The Effects of Baby Massage on Attachment between Mother and their Infants

Effects of infant massage on infant attachment security in a randomized controlled trial

Benefits of attachment security have been demonstrated in multiple realms of development, and an extensive body of research has identified some of the antecedents associated with the development of secure attachments. While previous research has indicated that infant massage may support the development of mothers' attachment to their babies, no published research exists that investigated infants' attachment security after mothers learn infant massage strokes. This study tested the impact of an infant massage intervention on mothers' massage frequency and attachment security in infants. Fifty-eight mother-infant dyads were randomly assigned to a treatment (massage, n = 28) or control (education, n = 30) group. Most mothers had preschool aged children participating in Head Start as well as an infant under 8 months of age; the remaining mothers were from the community. Mothers in the treatment group completed 4 weeks of infant massage training using standard strokes from Infant Massage USA, a chapter of the International Association of Infant Massage, headquartered in Sweden. At 12 months, mothers were guided through the standard sorting procedure of the Attachment Q-set (Waters, 1987). The treatment was effective, as 86 % of mothers in the massage group were still massaging their babies at the follow-up, an average of 10 months later, and infants whose mothers massaged them had higher attachment security scores. Surprisingly, 29 % of the mothers in the comparison group reported that they massaged their babies. A treatment X massage frequency ANOVA indicated that 12-month-old infants whose mothers in the treatment group had massaged them more than once per week were more securely attached than infants of mothers who massaged their infants less than once per week and also were more securely attached than infants in the comparison group. However mothers in the control group defined massage, it was not associated with infant attachment security at the follow-up. These results indicate that this inexpensive, easy to implement intervention effectively increased mothers' ongoing use of infant massage, which in turn predicted more attachment security in their infants.

The Impact of Video Calling Between Preterm Infants and Their Mothers on the Physiological Parameters of Infants and Mother-Infant Bonding

PURPOSE

This study aimed to determine the effect of video calling between preterm infants treated in the neonatal intensive care unit (NICU) and their mothers on the physiological parameters of infants and mother-infant bonding.

BACKGROUND

Preterm infants need prolonged treatment in the NICU, and their families may have difficulty seeing their babies during this treatment process.

METHODS

This is a prospective, randomized-controlled, experimental study. The study sample consisted of 75 preterm infants and their mothers. The data were collected using a maternal introductory information form, a preterm infant introductory information form, a preterm infant physiological parameters follow-up form, and the Mother-Infant Bonding Scale (MIBS). The study included 3 study groups: the video call group, the video call with lullaby group, and the control group. Video calls between preterm infants and their mothers were made through Zoom for 5 to 10 minutes daily for 7 days. The mothers filled out the MIBS online before and on the 7th and 30th days of the study.

RESULTS

Preterm infants in the video call and the video call with lullaby groups had higher MIBS mean scores on the 7th and 30th days of the study than their pretest MIBS scores. Preterm infants in the video call and the video call with lullaby groups had statistically significantly higher MIBS mean scores on the seventh day of the study than those in the control group. At the end of the 7-day study period, there was an improvement in the physiological parameters of preterm infants in the video call group and the video call with lullaby group compared with those in the control group, and this relationship was statistically significant.

CONCLUSIONS

In conclusion, the implementation of video calls between mothers and preterm infants in NICUs had a healing effect on the physiological parameters of preterm infants and increased mother-infant bonding.

Effectiveness of infant massage on babies growth, mother-baby attachment and mothers' self-confidence: A randomized controlled trial

Infant massage is a unique massage that can be application to babies in the postpartum period for centuries. While baby massage provides contact between the baby and the mother, it supports the growth processes of the baby. This study aimed to investigate the effects of online infant massage training on infant growth, mother-infant attachment, and mothers' self-confidence. This randomized controlled clinical trial included 60 healthy-term infants and mother. The Demographic Data Collection Form, Maternal Attachment Scale, and Pharis Self-Confidence Scale were completed by all the mothers participating in the study. At the end of the 4th week, infant massage training was given to the mothers of the babies in the massage group by the primary investigator. Body weight, height, and head circumference measurements were made at the end of the 4th, 8th, 12th, 16th, and 20th week of both group babies. At the end of the 20th week, the self-confidence of the mothers in both groups was assessed using the Maternal Attachment Scale and Pharis Self-Confidence Scale. Infants in the massage group had significantly higher mean body weight at the end of the 8th week (p = 0.006) and mean height at the end of 20th week (p = 0.05) than the infants in the control group. The Maternal Attachment Scale values were higher for the mothers in the massage group (p = 0.030). Infant massage is an effective method that strengthens maternal attachment and increases body weight and height in infants. The study is registered under the ClinicalTrials.gov identifier NCT05302427.

The role of midwives in supporting the development of the mother-infant relationship: a scoping review

BACKGROUND

The mother-infant relationship is complex and dynamic, informing the psychological development of the infant through bonding and attachment. Positive early interactions influence the quality of this relationship. Midwives are well placed to support the developing relationship between the mother and baby, yet there has been limited research exploring the role of the midwife in this context.

AIM

To explore interventions that have been provided by the midwife which support the development of the maternal-fetal or mother-infant relationship amongst a low-risk population from pregnancy, and up to six weeks postnatal. The review also sought to understand the types of interventions developed, format and delivery, outcomes measured and if cultural considerations had been incorporated.

METHODS

A scoping review of the research literature was undertaken using the Joanna Briggs Institute framework. Five online databases were searched for relevant articles published in English from 2000 to 2021.

FINDINGS

Sixteen articles met the inclusion criteria. Three themes emerged: (1) viewing the fetus as separate from the mother, (2) focused activities on the maternal-infant relationship and (3) targeted educational interventions.

DISCUSSION

Providing focused activities and targeted education during the pre and postnatal periods support the development of the mother-infant relationship. Significantly, there was insufficient research that considered the influence of culture in supporting the mother-infant relationship.

CONCLUSION

Further research is required to develop interventions that include a diverse sample to ensure culturally appropriate activities can be integrated into care during pregnancy and/or the postnatal period provided by midwives.

Effect of whole-body massage on growth and neurodevelopment in term healthy newborns: A systematic review

Background

Infant massage is commonly practiced in many parts of the world. However, the effectiveness of this intervention has not been reviewed for term, healthy newborns.

Methods

This systematic review of randomized and quasi-randomized controlled trials assessed the effect of whole-body massage with or without oil, compared to no massage in term healthy newborns. Key outcomes were neonatal mortality, systemic infections, growth, behaviour (crying or fussing time, sleep duration), and neurodevelopment. We searched MEDLINE via PubMed, Cochrane CENTRAL, EMBASE, and CINAHL (updated till November 2021), and clinical trials databases and reference lists of retrieved articles. Two authors separately evaluated the risk of bias, extracted data, and synthesized effect estimates using mean difference (MD) and standardized mean difference (SMD). The GRADE approach was used to assess the certainty of evidence.

Results

We included 31 randomized and quasi-randomized trials involving 3860 participants. Infant massage was performed by different care providers starting in the neonatal period and continuing for 1-2 months in most studies. Thirteen studies reported the use of oil with body massage. No study reported neonatal mortality or systemic infections. Meta-analyses suggested that whole-body massage may increase infant length at the end of the intervention period (median assessment age 6 weeks; mean difference (MD) = 1.6 cm, 95% confidence interval (CI) = 1.4 to 1.7 cm; low certainty evidence), but the effect on weight (MD = 340 g, 95% CI = 240 to 441 g), head circumference (MD = 0.8 cm, 95% CI = 0.6 to 1.1 cm), sleep duration (MD = 0.62 hours/d, 95% CI = 0.12 to 1.12 hours/d) and bilirubin levels (MD = -31.8 mmol/L or -1.8 mg/dL, 95% CI = -23.5 to -40.0 mmol/L) was uncertain. The effect on crying/fussing time at median 3 months of age, sleep duration at 6 months of age, weight, length, and head circumference at 6-12 months follow-up, and neurodevelopment outcomes, both at the end of the intervention period and follow-up was uncertain.

Conclusions

Whole-body massage may improve the infant length at the end of the intervention period (median age 6 weeks, range 1-6 months) but the effect on other short- or long-term outcomes is uncertain. There is a need for further well-designed trials in future.

Registration

Priyadarshi M, Balachander B, Rao S, Gupta S, Sankar MJ. Effect of body massage on growth and neurodevelopment in term healthy newborns: a systematic review. PROSPERO 2020 CRD42020177442.

Effects of Infant Massage: A Systematic Review

Infant massage is performed in various international contexts. There is a need for an updated literature review on this topic. The purpose of the current review was to investigate the effects of infant massage. A systematic literature review was conducted to investigate the effects of infant massage on the following outcomes: pain relief, jaundice, and weight gain. The inclusion criteria were infants from 0-12 months. The literature search was performed until January 2022, using the CINAHL, PubMed, and PsycINFO databases, and included studies published from 2017-2021, returning 16 RCT/CCT studies with a total of 1416 participating infants. A review template was used by two independent reviewers to assess the risk of bias in the included studies. The results were synthesized and presented in the form of tables and narratives. In five of seven studies (n = 422 resp. n = 717) investigating pain relief, infant massage was found to alleviate pain. In all six studies (n = 455) investigating effects on infant massage and jaundice, beneficial effects were found on bilirubin levels. In all four studies (n = 244) investigating weight gain, increased weight gain was found among participants who received infant massage. The present literature review provides an indication of the current state of knowledge about infant massage and identifies its positive effects; however, the results must be interpreted with caution. Infant massage may be effective at relieving pain, improving jaundice, and increasing weight gain. Although statistically significant differences were not found between all experimental and control groups, no adverse effects of infant massage were observed. By placing the aforementioned effects in the context of child health care, infant massage may prove beneficial on these outcomes. Given the dearth of research on infant massage in the context of child health care, further research is warranted.

Early Postpartum Maternal and Newborn Responses to Auditory, Tactile, Visual, Vestibular, and Olfactory Stimuli

OBJECTIVE

To compare maternal psychological well-being, newborn behavior, and maternal and newborn salivary oxytocin (OT) and cortisol before and after two maternally administered multisensory behavioral interventions or an attention control group.

DESIGN

Randomized prospective clinical trial.

SETTING

U.S. Midwest community hospital.

PARTICIPANTS

Newborns and their mothers (n = 102 dyads) participated. Mothers gave birth vaginally at term gestation and had no physical or mental health diagnoses. Newborns with low Apgar scores, receipt of oxygen, suspected infection, or congenital anomalies were excluded.

METHODS

Dyads were randomly assigned to the auditory, tactile, visual, and vestibular (ATVV) intervention, the ATVV with odor from a baby lotion (ATVVO), or the attention control (AC) Group. Maternal psychological well-being, newborn behavior, and endocrine responses (salivary cortisol and OT) were measured before and after the intervention.

RESULTS

Newborns in the ATVV and ATVVO groups exhibited increases in potent engagement behaviors (p < .0001 and p = .001, respectively). Newborns in the AC group exhibited a decrease in potent engagement (p = .013) and an increase in potent disengagement (p = .029). Mothers in the ATVVO group exhibited an increase in OT (p = .01) and the largest change in OT (p = .02) compared to mothers in the ATVV and AC groups. We noted no change in maternal psychological well-being or newborn endocrine responses.

CONCLUSION

Inclusion of an odor via lotion with a behavioral intervention (ATVV) influenced maternal OT more than the behavioral intervention alone. Newborns were behaviorally responsive to the interventions; however, endocrine measures were not associated with intervention changes.

Mother’s Ability to Massage her Baby with Technical Guidance from Medical Personnel: A Systematic Review

BACKGROUND: Baby spa is useful for baby’s growth and development. The previous research has shown that when the baby is massaged by the mother, a bond is formed between the mother and the baby compared to other people who do the massage. However, in its implementation, baby spas are often carried out by health workers. AIM: The purpose of this research is to determine the mother’s ability to do baby massage with the guidance of medical personnel. METHODS: This method of writing systematic reviews refers to the Preferred Reporting Items for Systematic Reviews guidelines. Articles were searched in several databases ; ScienceDirect, EBSCO, PubMed, Scinapse, Google Scholar from 2011-2021. The search strategy uses the keywords Infant OR Infant Preterm OR Very Low Birth Weight infants AND Massage OR Oil Massage AND Attachment AND Growth. RESULTS: The results show the chances of success of mothers doing baby massage with the help of medical personnel, the baby massage learning media used were baby phantoms, brochures, pamphlets, and baby massage videos, and the frequency of massage for 10–15 min each time the massage. The results obtained after the mother did the baby massage were the increase in body weight, body length, arm circumference of the baby, better bonding between mother and baby, improvement in mother’s mood, and increase in mother’s positive attitude in caring for the baby. CONCLUSION: This study proves that the role of medical personnel in training baby massage to mothers is proven to be effective in increasing the ability of mothers to do baby massage.

The effectiveness of baby massage in increasing infant's body weight

Background

The low birth weight (LBW) problem is found in various developing countries with an increasing trend of cases every year. This is caused by nutritional status and a history of maternal health. The impact of LBW in children is they are more likely to experience delayed growth and development. This study aims to identify the effect of baby massage on infants’ body weight.

Design and Methods

The research design used was quasiexperimental pre and post-test type with control group. There were 16 infants for each group selected by purposive sampling. Baby massage was given to the infants twice a week within four weeks, 10 to 15 mins per session. Data analysis was used paired ttest and independent t-test.

Results

The mean age of infants was 3.69 months for both group, the mean age at birth was 37.8 weeks (intervention) and 38 weeks (control), the mean birth weight of infants was 2,295 grams (intervention) and 2,288 grams (control). Most of the infants was male for both group. There was an effect of baby massage on the increase in infants’ weight gain with a history of low birth weight significantly with a p-value <0.05.

Conclusions

Baby massage can increase infants’ weight with a history of low birth weight aged 1-6 months. The role of health workers is to provide education and practice baby massage for mothers in order to stimulate the growth and development of infants. This intervention can be integrated with maternal and child health programs in primary health care facilities.

Massage therapy in infants and children under 5 years of age: protocol for an overview of systematic reviews

INTRODUCTION

Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years.

METHODS

The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure and Wanfang Data will be searched from the inception onwards for evidence of the treatment effects. We will include systematic reviews of randomised control trials evaluating the effects and safety of massage therapy in infants and children aged < 5 years. The primary outcomes will be any physical or psychological outcome, and adverse effects on children. Secondary outcomes will include any physical or psychological outcome on caregivers. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. A table will be used to summarise of information of the included studies, which includes the basic information, method and findings. The methodological quality of the included systematic reviews will be assessed by A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR 2). Extracted data from the included studies will be collected and presented using narrative approach. The pooled effect estimates for meta-analysed outcomes will be extracted when possible. If there is a discrepancy in results of two or more reviews on the same topic, then the causes of such discrepancy will be further explored.

DISCUSSION

This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention. Findings from this overview will be published in a peer-reviewed journal.

SYSTEMATIC REVIEW REGISTRATION

CRD42020186003 .

Does maternal attachment to her infant mediate the link between perceptions of infant crying at 6 months and parenting stress at 24 months? A structural equation modelling approach

BACKGROUND

Parenting stress is influenced by many factors including maternal attachment and excessive infant crying, yet the nature of these relationships is not well understood. For example, excessive infant crying despite maternal soothing may impact maternal attachment to the child, leading to higher stress. This paper explored whether maternal perception of excessive infant crying at 6 months was associated with higher maternal parenting stress at 24 months, and whether maternal attachment mediated this relationship.

METHODS

All families, present at 24 months in a randomized controlled trial of a 5-year early intervention programme targeting school readiness skills in disadvantaged area of Ireland, were included. At 6 months, infant crying was assessed using a maternal reported measure of duration of infant crying, and maternal attachment to the infant was assessed using the Condon Maternal Attachment Scale. Parenting stress was assessed at 24 months using the childrearing stress subscale from the Parenting Stress Index. Structural equation modelling was used to explore the direct and indirect effects of maternal perceptions of excessive infant crying on parenting stress, controlling for infant, maternal, and environmental characteristics, and focusing on the mediating role of maternal attachment.

RESULTS

Reporting excessive infant crying at 6 months was associated with lower maternal attachment at 6 months, which led to higher parenting stress at 24 months. In addition, vulnerable adult attachment style, previous maternal mental health difficulties, low paternal education, paternal involvement with the child, and not being married were associated with higher parenting stress.

CONCLUSION

Findings suggest that the association between maternal perceptions of excessive crying at 6 months and later parenting stress may be mediated through maternal attachment to the infant. Interventions based on improving maternal attachment could be investigated to determine the effectiveness of supporting mothers with low attachment.

Effect of attachment-based interventions on prenatal attachment: a protocol for systematic review

BACKGROUND

Parental attachment was defined as: series of inner behaviors that would cause the infant to develop an intimate relation with his/her parents. This emotional relationship is formed long before birth during the pregnancy and has been associated with psychosocial outcomes for women and children. This relationship is known as one of the major components of the child's social and emotional development. Parents' relationship with their fetus could be strengthened using various strategies, but efforts to augment the maternal-fetal relationship have not always been successful. This study aims to conduct a comprehensive systematic review and a meta-analysis survey of the effects of attachment-based interventions on prenatal attachment.

METHODS

A comprehensive search of relevant randomized and quasi-randomized controlled trials will be performed in EMBASE (via Scopus), ProQuest, Pubmed, Scopus, Ovid and Web of Science, The Cochrane Central Register of Controlled Trials, SID, MagIran, Irandoc, Barakat Knowledge Network System and Iranian registry of clinical trials website as Iranian databases using English and Persian keywords such as prenatal attachment, relationship, maternal attachment. Only randomized controlled clinical trials conducted between 2000 and 2016 will be included in this review. The study will be selected if their participants were expectant mothers, their partners or both. Our primary outcome will be the effect size of intervention. The quality of experimental studies will be evaluated using CONSORT checklist and Study Quality Guide by Cochrane Consumers and Communication Review Group. Two authors will independently assess the eligibility of the studies. Any disagreements will be resolved through a third reviewer. The risk of bias will be independently determined using the Cochrane Risk of Bias Tool. The quality of the papers will be assessed based on the CONSORT checklist. If possible quantitative data will be pooled in statistical meta-analyzing with random effect model.

DISCUSSION

In this review the current state of knowledge on prenatal attachment is examined. Effectiveness of attachment-based interventions during pregnancy is analyzed. Finally, practice and research implications based on analysis of the current status of maternal-fetal attachment are identified. The expected findings will help healthcare providers to develop pregnant women and infants' health when offering prenatal care.

Maternal-fetal emotional relationship during pregnancy, its related factors and outcomes in Iranian pregnant women: a panel study protocol

BACKGROUND

Considering the importance of attachment in child's development and mother's health, various related factors and also lack of necessary information in this regard in our country, the research team decides to conduct this study to evaluate maternal-fetal attachment during pregnancy, its changes and post-partum consequences on mother-infant relationship. This process should be studied during pregnancy and also after delivery so that the effect of related factors and the changes in attachment over time could be determined and comprehensible information about the effective underlying conditions on this issue would be gathered.

METHODS

The present research is a longitudinal study (panel study). Data gathering would start at the first trimester, continue during second and third trimesters of pregnancy, first visit after delivery, second, fourth and end sixth months later. Pregnant women in the first trimester would be selected and contacted. If they have inclusion criteria, they would be selected as a participant. At first, their demographic-reproductive characteristics, Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (SSTAI), The Social Support Appraisal (SSA), Adult Attachment Scale (AAS) and Parental Bonding Instrument (PBI) would be completed; during the second trimester, BDI, SSTAI and Cranley's Maternal-Fetal Attachment Scale (CMFAS) would be completed. In the third trimester, the same questionnaires would be completed. During the first month after birth, Avant's questionnaire of Mother-Infant Attachment Behaviors would be completed. At the second, fourth and sixth months after delivery Muller's Mother -Infant Attachment Scale would also be completed.

DISCUSSION

The results of the study will be provided to maternal child health policy-makers in the health system. This information could not be obtained through cross-sectional studies and through one episode of data collection and more studies are needed to provide us a perspective of the mother-infant relation over time. Studying attachment during pregnancy would provide us a chance to learn more about this process.

Systematic Review of Skin-to-Skin Care for Full-Term, Healthy Newborns

OBJECTIVE

To determine the effect of skin-to-skin mother-infant holding, touch, and/or massage on full-term, healthy newborns and their primary caregivers.

DATA SOURCES

A seven-member scientific advisory panel searched the databases PubMed, CINAHL, and Scopus using the search terms massage, skin-to-skin contact, kangaroo care, touch, therapeutic touch, and full-term newborns for research with human participants published in English with no date parameters.

STUDY SELECTION

The initial search yielded 416 articles. After reviewing titles and retaining only articles that met the review criteria, 280 articles remained. The panel co-chairs reviewed and discussed the abstracts of these articles and retained 90 for review.

DATA EXTRACTION

Each article was assigned to one panel member and one co-chair for review. Members of the panel met via teleconference to present articles and to determine whether they had scientific merit and addressed the research question. Articles that did not meet these standards were eliminated. Forty articles included relevant evidence: 33 articles on skin-to-skin holding and 7 on infant massage.

DATA SYNTHESIS

We created a table that included the purpose, design, and findings of each study. This information was synthesized into a feasibility report by the co-chairs.

CONCLUSION

Evidence supports recommendations for skin-to-skin care for all full-term, healthy newborns. Although there is inadequate evidence to recommend massage as standard care for all newborns, massage has been shown to help consolidate sleep patterns and reduce jaundice.

Effect of Kangaroo Care Combined with Music on the Mother-premature Neonate Attachment: A Randomized Controlled Trial

BACKGROUND

Premature birth may complicate the development and quality of the mother-infant attachment relationship. Music and kangaroo care are two common complementary cares performed in the neonatal intensive care unit (NICU). The present study investigated the effect of kangaroo care combined with music on the mother-premature neonate attachment.

MATERIALS AND METHODS

In this clinical trial, 64 mothers with premature neonates were selected and assigned to the control and study groups through random allocation. In the control group, kangaroo care, and in the study group, kangaroo care combined with music was adopted. The level of mother-premature neonate attachment was measured and compared before and after the intervention in both the groups using Avant's Maternal Attachment Assessment Scale.

RESULTS

There was a significant increase in the mean overall score of attachment in the kangaroo care combined with music group (70.72 (11.46)) after the intervention compared to the kangaroo care without music group (53.61 (9.76)).

CONCLUSIONS

The mean overall score of mother-neonate attachment in the kangaroo care combined with music group was higher than the kangaroo care group. This difference can be related to the effectiveness of music combined with kangaroo care.

Effects of infant massage on state anxiety in mothers of preterm infants prior to hospital discharge

AIMS AND OBJECTIVES

This study evaluated the effect of infant massage on anxiety in mothers of preterm infants who discharged from the neonatal intensive care unit.

BACKGROUND

Birth of preterm infants commonly leads to great levels of distress and anxiety in mothers. Although various methods have been suggested to help mothers cope with such stressful conditions, the effects of infant massage have not been adequately studied in mothers.

DESIGN

This was a quasi-experimental clinical trial.

METHODS

Overall, in 70 mothers and their preterm infants who scheduled to be discharged within 24 hours, State-Trait Anxiety Inventory scale (Spielberger) was completed for mothers in both groups in the morning of the day before discharge. The experimental group received eight minutes of massage including two standard similar parts (each part four minutes). The massage was repeated in two parts on the day of discharge, and then, state anxiety was re-measured using Spielberg's scale for all mothers. The control group received no intervention.

RESULTS

The results showed that on the day of discharge, there was a significant difference in the overall mean score of maternal state anxiety between the two groups (p < 0·002), although not in the severity of maternal state anxiety. In both groups, the mean score of maternal state anxiety was significantly decreased on the day of discharge (p < 0·001).

CONCLUSIONS

The findings provide evidence that infant massage by mother has an effect on the state anxiety of mothers of preterm infants, so it is recommended that mothers apply massage for preterm infants to improve their mental health.

RELEVANCE TO CLINICAL PRACTICE

Mothers of preterm infants can promote mental health by continuing massage of their infants at home.

Massage therapy research review

In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e.g. Swedish versus Thai massage), and different active therapies such as massage versus exercise. Typically, the massage therapy groups have experienced more positive effects than the control or comparison groups. This may relate to the massage therapy providing more stimulation of pressure receptors, in turn enhancing vagal activity and reducing cortisol levels. Some of the researchers have assessed physical, physiological and biochemical effects, although most have relied exclusively on self-report measures. Despite these methodological problems and the dearth of research from the U.S., the massage therapy profession has grown significantly and massage therapy is increasingly practiced in traditional medical settings, highlighting the need for more rigorous research.

Affectionate Touch to Promote Relational, Psychological, and Physical Well-Being in Adulthood: A Theoretical Model and Review of the Research

Throughout the life span, individuals engage in affectionate touch with close others. Touch receipt promotes well-being in infancy, but the impacts of touch in adult close relationships have been largely unexplored. In this article, we propose that affectionate touch receipt promotes relational, psychological, and physical well-being in adulthood, and we present a theoretical mechanistic model to explain why affectionate touch may promote these outcomes. The model includes pathways through which touch could affect well-being by reducing stress and by promoting well-being independent of stress. Specifically, two immediate outcomes of affectionate touch receipt—relational-cognitive changes and neurobiological changes—are described as important mechanisms underlying the effects of affectionate touch on well-being. We also review and evaluate the existing research linking affectionate touch to well-being in adulthood and propose an agenda to advance research in this area. This theoretical perspective provides a foundation for future work on touch in adult close relationships.

Blended Infant Massage-Parenting Enhancement Program on Recovering Substance-Abusing Mothers' Parenting Stress, Self-Esteem, Depression, Maternal Attachment, and Mother-Infant Interaction

PURPOSE

This study aimed to determine whether a blended Infant Massage-Parenting Enhancement Program (IMPEP) improved maternal psychosocial health outcomes (parenting stress, depressive symptoms, self-esteem, maternal attachment) and maternal-infant interaction among substance-addicted mothers (SAMs) actively engaged in outpatient rehabilitation.

METHODS

Designed as a randomized, three-group controlled trial testing two levels of psychoeducational intervention (IMPEP vs. PEP) and a control group (standard care parenting resources), the study was conducted in two substance abuse centers in southeast Florida on a convenience sample of 138 recovering SAM-infant pairs. IMPEP or PEP classes were held weekly on Weeks 2-5, with data collected at baseline (Week 1), Week 6, and Week 12 via structured interviews, observation (Observation Checklist on Maternal-Infant Interaction), and self-administered questionnaires (Abidin Parenting Stress Index, Beck Depression Inventory, Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory), analyzed descriptively and inferentially using Kruskall-Wallis analysis of variance and post hoc Wilcoxon rank sum and Mann-Whitney U tests.

RESULTS

Both IMPEP and PEP groups had significantly increased Parenting Stress Index scores (decreased parenting stress) and decreased Beck Depression Inventory scores (decreased depressive symptoms) compared to controls at Week 12, whereas there were no clinically meaningful differences among study groups in Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory, or Observation Checklist on Maternal-Infant Interaction scores. Only the IMPEP group showed significant improvements in both psychological and physical (waist-hip ratio) measures of parenting stress over time.

CONCLUSIONS

The findings suggest that infant massage blended into a structured parenting program has value-added effects in decreasing parenting stress and maternal depressive symptoms, but not on SAM's self-esteem, attachment, or maternal-infant interaction.

The Early Mother-to-Child Bond and Its Unique Prospective Contribution to Child Behavior Evaluated by Mothers and Teachers

Maternal bonding has been described as the quality of the affective tie from a mother to her infant. This early bond's mental components and its longitudinal impact on child outcome have been markedly understudied. Although most researchers assume impaired maternal bonding to have a negative impact on child development, there is a lack of prospective studies evaluating this hypothesis. Since maternal mental health problems may negatively affect both bonding quality and child development, it is still to be determined whether there is a unique contribution of bonding quality to child behavior problems over and above maternal psychopathology. We examined a community sample of 101 mother-child dyads at the child's age of 2 weeks (t1) and 6 weeks (t2), 4 months (t3), 14 months (t4), and 5.5 years (t5). Maternal bonding and psychopathology were assessed at time points t1-t4 using the Postpartum Bonding Questionnaire (PBQ-16) and the Symptom Checklist Revised (SCL 90-R). Child behavior problems were rated in a multi-informant design by mothers and teachers at t5 using the Strengths and Difficulties Questionnaire (SDQ). In the case of maternal judgment of child behavior problems, bonding at 14 months (t4) proved to be a significant predictor (β = 0.30; p = 0.011). Teacher-rated child behavior problems were significantly predicted by maternal bonding at 2 weeks (t1; β = 0.48; p = 0.025). Our results indicate a prospective influence of the early mother-infant bond on child development and underline the unique contribution of bonding quality to child behavior problems over and above the impact of maternal psychopathology in a community sample.

Emotional Rejection of the Infant: Status of the Concept

Emotional rejection of the infant is a morbid, clinical phenomenon, central to mother-infant psychiatry. It occurs in about 1% of births in the general population, but much more often in mothers referred to specialist services. It has severe consequences for children, but responds well to treatment. It is now better recognized, but research is required, especially cohort studies and neuroscientific investigations.