By Cherry Bond, R.S.C.N., R.G.N., C.I.M.I.
Massage can relax and calm a baby by reducing emotional and physical stress and by promoting better sleep. It can be used to relieve gas, constipation, and colic. It can help to relieve nasal congestion and a baby's sticky eyes. In fact, massage stimulates an infant's whole system and encourages healthy growth and development.
Massage movements can be adapted for premature and sick infants. For safety's sake, check with your doctor or nurse at the hospital before you massage your newborn. Then ask if there are staff members trained in infant massage who can guide you.
Before you continue with this article, it's important to read "Six Steps to Positive Touch in the Neonatal Intensive Care Unit," another article in the Guide to Your Preemie's World. You'll learn how to read the signals your baby gives to show you he's ready for touch. You'll also learn how to reassure and ready him for the massage experience. Keep These Points in Mind Foot Massage: Here's How Some Cautions Baby Massage Oil in the NICU
Keep These Points in Mind
- Begin on a body part where your baby already seems to like touch. Head, hands, and feet are often favored.
- Always start by asking permission (see Step 3 in "Six Steps..."). This is best done when the baby is not too hungry or full. If your baby is not feeling well enough or does not have enough energy for a massage, he won't give permission.
- Begin with a gentle, still hold.
- Movement should be positive, slow, and rhythmical. Quick, feathery, light fingertip strokes can be very arousing and may be irritating. Slower, holding-type touch is usually more soothing.
- Try one slow stroke at a time.
- Continue massaging only if your baby is happy. If the massage is too stimulating, return to still holding for a while.
Foot Massage: Here's How
This foot massage can be very reassuring. It helps release tension in the feet and can be used on the hands as well. A foot massage encourages your baby
to flex (tuck up) her legs and feet into a relaxed position. Massaging your baby's hands can encourage her to bring her arms and hands to a stress-free position near her face or upper body and toward the midline.
- Begin by asking permission.
- Undress only the area you want to massage. Tuck up your baby's arms with a sheet or small blanket so she can reach her fingers to suck on for comfort. Make sure there is something to support her legs if she suddenly stretches them out. Most babies feel very vulnerable on their back, so prop her on her side in the crib or incubator. If she can be held, nestle her in a soft pillow on your lap and keep her covered.
- Briskly rub a little oil (see below) into your hands.
- Supporting one leg in a flexed position near the body, cup the foot with your hand and help her to relax with gentle, still holding in your warm palm. This can be very reassuring, relaxing, and supportive to your baby.
- Support the leg with the sole of her foot securely nestled against your palm. Begin slow stroking from ankle to toes across the whole top of her tiny foot. Apply gentle but positive pressure using a thumb or finger. If you are working on your baby's hands, follow the same procedure, starting with the back of the hands and then the fingers. If your baby wants more massage, continue to step
- Cup your baby's foot with your hands in the same position as in Step 5. Make very slow circles around the ankles on both sides of the foot (or wrists, if you are doing her hands).
- While you are still cupping the foot, gently press each toe (be careful not to tickle the sole of the foot). If the toes are too sensitive to massage individually, give them all a little squeeze together to relax them. Or just gently hold your baby's toes in your warm hands.
- With your thumb or index finger laying along and just underneath the toes, give this area three little presses. Then slide your finger/thumb downward to just below the middle of the sole, and press three times.
- Cup the whole foot and rotate the baby's ankle in a slow, circular motion to release any tension in the ankle and foot.
- Still cupping the foot, finish with slow strokes all over the top of the foot (or the back of the hand), moving from toe to ankle.
- Finish as you began: with still holding, the foot cupped inside the palm of your hand.
- After the massage, keep the feet warm and relaxed by putting booties or socks on the baby. Tell your baby "thank you" so she begins to understand that you both have shared a very special time.
- The amount of time you massage your baby will vary, depending on how your baby feels at any given time. A one- or two-minute session may be sufficient, and usually it's enough to massage one body area per session.
- Massage can be stimulating as well as relaxing, so watch for signs of overstimulation or "no" signals from your baby.
- Do not begin if the baby has a raised temperature or appears tired or ill.
- Babies who are nearly ready to go home after a long period in the NICU may be anemic and may be using a lot of energy developing their feeding skills. If so, massage can be too much for them at this stage.
- Being aware of baby language (cues or signals) is essential to safe and successful massage. All infant massage instructors should know these cues.
Baby Massage Oil in the NICU
- Using oil prevents friction and increases toleration of movement over the skin. It also helps keep the baby's skin from becoming too dry.
- It is best to use a light, plant-based oil. Some massage instructors use sunflower or fractionated coconut oil, which is not too greasy and is quickly absorbed into the skin. This kind of oil allows the skin to function normally, without blocking the pores.
- Oil that is highly purified may be safer and will keep better in the high room temperatures common in a neonatal unit. Always smell the oil as you rub it into your hands. Rancid oil has an obvious, strong smell.
- Oil with no scent is safer for delicate newborn skin. Essential oils should be avoided.
Join a Massage Group
After discharge from the hospital, parents and baby can benefit from joining a baby massage group in the community. These groups can provide support, friendship, and a number of health benefits for all of you. For information on baby massage groups, click here.
Cherry Bond, a qualified infant massage instructor (C.I.M.I.), children's nurse (R.S.C.N.), and adult nurse (R.G.N.) in England, initiated a program of positive touch in the neonatal unit at Queen Charlotte's Maternity Hospital in London. She has a master's degree in behavioral sciences for advanced neonatal practice and works part-time in the baby unit at St. Mary's Hospital, Paddington. She helped to establish a British chapter of the International Association of Infant Massage (IAIM) and serves as an advisor on its special-needs committee.