanding of their baby's needs.

these. Behavioural cues indicate the mood of babies,

Our Sure Start team has found that baby 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


behavioural cues or signals given out by babies; these

massage can help them to see the world from their


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


or restless during massage.
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

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Paediatric Nursing

vol 17 no 2 March 2005