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Cited by 293Infant Development and Preterm CareInfant Health and DevelopmentNeonatal skin health care

Massage for promoting growth and development of preterm and/or low birth-weight infants

Open access
Vickers, Andrew, Ohlsson, Arne, Lacy, Janet, Horsley, Angela·2004·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd000390.pub2PMC PMC6956667
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Abstract

BACKGROUND: It has been argued that infants in Neonatal Intensive Care Units are subject both to a highly stressful environment - continuous, high-intensity noise and bright light - and to a lack of the tactile stimulation that they would otherwise experience in the womb or in general mothering care. As massage seems to both decrease stress and provide tactile stimulation, it has been recommended as an intervention to promote growth and development of preterm and low-birth weight infants. OBJECTIVES: To determine whether preterm and/or low birth-weight infants exposed to massage experience improved weight gain and earlier discharge compared to infants receiving standard care; to determine whether massage has any other beneficial or harmful effects on this population. SEARCH STRATEGY: The following databases were searched: the specialized register of the Cochrane Neonatal Review Group and that of the Cochrane Complementary Medicine Field. Searches were also undertaken of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2003), MEDLINE, EMBASE, Psychlit, CINAHL and Dissertation Abstracts International (up to July 1, 2003). Further references were obtained by citation tracking, checking personal files and by correspondence with appropriate experts. Data provided in published reports was supplemented by information obtained by correspondence with authors. There were no language restrictions. SELECTION CRITERIA: Randomised trials in which infants with gestational age at birth <37 weeks or weight at birth <2500g received systematic tactile stimulation by human hands. At least one outcome assessing weight gain, length of stay, behaviour or development must be reported. DATA COLLECTION AND ANALYSIS: Data extracted from each trial were baseline characteristics of sample, weight gain, length of stay and behavioural and developmental outcomes. Physiological and biochemical outcomes were not recorded. Data were extracted by three reviewers independently. Statistical analysis was conducted using the standard Cochrane Collaboration methods. MAIN RESULTS: Massage interventions improved daily weight gain by 5.1g (95% CI 3.5, 6.7g). There is no evidence that gentle, still touch is of benefit (increase in daily weight gain 0.2g; 95% CI -1.2, 1.6g). Massage interventions also appeared to reduce length of stay by 4.5 days (95% CI 2.4, 6.5) though there are methodological concerns about the blinding of this outcome. There was also some evidence that massage interventions have a slight, positive effect on postnatal complications and weight at 4 - 6 months. However, serious concerns about the methodological quality of the included studies, particularly with respect to selective reporting of outcomes, weaken credibility in these findings. REVIEWERS' CONCLUSIONS: Evidence that massage for preterm infants is of benefit for developmental outcomes is weak and does not warrant wider use of preterm infant massage. Where massage is currently provided by nurses, consideration should be given as to whether this is a cost-effective use of time. Future research should assess the effects of massage interventions on clinical outcome measures, such as medical complications or length of stay, and on process-of-care outcomes, such as care-giver or parental satisfaction.

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  • Moderate pressure massage in preterm infants increases infant growth and reduces length of stay in the NICU, with small effect sizes.

    “Two recent reviews of studies with preterm infants demonstrated that moderate (but not gentle) pressure massage can increase infant growth and reduce length of stay in the neonatal intensive care unit (NICU) [128,129], although effect sizes were small.”

    From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [129]

    The Effects of interventions section (page unavailable) reports greater daily weight gain with massage (5.1 g) and a shorter hospital stay (4.5 days), but no such advantage from gentle, still touch. It does not identify the effective massage as moderate-pressure massage; the Background describes neonatal massage as gentle stroking. It calls the weight-gain difference of low clinical significance, while the Discussion describes the shorter stay as of considerable value, so the blanket characterization of small effects is not supported. (LLM, conf=0.88)

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  • There are more studies of massage with infants than with toddlers and preschoolers, and more evidence for benefits of massage in high-risk groups such as preterm infants and infants of depressed mothers.

    “Across outcomes, there are more studies of massage with infants as opposed to with toddlers and preschoolers, and more evidence for the benefits of massage in high-risk groups, such as preterm infants [128,129] and infants of depressed mothers [130].”

    From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [129]

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Cites

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4 of the 117 references couldn’t be matched to a known paper.

Research works printed but not linked: 14

  1. Field 1987 {published and unpublished data} Field T, Scafidi F, Schanberg S. Massage of preterm newborns to improve growth and development. Paediatric Nursing 1987;13:385-7.
  2. Harrison 2000 {published and unpublished data} Harrison LL, Williams AK, Berbaum ML, Stem JT, Leeper J. Physiologic and behavioral effects of gentle human touch on preterm infants. Research in Nursing and Health 2000;23:435-46.
  3. Adamson-Macedo 1991 {published data only} Adamson Macedo EN. Stroking, emotion and cognition: 11 years on. Association of Paediatric Chartered Physiotherapists Newsletter 1991;60:6-14.
  4. Armstrong 1996 {published data only} Armstrong S. Infant/parent interaction analysis and developmental outcome for a high risk premature intervention population: a longitudinal analysis. Dissertation Abstracts International 1996;57:3688.
  5. Cody 1995 {published data only} Cody AL. The effects of infant massage on the attitudes and perceptions of mothers who massage their hospitalized premature infants. Dissertation Abstracts International 1995;56:2858.
  6. de Roiste 1991 {unpublished data only} de Roiste. Aspects of tactile stimulation with infants in intensive and special care baby units. PhD thesis, University of Glasgow, Scotland. 1991.
  7. Haselmeyer 1963 {published data only} Hasselmeyer EC. Handling and premature infant behaviour. Dissertation Abstracts International 1963;24:2874-5.
  8. Kalscheur 1985 {published data only} Kalscheur JA. Analysis of movement of high-risk premature infants in response to tactile stimulation. Masters Abstracts International 1985;23:282.
  9. Kassis 1967 {unpublished data only} Kassis NI. Extra-tactile kinesthetic stimulation and the toleration of stress in hospitalised infants. UCLA Nursing Dissertation 1967.
  10. Kilgo 1986 {published data only} Kilgo JL. Tactile-kinesthetic stimulation: Effect on the development of preterm infants and the anxiety level of the mothers implementing the stimulation. Dissertation Abstracts International 1986;47:836.
  11. Rausch 1981 {published data only} Rausch PB. Effects of tactile and kinesthetic stimulation on premature neonates. Journal of Obstetric, Gynecologic and Neonatal Nursing 1981;10:34-7. [MEDLINE: 81146310]
  12. Sampers 1993 {unpublished data only} Sampers JL. The effects of tactile containment on preterm infants in a neonatal intensive care unit. Unpublished: Doctoral dissertation, University of Maryland College Park 1993:Doctoral dissertation, University of Maryland College Park 1993 AAC9425128.
  13. Scarr-Salapatek 1973 {published data only} Scarr Salapatek S, Williams ML. A stimulation program for low birthweight infants. American Journal of Public Health 1972;62:662-7.
  14. Field T, Ignatoff E, Stringer S, Brennan J, Greenberg R, Widmayer S, Anderson G. Nonnutritive sucking during tube feedings: effects on preterm neonates in an ICU. Pediatrics 1982;70:381-4.

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Authors
Vickers, A., Ohlsson, A., Lacy, J., & Horsley, A.
Affiliations
  • Memorial Sloan Kettering Cancer Center (US)
  • University of Toronto (CA)
  • Scarborough Health Network (CA)
  • 7 Biggart Close Manor Park Chilwell Nottingham UK NG9 6NN
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2004-04-19
Volume
2009
Issue
1
Pages
CD000390-CD000390
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd000390.pub2
PMC
PMC6956667
OpenAlex
W1733579415
Cited by
293
References
117
Citations by year
2026: 4 · 2025: 7 · 2024: 6 · 2023: 9 · 2022: 17 · 2021: 16 · 2020: 15 · 2019: 13 · 2018: 15 · 2017: 13 · 2016: 13 · 2015: 21 · 2014: 8 · 2013: 20 · 2012: 14
FWCI
1.65
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
  • Health Sciences › Health Professions › Speech and Hearing › Neonatal skin health care
Keywords
infant massage, preterm infants, low birth weight infants, tactile stimulation, infant weight gain, length of hospital stay, neonatal intensive care, infant development, infant behavior, gentle touch, neonatal stress, hospital discharge, postpartum complications, gestational age, birth weight, neonatal nutrition
MeSH terms
Humans, Infant Care, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Massage, Physical Stimulation, Weight Gain

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