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Massage for promoting growth and development of preterm and/or low birth-weight infants
Open accessAbstract
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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“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]
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“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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Metadata
- 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
- 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
- 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
- bronze
- doi.org
- 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 › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › 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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