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Infant Massage as a Complementary Practice in
Infant Mental Health Kristine Snell, MSW, LISW-S, IGSIS, CEIM
Objectives for Today
Attendees will learn the benefits of infant massage across settings and
populations.
Attendees will become familiar with the Sensational Baby infant massage
program content, use and training.
Attendees will gain knowledge regarding the physiological and psychological
impact of guided nurturing touch in supporting parent-infant attachment in
both typical and challenging situations
Attendees will be able to describe the foundations of infant mental health
present in a nurturing touch approach
Defining Infant Mental Health
The social and emotional well-being of the very young child in the context of family relationships, beginning at birth and extending through the preschool years
“There is no such thing as a baby “ D.W. Winnicott
The field of Infant Mental Health promotes the emotional well-being of young children and their families to reduce risk factors, and prevent or reduce emotional problems. Research , advocacy, public education and improved policy are foundational goals
Infant Mental Health- Informed practices should be the foundation of education for all providers of services to young children
Birth to 1 year : baby is organizing, experience dependent and born with certain capacities, and is developing responses to predictable experiences. Parents are getting to know how to parent this particular baby.
Parents have their own set of expectations and stressors that impact their ability to effectively interact with their child.
We are building the capacity of the child from birth to 3 years to:
1. Experience, regulate and express emotion
2. Form close and secure interpersonal relationships
3. Confidently explore their environment and learn
Pathways to Positive Bonds
But
Unlike adults, babies have a fairly limited pool of responses to stress and
trauma
Physical symptoms (poor weight gain, feeding challenges , digestive issues,
delayed development, inconsolable crying, sleep problems, excessive sensory
concerns) may develop in response to not having emotional needs met
Infant Massage provides pathways to help caregivers develop a keener
awareness of, and response to, baby cues
Why is this important?
Our current social structure emphasizes the Distance Senses: sight and
hearing
While ignoring Proximity Senses ; taste, smell, touch
and minimizing the significance of non-verbal communication
This can be a problem in forming responsive and nurturing relationships
The Sensational Baby infant massage program incorporates activities
that address all the senses using modeling and feedback that recognizes
and reinforces the immediate experience of each participant
The New still Face
Infant Massage core principles are consistent with
and informed by Infant Mental Health perspectives
• Finding /Treating the parent-baby dyad as “one”
is the most effective way to resolve early
attachment disorders and “inoculate” against
excessive stress
• Finding a “point of entry” into the relationships
occurs by observing the dyad and recognizing
the opportunity for “connection” in both the
parent and the baby
• Parental reflection on their own upbringing can
bring insight and prevent a potentially
dysfunctional view of the baby- we all have a
touch history
• Infant Massage supports the approach of doing
“with” rather than “to” or “for” the baby and
can relieve some emotional blocks to a trusting
reciprocal relationship through the immediacy
of the experience
What is Infant Massage?
Infant Massage was formalized as guided-touch interaction program by
Vimala McClure (Infant Massage, A Handbook for Loving Parents
Bantam Books 2000) based on her experiences witnessing the powerful
effects of massage used in Indian orphanages.
Infant Massage is modeled by certified instructors using dolls with parents
providing the actual massage to the baby either in a small group or one-to –
one with a parent educator. Simple unscented, fruit or vegetable oils are used
for the massage.
Massage is baby-paced and is best taught over a 4-5 week period to allow the
baby and parent to get to know what works best for them and to gain
confidence in reading baby’s cues.
How is Infant Massage incorporated into
on-going services to families?
Infant massage can be implemented as a stand alone service as an individual
consultation referral or in parent-baby groups
Infant massage can be used as a strategy in on-going early childhood mental
health treatment , enrolled under the infant’s name
Referrals have been from pediatricians, maternal mental health psychiatry,
hospice, physical and occupational outpatient therapies, home visitor
programs and children's services
Free community based program attracts parents across demographics
Targeted group with a common need or interest
What does a parent experience in an
Infant Massage class?
A quiet and soothing setting
A “nest” to sit with baby and other parents and babies
Extra life sized dolls
Opportunity to talk about concerns, joys, reflections
Learn a new stroke weekly with review each time ( typically 5 sessions)
Songs and rhymes
Learning how massage can be used past infancy
These same strategies are modified and used in home sessions too
Making connections with shared experiences
Infant massage for all
All parents are taking a new journey with each child
First time parents experiencing the transition from pregnancy to parenting will experience periods of self-doubt, exhaustion and the task of integrating this new role into their lives .
Recovery from pregnancy and childbirth outcomes
Babies may be experiencing sensory, regulatory or developmental concerns , prematurity
Parents and infants who are experiencing distress in their relationship (difficult attachment, barriers due to stress and trauma, parental mental health needs, disruption in family life )
Extended family ( 2-3 people) can learn strategies so baby is experiencing predictable and invited comfort
Top 5 Reasons Parents Love Infant Massage
1. It’s easy to learn and feel successful right away
2. Relieves baby’s digestive distress, including colic, gas and
constipation
3. Provides more restful, deeper sleep
4. Stimulates brain growth and nervous system
development , weight gain
5. Helps relieve post partum depression /less
Isolation
Gaining confidence in giving comfort
All dressed up with Some Place to go !
Fathers who used massage techniques with their infant experienced
increased self-esteem ; babies greeted their fathers with more eye contact
, smiling , vocalizing and reaching responses
Applying the Lessons
Babies with 2-3 consistent trusted caregivers relieves
maternal distress
Sharing Experiences…baby wearing
As the child moves from infancy to toddlerhood to preschooler, the
opportunities for touch interaction shift and discipline patterns begin
that may or may not include negative touch.
When a parent learns infant massage they are creating a foundation for
lifelong positive touch, privacy , permission messages
Complex Medical Needs
Pre term babies and tactile kinesthetic
stimulation
In one study 1-3 month old pre-term infants of depressed team mothers of
low socioeconomic status participated in either 15 minutes of massage or
rocking for 2 days per week for a 6 week period.
Babies who were massaged :
Had 47% greater weight gain per day
Hospitalized 6 days less than the control group
More mature habituation cluster of Brazelton exam
More mature sleep organization
( Field et al 1986, Scafidi et al 1990)
Maternal Mental Health
Through this rhythmic touch interaction both baby and mother experience an
increase in release of Seratonin, the “feel good “ hormone which supports a
positive attachment. Parents comment on how much more relaxed they too feel
after giving the massage.
Likewise for women in substance abuse recovery this can have a positive
impact on bonding with a baby that may be going through drug withdrawal
The act of massaging gives a very concrete activity to do with baby, especially
when the nurturing drive may be muted
The use of songs and rhymes improves mood, reinforces learning
Families in Transition
Foster Care: Children's Research Triangle , Chicago Illinois, provides infant
massage to both foster and biological parents to support the baby in all care
settings. Instructors include the foster parents, biological parents, and other
family members . Infant massage can be the one consistent intervention for the
infant who may be moved back to family return to foster care, pre-adoptive home,
etc.
When parent live apart: Both parents can take part in infant massage training to
provide familiar nurturing routines in both households
Incarceration : Parents returning home from incarceration can become more
attuned to the infant’s needs and preferences through infant massage
Deployment: The US Army has instituted infant massage classes at Fort Hood Texas
as part of their family support program ; with plans to expand to other sites
69 Infant massage chapters around the
world; what is happening in USA ?
Oklahoma: Department of Mental Health is in year 2 of a 4 year expansion
grant to train 77 CEIMS in 77 counties
Anne Arundel County Maryland: County Public Schools birth to 5 series
incorporating Infant Massage into their early intervention programming
The Alliance for The Advancement of Infant Mental Health Endorsement:
29 states are participating in workforce development in infant mental health
Infant Massage USA curriculum has been accepted as meeting competencies
towards Endorsement
Fussy Baby Network : Linda Gilkerson, PHD , Founder, Facilitating Attended
Interactions ( FAN) , recommends infant massage training to all interns and
states” infant massage certification training teaches the foundations of infant
mental health”
Training in Infant Massage
IMUSA provides a comprehensive infant mental health informed curriculum which has been approved by the Alliance for Infant Mental Health
Begins with intensive 4 day on-site training
Trainees observe a class and on the final day of training teach portions of the class
Certification is granted following a written test, instruction of 5 families
and research on one related topic
People from a variety of educational backgrounds are eligible for training
Expanding infant massage education in
our Community
Childcare: Pros/Cons
Doulas
Breastfeeding Counselors
Early Head Start
Home Visitors
Community Health Centers / WIC
Children's Services / Foster Parents
Strolling Thunder 2018
Benefits / Citations
Improved Sleep Patterns : Infants experience improved sleep immediately after being massage ( 1) Infants and toddlers
with sleep onset problems were given daily massages by their parents for 15 minutes prior to bedtime for one month.
The massage babies showed fewer sleep delay behaviors and had a shorter latency to sleep onset by the end of the
study. During the day, babies were more awake, alert and active.(2)
Reduction of Stress: Cortisol levels, a stress indicator, were significantly lowers after infant massage (3)
Massaged pre-term infants showed fewer stress behaviors and less activity during a five day study. (4)
Enhanced Motor Development: Premature infants experienced enhanced motor development and improved Brazelton
neonatal behavioral assessment scores (5)
Improved interaction with Fathers and Babies: Fathers who used massage techniques with their infant experienced
increase self-esteem as parents. The babies greeted their fathers with more eye contact, smiling, vocalizing and
reaching responses. Fathers were more expressive and showed more enjoyment and more warmth during floor-play
interactions with their infants. (6)
Help for Depressed Babies and Mothers : Learning the practice of infant massage by mothers may be an effective
treatment for facilitating mother-infant interaction in mothers with postnatal depression, Edinburgh Postnatal
Depression scores improved for the mothers who learned massage, as did their video-taped mother-baby
interactions.(7)
Increased Weight Gain for Premature Infant: Premature infants that were massaged regularly had higher daily weight
gain, increased motor activity and better Brazelton neonatal behavioral assessment scores. They had a better
conversion of calories to weight gain. (8)
Helpful for Cocaine-exposed Babies: Massaged cocaine exposed newborn had fewer postnatal complications and showed
increased weight gain, and better performance on the Brazelton Neonatal Behavioral Assessment Scale (9)
Citations continued
Reduction of Neonatal Jaundice in Full-term Massaged Infants Massage: helps in increasing blood flow and stimulation of the lymphatic system, aiding in the collection and excretion of waste products from the body. The stimulation of the vagus nerve also increases gastric fluids, aiding in digestion and increasing appetite. Babies were then more likely to nurse more frequently. Massage also helps decrease the stress hormone cortisol. As a result the babies in the treatment group were found to have lower levels of jaundice than the control group. (10)
Field,T,& Hernandez-Reir,M. ( 2001). Sleep problems in infants decreased following massage therapy. Early Child development and Care, 168, 95-104.
Acolet D, Modi N et al, Changes in plasma cortisol and catecholamine concentrations in response to massage in preterm infants. Arch Dis Child. 1993; 68:29-31.
Hernandez-Reir, M.,Diego,M &Field,T. (2007). Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behaviors & Development, 30,557-61.
Dieter JNI. Emory ED. Supplemental stimulation of premature infants: a treatment model, J Pediatr Pscychol, 1997:22(3) : 281-295
Cullen, D.,Field,T., Escalona, A & Hartshorn, K. ( 2000). Father-infant interactions are enhanced by massage therapy. Early Child
Onazawa K, Glover V, Adams D, Nodi N, Kumar RC. Infant massage improves mother-infant interaction for mothers with postnatal depression.
Phillips, RB Moses HA. Skin hunger effects on preterm neonates, Infant Toddler Intervention. 19961):39-46.
Wheeden A, Scafidi FA, Field, T et al. Massage effects on cocaine exposed preterm neonates. Dev. Behav Pediatr. 1993: 14(5):318-322.
Chen, J., Sadakata, M., Ishida, M., Sekizuka, N., Sayama, M. (2011). Baby massage ameliorates neonatal jaundice in full-tem newborn infants. Tohoku Journal of Experimental Medicine, 223 (2), 97-102.
Citations Continued
VanDer Kolk, B , M.D. The Body Keeps the Score Penquin Books 2014
Kendall-Tackett, K . PhD. IBCLC Depression in New Mothers Hawthorn Press 2005
Ashley Montagu, PhD. Touching 3rd edition 1986 Harper & Row
Bailey, Becky PhD. I Love You Rituals 2000 Harper Collins
Bowlby, John PhD. A Secure Base 1988 Basic Books