Effects of massage on newborn infants with jaundice: A meta-analysis

The Effect of Abdominal Massage on Bilirubin Levels in Term Infants Receiving Phototherapy: A Randomized Controlled Trial

BACKGROUND

The incidence of neonatal hyperbilirubinemia in Europe and the United States is estimated to be 3.2 and 4.4 per 10,000 live births, respectively. Abdominal massage for hyperbilirubinemia is considered a safe complementary treatment for infants that may increase number of defecations and decrease bilirubin levels.

PURPOSE

This study was designed as a randomized controlled trial to determine the effect of abdominal massage on bilirubin levels in term infants receiving phototherapy.

METHODS

The sample consisted of 43 term newborns (intervention group: 23; control group: 20) who received phototherapy in a university hospital between June 2019 and February 2021. Information and observation forms were used for data collection. The intervention group received 6 abdominal massages over 2 days, performed 3 times a day, 6 hours apart, and lasting 5 minutes each.

RESULTS

Transcutaneous bilirubin levels and heart rate were significantly lower in the intervention group than in the control group at 48 hours (P = .015 and P = .033, respectively). Number of defecations was higher in the intervention group at 24 hours (P = .007) but there was no significant difference at 48 hours. The decrease in serum bilirubin between 24 and 48 hours was significantly greater in the intervention group (P = .005).

IMPLICATION FOR PRACTICE AND RESEARCH

Abdominal massage was effective in reducing bilirubin levels and may increase the number of defecations. Providing massage training to the parents of infants who are discharged early could be a protective approach to prevent the rise in bilirubin levels.

The effect of massage on the bilirubin level in term infants receiving phototherapy

BACKGROUND

Massage has positive physiological effects on infants. Infant massage increases the excretion of waste products such as bilirubin from the body by accelerating the flow of the blood, lymph, and tissue fluids.

PURPOSE

The aim of the study is to investigate the effect of infant massage on hyperbilirubinemia in newborns receiving phototherapy.

METHODS

The study population consisted of infants admitted to the neonatal intensive care unit of a public hospital in Istanbul between October 2021 and January 2022 with a need for phototherapy. Sixty-one newborns who met the study criteria were randomized and divided into two as the experimental (n=30) and control (n=31) groups. All infants were followed up for 3 days, and phototherapy was applied twice a day. In addition to phototherapy, infant massage was applied to the experimental group for 10 min just before the phototherapy. The bilirubin level was measured 2 h after the end of phototherapy for both groups. Moreover, diapers were changed 8 times a day, every 3 h, in both groups.

RESULTS

The groups were homogeneous in terms of descriptive data, and no significant difference was observed between the groups (p>0.05). When bilirubin levels were compared, there was a significant decrease in bilirubin levels in the experimental group starting from the third day (p =.000). The frequency of defecation on the second and third days increased significantly in the experimental group (p =.000).

CONCLUSION

Infant massage can increase the frequency of defecation and help decrease bilirubin levels in newborns diagnosed with hyperbilirubinemia.

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.

Effect of Massage Therapy for the Treatment of Neonatal Jaundice: A Systematic Review and Dose-Response Meta-analysis

Background

The effectiveness of massage therapy in the treatment of neonatal jaundice has been established in previous literature, but how much the level of massage can reduce the mean of bilirubin in neonates with jaundice is a question that has been addressed in this review.

Methods

Four electronic databases, including Cochrane, PubMed, Scopus, and Web of Science, were searched for relevant literature. For the dose-response association between massage therapy and treatment of neonatal icterus, we conducted a meta-analysis using the random-effects model. For any level of intervention, we calculated the overall mean difference (MD) with 95% confidence intervals (CI).

Results

Twenty studies were included in our meta-analysis. There was a positive and significant increasing dose-response trend between massage therapy and the mean reduction of bilirubin in neonates with hyperbilirubinemia as follows: <50 minutes massage during the experiment -0.36 (95% CI: -0.67, -0.06; I² = 66%), 50-60 minutes massage during the experiment -0.41 (95% CI: -0.95, 0.13; I² = 84%), and ≥101 minutes massage during the experiment -1.20 (95% CI: -1.63, -0.78; I² = 83%). The heterogeneity across studies was mild to moderate.

Conclusions

The presence of a dose-response relationship favors the causal relationship between massage therapy and reduction of neonatal jaundice.

Novel Innovations and Recent Findings in Lactation Support

Rationale

Staying current with the burgeoning amount of breastfeeding research can be a daunting task. It is incumbent upon the IBCLC and other lactation care providers to be cognizant of new research and innovations in lactation support.

Method

Recent products and findings regarding neonatal jaundice, hypoglycemia, mastitis, and therapeutic taping are presented.

Findings

New research findings, techniques, and products have been gathered to augment the provider's knowledge and skill set regarding a broad range of items relevant to clinical lactation practice. Most are affordable options for practitioners and parents, and represent safe and effective options for screening and treatment.