Mothers’ experiences learning and performing infant massage—A qualitative study

Mothers' experience of infant massage in child health care: A qualitative interview study

AIM

To investigate mothers' experience of infant massage.

DESIGN

This was an exploratory-descriptive qualitative study based on individual interviews.

METHODS

A qualitative interview study with an inductive approach was used according to the COREQ guidelines. The participants in the study were mothers (n = 11) residing in Sweden who received training in infant massage from the child health care nurse in the child health care services. The transcribed interviews were analysed using a qualitative content analysis.

RESULTS

The collected material resulted in two categories and eight subcategories. The categories were learning infant massage and using infant massage as a tool. The eight subcategories were massaging in a parent group, massaging at home, massage movements and the child health care nurse's supporting hand, reading the child's signals, creating time and relaxation together, interaction and connection between the child and the parent, relief from stomach problems and anxiety and continuing to massage the older child. The study showed that mothers experienced that the relationship created through infant massage brought more joy, tenderness and security to the child. The child health care nurse had an important role in supporting the mothers, especially when it came to different views on doing infant massage at home and in groups.

PATIENT OR PUBLIC CONTRIBUTION

Mothers with experience of infant massage were interviewed.

The effects of massage therapy and white noise application on premature infants' sleep

AIM

Sleep is vital to premature infants' physical, social and emotional development. The significance of sleep duration, efficiency, and function in premature infants regarding growth development, behavior and neurological development has been increasing.

MATERIALS AND METHODS

This study was conducted in a randomized controlled experimental design with three groups. Premature infants at 28-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of Şanlıurfa Mehmet Akif İnan Training and Research Hospital Haliliye Annex Building were the research population. The sample of the present study consisted of 120 premature infants in the massage therapy group (40), white noise group (40), and control group (40).

RESULTS

The sleep duration and sleep efficiency of the premature infants in the massage group increased compared to before the application, whereas the number of awakenings and WASO values decreased. The sleep duration of premature infants in the massaged group increased by some five hours. In the white noise group, the sleep duration increased by about two hours than the pre-treatment, and there was an increase in sleep efficiency. White noise application provided a significant decrease in the number of awakenings and WASO values in premature infants.

CONCLUSION

In this experimental study, which was designed with three groups, it was revealed that massage and white noise application in premature infants were significant non-pharmacological methods to increase sleep duration and sleep efficiency. It was concluded that massage therapy and white noise application is one of the considerable interventions regarding sleep duration, efficiency and functions in premature infants who left the intrauterine period early.

The effectiveness of mother-led infant massage on symptoms of maternal postnatal depression: A systematic review

INTRODUCTION

Postnatal depression is a significant public health issue which may escalate and lead to adverse outcomes for women, infants, their family and the wider society. The aim of this review was to examine the effectiveness and experiences of mother-led infant massage on symptoms of maternal postnatal depression and to synthesise these findings to inform policy, practice and further research.

METHODS

A systematic search of five academic databases was conducted: CINAHL, MEDLINE, EMBASE, PsycINFO and Allied and Complementary Medicine Database in February 2023 with no date or geographic limiters set owing to the paucity of research on this subject area. Quality appraisal was undertaken using the Joanna Briggs Institute quality appraisal tools and all included RCT's were assessed separately using the Cochrane Risk of Bias Tool. Narrative synthesis was used to analyse the data.

FINDINGS

A total of (n = 323) studies were returned of which (n = 8) met the inclusion criteria for the review. This review identified a total sampling of (n = 521) women with maternal postnatal depression. The results are presented under three themes: 1) the effectiveness of mother-led infant massage on symptoms of postnatal depression; 2) women's experiences of mother-led infant massage; and 3) the effects of mother-led infant massage on the mother-infant relationship.

DISCUSSION

The review highlights women who used infant massage displayed a reduction in symptoms of postnatal depression, improved mother-infant interactions and improved self-efficacy in addition to benefits for infants. Public Health Nurse/Community Midwife-led infant massage may help to relieve such symptoms and empower women.

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.

Effects of massage intervention on discharged premature infants' weight, parental stress, and parent-child attachment: A randomized controlled trial

Infant massage enhances the growth and development of premature infants and promotes parent-child bonding. However, its effects on parental stress and parent-child attachment in premature infants, as well as gender differences thereof, remain unclear. In this randomized controlled trial, we used a repeated-measures design and included 61 premature infants (mean gestational age: 35.1 ± 1.5 weeks). Weight, parental stress, and parent-child attachment were measured at multiple time points: before massage and 1, 4, 8, and 12 weeks after commencing infant massage. The results revealed that the massage group infants had significantly higher weight gain than the control (no massage) group infants at all four time points. Moreover, parents in the massage group reported notably lower levels of stress than those in the control group, particularly in the parental distress and difficult children subscales. No significant between-group differences were observed in parent-child attachment. Furthermore, no significant differences were observed between fathers and mothers in parental stress and parent-child attachment. However, fathers reported higher levels of distress than mothers at 4 and 12 weeks. In conclusion, infant massage led to increased infant weight and reduced parental stress over time, and differences between fathers and mothers were not significant, except fathers exhibiting higher levels of distress than mothers over time. Healthcare professionals should educate and support parents on infant massage before discharge of premature infants.

The effects and process of the intervention "Individual Shantala Infant Massage" in preventive child healthcare to improve parent-child interaction: study protocol for a quasi-experimental study

BACKGROUND

Individual Shantala Infant Massage is an intervention that is offered by several Dutch Preventive Child Healthcare (PCH) organizations as optional preventive support, in addition to basic care as offered to all children. It targets vulnerable families and aims to enhance sensitive parenting and to reduce (effects of) parental stress. The intervention is carried out by a certified nurse. It consists of three structured home visits. Parents learn to massage their infant and receive parenting support. This study aims to investigate the effectiveness and the process of the intervention. The main hypothesis is that Individual Shantala Infant Massage leads to increased parental sensitive responsiveness, lower perceived and physiological parental stress, and improved child growth and development in the intervention group, compared to a control group where this intervention is not offered by PCH. Secondary research questions address effects on parenting confidence and parental concerns regarding the infant, the influence of background characteristics and the intervention process.

METHODS

The study is a quasi-experimental non-randomized trial. The aim is to include 150 infant-parent dyads in both the intervention and the control group. This takes into account possible attrition and missing data as 105 dyads with complete data per group are sufficient for analysis. All participants complete questionnaires at T0 (pre-test, child age between six-sixteen weeks), T1 (post-intervention, or ± four weeks after T0), and T2 (follow-up at five months). At T2, a hair tuft is cut from the parents' head to measure hair cortisol levels. Data on infant growth and development is obtained from PCH files. In the intervention group, additional data is collected to evaluate the intervention process: parents complete an evaluation questionnaire at T1, nurses keep semi-structured logbooks of intervention sessions and interviews are conducted with parents and professionals.

DISCUSSION

Study results can contribute to the evidence base of infant massage as applied in Dutch PCH, and can inform parents, PCH practitioners, policy makers and researchers both inside and outside the Netherlands on feasibility and effectiveness of the infant massage intervention as applied in this format and setting.

TRIAL REGISTRATION

ISRCTN registry: ISRCTN16929184. Date (retrospectively) registered: 29/03/2022.

Lessons learned from child health care nurses' experiences of teaching infant massage groups: A qualitative interview-based study

AIM

To describe child health care nurses' experiences of teaching infant massage in parent groups.

DESIGN

This was an exploratory-descriptive qualitative study based on individual interviews.

METHOD

Qualitative semi-structured interviews were conducted with child health care nurses (N = 9) according to the COREQ guidelines and analyzed with qualitative content analysis.

RESULTS

Five categories were identified: (1) Infant massage can promote attachment between parents/guardians and their children; (2) Infant massage can have a calming impact; (3) Stress and lack of time can be challenging; (4) The composition of parent groups can be important and (5) The child health care nurse can observe parents'/guardians' relationships with their children. Child health care nurses are uniquely familiar with infant massage and the benefits it provides both parents/guardians and their infants. Specifically, infant massage has a calming effect that reduces stress and strengthens the relationship between infants and their parents/guardians.

PATIENT OR PUBLIC CONTRIBUTION

Child health care nurses were interviewed.

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.

A qualitative study on mothers' experiences attending an online infant massage class: "It is funny! I feel close to my baby!"

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic impacts maternal and perinatal health. Fear of COVID-19 transmission may lead to psychological disorders among mothers, such as anxiety and depression, which might affect the infant's health. Innovation is needed to address problems related to this condition. This study aimed to explore the experiences of mothers who had attended online infant massage classes.  METHODS: This qualitative survey recruited 12 Indonesian mothers who had infants aged < 12 months and joined the online infant massage class. An open-ended question form was used to collect data, which were analyzed using thematic content analysis.

RESULTS

There were six themes related to the experiences of mothers attending online infant massage classes: favorite session, new knowledge and skills, benefits, barriers during infant massage class, factors related to infant massage practice, and mother's hope.

CONCLUSIONS

Mothers had a good experience learning infant massage and had better interaction with their infants after the class. The findings show that an online infant massage class could benefit both mothers and infants.

Aromatherapy massage seems effective in critically ill children: an observational before‐after study

Children treated in a pediatric intensive care unit (PICU) are at risk of distress and pain. This study investigated if aromatherapy massage can reduce children's distress and improve comfort. This observational before‐after study was performed in a 22‐bed PICU in Cape Town, South Africa. The aromatherapy massage consisted of soft massaging using the “M‐technique” and a 1% blend of essential oils of Lavender (Lavandula angustifolia), German Chamomile (Matricatia recutita) and Neroli (Citrus aurantium) mixed with a grapeseed carrier oil. All present children were eligible, except those who had recently returned, were asleep or deemed unstable. The primary outcome was distress measured with the COMFORT‐Behavior scale (COMFORT‐B). Secondary outcomes were heart rate, oxygen saturation (SatO₂), the Numeric Rating Scale (NRS)‐Anxiety and pain assessed by the NRS‐Pain scale. Outcomes variables were evaluated with Wilcoxon signed‐rank test and multiple regression analysis. The intervention was applied to 111 children, fifty‐one of whom (45.9%) were younger than three years old. The group median COMFORT‐B score before intervention was 15 (IQR 12–19), versus 10 (IQR 6–14) after intervention. Heart rate and NRS‐Anxiety were significantly lower after the intervention (P < 0.001). Multiple regression analysis showed that interrupted massages were less effective than the uninterrupted massages. Parental presence did not influence the outcome variables. We did not find a significant change on the NRS‐Pain scale or for SatO₂. Aromatherapy massage appears beneficial in reducing distress, as measured by the COMFORT‐B scale, heart rate and the NRS‐Anxiety scale, in critically ill children. Thus, the potential of aromatherapy in clinical practice deserves further consideration.

The relationship between maternal function and maternal attachment of women during the postpartum period

OBJECTIVE

The objective of this study was to investigate the relationship between maternal functions including self-care and adjustment and maternal attachment during the postpartum period.

BACKGROUND

Mothers adapt to their new role during the postpartum period by recognising both their baby and their physical, emotional, and social recovery. During this period, a mother's interaction with her baby supports attachment.

METHOD

The study design was planned as a descriptive-relational type. The study was performed in two Family Healthcare Centres located in Antalya city, Turkey country. The population of the study consisted of 250 mothers aged 18-45 years who had a postpartum period between 8 and 11 weeks. A simple sampling method was used. Data were collected using the mothers' identification forms, the Barkin Index of Maternal Function, and the Maternal Attachment Inventory. The forms were administered to mothers via the face-to-face interview method. Numerical, percental, and relational statistical methods as well as arithmetic means were used in the data analysis.

RESULTS

The mean score of the Barkin Index of the Maternal Function was 76.97 ± 10.19 and the mean score of the Maternal Attachment Inventory was 100.92 ± 3.17. There was a positive, low, and significant relationship between maternal function and maternal attachment (r = 0.22, p = 0.00). There was a positive, low, and significant relationship between maternal attachment and self-care, maternal psychology, infant care, social support, and maternal adjustment scores.

CONCLUSION

The maternal attachment level was found to be high in women with high maternal function. To develop the relationship between functional status and maternal attachment, mothers may provided with social support and, if necessary, psychological support.

Feasibility of Early Intervention Through Home-Based and Parent-Delivered Infant Massage in Infants at High Risk for Cerebral Palsy

Infant massage (IM) can be considered an early intervention program that leads to the environmental enrichment framework. The effectiveness of IM to promote neurodevelopment in preterm infants has been proved, but studies on infants with early brain damage are still lacking. The main aim of this study was to assess the feasibility, acceptability and usability of IM, carried out by parents at home, on infants at high risk for Cerebral Palsy. An IM daily diary and an ad hoc questionnaire, called Infant Massage Questionnaire Parent-Infant Experiences (IMQPE), were developed. IMQPE consisted of a total of 30 questions, divided into 5 areas. The parents were trained to carry out the IM with a home-based course, conducted by an expert therapist. The intensive IM program was set according to a defined daily length of at least 20 min, with a frequency of at least 5 days per week for a total of 8 weeks. Data collection consisted in the selection of the variables around the characteristics, both of the infants and the mothers, IM dosage and frequency, different body parts of the infants involved and IMQPE scores. Variable selection was carried out by minimizing the Bayesian Information Criteria (BIC) over all possible variable subsets. Nineteen high-risk infants, aged 4.83 ± 1.22 months, received IM at home for 8 weeks. The massage was given by the infants' mothers with a mean daily session dose of 27.79 ± 7.88 min and a total of 21.04 ± 8.49 h. 89.74% and 100% of mothers performed the IM for the minimum daily dosage and the frequency recommended, respectively. All the families filled in the IMQPE, with a Total mean score of 79.59% and of 82.22% in General Information on IM, 76.30% in Infant's intervention-related changes, 76.85% in IM Suitability, 79.07% in Infant's acceptance and 83.52% in Time required for the training. Different best predictors in mothers and in infants have been found. These data provide evidence of the feasibility of performing IM at home on infants at high risk for CP. Study registration: www.clinicaltrial.com (NCT03211533 and NCT03234959).