Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates

Abstract

Objective: To study the effect of maternal massage therapy on hospital stay in very-low-birth-weight infants who were already submitted to skin-toskin care.Study Design: A randomized study was performed including infants of birth weight X750 and p1500 g and gestational age p32 weeks. The exclusion criteria were as follows: death before completing 48 h and presence of major malformations. Neonates were divided into intervention group (IG) (standard care plus maternal massage) and control group (CG). Anthropometric data were always verified by a person blind to the group to which the newborn belonged. Maternal massage was performed four times a day on the face and limbs. Passive exercises of upper and lower limbs were also done by the mothers.Result: A total of 104 newborns were included, 52 in each group. Both groups were similar in gestational age (IG: 29.7 ± 1.6; CG: 29.4 ± 1.6 weeks), birth weight (IG: 1186±194; CG: 1156±198 g), gender, number of small-for-gestational-age infants, SNAPPE-II, deaths, gains in weight, length and head circumference. Incidence of late-onset sepsis was significantly lower in the intervention group (IG: 10.8%, n ¼ 5; CG: 38.3%, n ¼ 18; P ¼ 0.005). IG was discharged from the hospital 7 days before CG (IG: 42, confidence interval (CI) 95%: 38 to 46; CG: 49, CI 95%: 42 to 56), and presented 1.85 hazard ratio (CI 95%: 1.09 to 3.13; P ¼ 0.023) for early discharge. Keywords: massage therapy; tactile stimulation; kinesthetic stimulation; very-low-birth-weight infants; neonatal sepsis Introduction Early interruption of gestation brings consequences that still cannot be fully avoided even in neonatal units with the most modern technological resources and best survival rates. There is a high probability of preterm infants going beyond the neonatal period before reaching a growth 1 and development 2 pattern similar to that of term newborns. In addition, the need for a long hospital stay period makes the presence of parents essential for assistance, once the parents' competence to understand and provide the premature infant's needs is consolidated as one of the main medical criteria for hospital discharge. 3 Studies involving the hospital stay period of preterm infants showed that relatively simple measures improve their prognoses, such as skin-to-skin contact reduces the painful sensation of term neonates 4 and promotes the development and parental relation of preterm infants; 5 the creation of a sleep-provoking environment increases the growth rate of very-low-birth-weight (VLBW) infants; 6 the application of tactile-kinesthetic stimulation contributes to both growth and development of preterm infants between 1000 and 2000 g, without adverse effects on physiological parameters; 7 instructions to first-child parents on how to bathe and massage favors parent-infant bonding; 8 and the participation of mothers through massage with moderate pressure improves growth and development rates of term infants. 9 Despite these evidences, in two systematic revisions, one regarding the tactile-kinesthetic s...

Comforting Touch in the Very Preterm Hospitalized Infant

“…The study selection process is outlined in the Figure. Of the 11 studies, 2 evaluated infant massage, 25,31 5 GHT, 46,50-53 2 TAC-TIC therapy, 48,54 1 social stimulation including touch, 49 and 1 therapeutic touch. 45 A range of study methodologies was reviewed, including random ized controlled trials (RCTs), 25,45,[50][51][52][53] follow-up outcomes of these RCTs, 31,52 pretest/ posttest time series interrupted design, 48,54 a quasiexperimental, 46 and an observational, counterbalanced across-session and infants design. 49 Of the and improved neurologic, motor and behavioral development [29][30][31][32] ), many of the existing studies have varying protocols, are limited to healthy or convalescing preterm infants greater than or equal to 32 weeks' postmenstr ual age (PMA), and are seldom contingent on infant cues.…”

Application of tactile/kinesthetic stimulation in preterm infants: a systematic review

“…14,17,33---35 In some studies, only the mothers provided KTS. 16,35,36 Ferber et al 15 suggested that during the first ten seconds of TS, the caregiver should only rest his hand on the PI, avoiding movements.…”

Critical review of massage therapy employed for newborns

“…Compared to control group in which infants have not been massaged, previous studies reported that on average, preterm infants who had a 10-day massage gained more weight and were discharged 3-6 d sooner [22,23] . However, a later study showed that newborns after maternal massage were discharged 7 d before the group without massage therapy, which would generate significantly lower hospital costs [24] .…”