OBJECTIVE: To investigate mothers\' experience of infant massage.
METHODS: 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.
UNASSIGNED: Mothers with experience of infant massage were interviewed.

Mothers of infants born extremely preterm requiring prolonged medical intervention in the Neonatal Intensive Care Unit (NICU) are at high risk of developing stress. Parent-administered infant massage is a well-established, safe intervention for preterm infants with many developmental benefits, but the published literature has mostly examined its impact on infants and parents through self-reported or observational measures of stress. The aim of this study was to measure salivary cortisol, a biomarker for stress, in extremely preterm infants and their mothers immediately pre and post parent-administered infant massage in order to detect potential changes in physiologic stress. Twenty-two mother-infant dyads completed massage education with a physical or occupational therapist. All dyads provided salivary cortisol samples via buccal swab immediately pre- and post-massage at the second session. Of mothers determined to be \"cortisol responders\" (15/22), salivary cortisol levels were lower after massage (pre-minus post-level: -26.47 ng/dL, [CI = -4.40, -48.53], p = .016, paired t-test). Our primary findings include a clinically significant decrease (as measured by percent change) in maternal cortisol levels immediately post parent-administered massage, indicating decreased physiological stress. Integration of infant massage into NICU clinical practice may support maternal mental health, but further powered studies are necessary to confirm findings.
Las madres de infantes nacidos extremadamente prematuros en la Unidad de Cuidado Intensivo Neonatal (NICU) se encentran bajo alto riesgo de desarrollar estrés. El masaje que una madre le da al infante es una intervención segura, bien establecida, para infantes prematuros, con muchos beneficios de desarrollo, aunque la información publicada disponible ha examinado por la mayor parte el impacto del masaje en los infantes y progenitores por medio de medidas de estrés auto reportadas o de observación. El propósito de este estudio fue medir el cortisol salival, un biomarcador de estrés, en infantes extremadamente prematuros y sus madres inmediatamente antes y después del masaje que la madre le da, para detectar posibles cambios en el estrés fisiológico. Veintidós díadas madre-infante completaron 2 sesiones educativas de masaje con un terapeuta físico u ocupacional. Todas las díadas aportaron muestras de cortisol salival por medio de hisopado bucal inmediatamente antes y después del masaje en la segunda sesión. Los niveles de cortisol en infantes no fueron suficientes para el análisis. De las madres a quienes se les determinó haber dado “respuesta de cortisol” (15/22), los niveles de cortisol salival fueron más bajos después del masaje (nivel antes menos nivel después: −26.47 ng/dL, [CI = −4.40, −48.53]. p = .016, prueba-t pareada). Entre nuestros resultados primarios se incluye una baja clínicamente significativa (tal como fue medida por el cambio porcentual) en los niveles de cortisol materno inmediatamente después del masaje. Estos resultados sugieren que el masaje dado por la madre a infantes prematuros pudiera reducir el cortisol materno, un marcador fisiológico de estrés.
在新生儿重症监护室(NICU)出生的极早产婴儿的母亲面临压力的风险很高。家长为婴儿进行按摩是一种被广泛认可且安全的干预方法, 对早产儿有许多发育上的益处, 但已发表的文献大多只是通过自我报告或对压力进行观察性测量来研究其对婴儿和父母的影响。这项研究的目的是测量极早产婴儿及其母亲在父母给予按摩前后的唾液皮质醇(压力的生物标志物)水平, 以检测生理压力的潜在变化。22对母婴在物理治疗师或职业治疗师的指导下完成了2次按摩教育课程。所有母婴在第二次按摩课程的前后立即通过颊拭子采集了唾液皮质醇样本。婴儿皮质醇水平不足以进行分析。在被确定为“皮质醇反应者”的母亲中(22对中的15对), 按摩后唾液皮质醇水平降低(按摩前和按摩后水平之差:−26.47 ng/dL, [CI = −4.40, −48.53], p = .016, 配对 t 检验)。我们的主要发现包括按摩后母亲皮质醇水平在临床上显著下降(按百分比变化测量)。这些发现表明, 母亲给予早产婴儿按摩可能会降低母亲的皮质醇水平(压力的生理标志)。.
أمهات الأطفال المولودين قبل الأوان في وحدة العناية المركزة لحديثي الولادة (NICU) معرضات بشكل كبير لخطر الإصابة بالإجهاد والتوتر. ويعد تدليك الرضع الذي يقوم به الوالدان أحد التدخلات الآمنة الراسخة للخدج وله العديد من الفوائد على النمو، لكن الأدبيات المنشورة تناولت في الغالب تأثيره على الرضع والآباء من خلال مقاييس الإجهاد المبلغ عنها ذاتيًا أو من خلال اجراءات الملاحظة. كان الهدف من هذه الدراسة هو قياس الكورتيزول اللعابي، وهو علامة حيوية للإجهاد، عند الخدج للغاية وأمهاتهم مباشرة قبل وبعد تدليك الرضع الذي يقوم به الوالدان من أجل اكتشاف التغيرات المحتملة في الإجهاد الفسيولوجي. أكمل اثنان وعشرون ثنائياً من الأم والرضيع جلستين تعليميتين للتدليك مع معالج فيزيائي أو مهني. قدمت جميع الثنائيات عينات من الكورتيزول اللعابي عبر مسحة الشدق مباشرة قبل وبعد التدليك في الجلسة الثانية. وكانت مستويات الكورتيزول عند الرضع غير كافية للتحليل. من بين الأمهات اللاتي تم تحديدهن على أنهن “مستجيبات للكورتيزول” (15/22)، كانت مستويات الكورتيزول اللعابي أقل بعد التدليك. تتضمن النتائج الأولية التي توصلنا إليها انخفاضًا ملحوظاً على المستوى الاكلينيكي (حيث تم قياسه بنسبة التغير) في مستويات الكورتيزول الأمومي بعد التدليك مباشرة. تشير هذه النتائج إلى أن تدليك الأم للخدج قد يقلل من هرمون الكورتيزول الأمومي، وهو علامة فسيولوجية للإجهاد العصبي والتوتر.

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.

Mothers of extremely preterm infants experience high rates of mental health disorders that impair maternal-infant interaction and lead to worse infant developmental outcomes. Therapist Education and Massage for Parent-Infant Outcomes (TEMPO) is a therapist-led program that standardizes the nature and frequency of parent education through weekly scheduled therapy sessions. Using a family-centered approach, the therapist facilitates positive maternal-infant interactions and massage interventions from birth throughout hospitalization with the goal of improving maternal mental health. This qualitative study presents the results of 19 parent interviews and of a focus group of four TEMPO interventionists to elicit feedback about the program. Overall, parents and therapists viewed the program positively. Parents and therapists valued the focus on parent education and engagement to increase parent competence and bonding opportunities. Both groups acknowledged that infant massage had both infant-centered and parent-centered benefits. One area where parent and therapist views did not align was regarding feasibility of TEMPO. Parents noted multiple logistical challenges to regular NICU visitation, but ultimately agreed that attending weekly therapy sessions was feasible. Therapists noted increased time and effort required of TEMPO and felt that institutional and system-level changes would be necessary to implement weekly parent education as standard of care.

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.

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

OBJECTIVE: Infants\' sleep disorders and parents\' insufficient sleep are common problems in the infant care. The current study was conducted to assess the effectiveness of infant massage on infants\' night-time sleep condition and mothers\' sleep quality.
METHODS: 140 infants were randomly put into two different groups, experimental group with fifteen-minute bedtime messages for two weeks and the control group with normal infant routine care. The Brief Infant Sleep Questionnaire, a personal information submission form, and Pittsburgh Sleep Quality Index for the mothers were the tools used to gather data in this study.
RESULTS: Infants in experimental group showed meaningful differences in variables such as, sleep latency (P < 0001, eta = 0.099), number of night waking (P = 0.03, eta = 0.027) and longest continuous sleep period (P = 0.03, eta = 0.026). As for other variables no meaningful differences were observed. There wasn\'t meaningful difference in the mother\'s overall night-time sleep quality between the two groups (P = 0.184, eta = 0.012) except for the duration of the mother\'s night-time sleep (P = 0.028, eta = 0.026) and the reduction of maternal sleep disorder (P = 0.020 eta = 0.029).
CONCLUSIONS: The findings indicated that infants\' bedtime massages would improve some of the sleep markers of mothers and infants, and therefore, can be suggested as a practical, harmless, and cost-free method to improve sleep.

OBJECTIVE: Infant massage (IM) is a well-studied, safe intervention known to benefit infants born preterm. Less is known about the benefits of maternally-administrated infant massage for mothers of preterm infants who often experience increased rates of anxiety and depression in their infants\' first year of life. This scoping review summarizes the extent, nature, and type of evidence linking IM and parent-centered outcomes.
METHODS: The Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for scoping reviews (PRISMA-ScR) protocol was followed using three databases: PubMed, Embase, and CINAHL. Thirteen manuscripts evaluating 11 separate study cohorts met pre-specified inclusion criteria.
RESULTS: Six primary topics related to the influence of infant massage on parent outcomes emerged: 1) anxiety, 2) perceived stress, 3) depressive symptoms, 4) maternal-infant interaction, 5) maternal satisfaction, and 6) maternal competence. Emerging evidence supports that infant massage, when administered by mothers, benefits mothers of preterm infants by reducing anxiety, stress, and depressive symptoms and improving maternal-infant interactions in the short-term, but there is limited evidence to support its effectiveness on these outcomes in longer periods of follow-up. Based on effect size calculations in small study cohorts, maternally-administered IM may have a moderate to large effect size on maternal perceived stress and depressive symptoms.
CONCLUSIONS: Maternally-administered IM may benefit mothers of preterm infants by reducing anxiety, stress, depressive symptoms, and by improving maternal-infant interactions in the short-term. Additional research with larger cohorts and robust design is needed to understand the potential relationship between IM and parental outcomes.

To describe child health care nurses\' experiences of teaching infant massage in parent groups.
This was an exploratory-descriptive qualitative study based on individual interviews.
Qualitative semi-structured interviews were conducted with child health care nurses (N = 9) according to the COREQ guidelines and analyzed with qualitative content analysis.
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.
Child health care nurses were interviewed.

BACKGROUND: Very preterm (VPT) infants develop adverse neurological sequelae from early exposure of the immature brain to the extrauterine environment.
OBJECTIVE: To determine the effects of infant massage on brain maturation in low-risk VPT infants.
METHODS: A randomised controlled trial of VPT infants, who received standard care or daily massage therapy, administered by the mother, from 34 weeks\' to 40 weeks\' corrected age (CA).
METHODS: VPT infants (born at 28 weeks to 32 + 6 weeks\' gestational age, G.A.) and a healthy at term cohort for comparison.
METHODS: At term equivalent age (39 weeks\' to 42 weeks\' CA), EEG was recorded to calculate global relative power (GRP), using power spectral analysis.
RESULTS: Sixty infants were recruited, and EEGs of 25 massage and 20 standard care infants were analysable. There was no difference between groups in primary outcome (beta GRP). There was a significantly higher central alpha relative power measured in the intervention group infants, compared to standard care (SC) group (mean difference = 1.42, 95 % confidence interval (CI): 0.12 to 2.73; p = 0.03). A massage dose effect was shown by a positive correlation between, massage dose and beta, alpha and theta GRP (r = 0.42, 95%CI = 0.12 to 0.64, r = 0.45; 95%CI = 0.16 to 0.66, r = 0.39; 95%CI = 0.10 to 0.62 respectively) and a negative correlation between massage dose and delta GRP (r = -0.41, 95%CI = -0.64 to -0.12), suggesting that a higher dose of massage is associated with more favourable brain maturation.
CONCLUSIONS: Central alpha regional relative power was greater in massaged infants compared to SC group infants, suggesting relatively greater brain maturation in this area. A measurable massage dose effect in favour of greater brain maturation, shows promise for verification in a larger clinical trial.