A Plain-English Guide to Infant

Massage Research: What Every Parent

Should Know

The International Association of Infant Massage, Australia www.iaim.org.au

A G u i d e t o I n f a n t M a s s a g e : W h a t E v e r y P a r e n t S h o u l d K n o w “Infant massage” is more popular than ever amongst both parents and health workers for good reason. Over the past

twenty years, literally dozens of scientific studies have shown using massage with babies may help with many issues –

from promoting better sleep, through to enhancing brain growth and development.

The results of these sorts of studies are very exciting to both parents and health workers alike. However (just like

childbirth, breastfeeding, settling a new baby, and many other parenting skills), while infant massage and healthy touch

might be completely natural – they don’t necessarily always come easily to parents. For this reason, you may turn to

books, videos, the internet, classes and other sources of information to find out how to use massage with a your new little

baby...and the quality of this information can vary widely.

The International Association of Infant Massage, Australia (IAIM) is a not-for-profit charity, dedicated to supporting

parents access high-quality information about infant massage. We are part of a global organisation active in over 53

countries, the most experienced infant massage organisation in the world, and have the highest level of accreditation and

recognition of any infant massage organisation in Australia.

In this e-book, we aim to provide parents with a plain-English summary of the research about infant massage to support

you make an informed choice and answer questions like:

Is infant massage something my baby needs?

What is the best and safest way to learn infant massage?

How do I know if information about infant massage is of a “high quality”?

First though, let’s take a look at why so many people are interested in infant massage and what it actually is...

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W h a t E v e r y P a r e n t S h o u l d K n o w : There’s Good Reason to be Interested in Infant Massage

The benefits of massage and touch for babies has been of interest to medical & health researchers for well-over 25

years. Just a small sample of the most important peer-reviewed studies in this field reveal:

When baby rats are given high-levels

of touch and massage in infancy,

gene expression can be altered and

their brains develop a resistance to

opiate addiction later in life (Journal of Neuroscience, 2011)

Babies whose mothers were depressed,

had better social, emotional and

behavioural outcomes when their

mother’s learned the IAIM infant

massage program, compared with

babies whose mothers attended a

depression support group only (Journal of Affective Disorders, 2001)

Brain scan studies revealed more

stunted brain growth in children

who had lower levels of touch and

nurturing during the early years. (Proceedings of the National Academy of

Sciences, 2012)

High quality touch education for

mothers was found to improve

maternal mood, and to reduce key

risk factors for development of child

abuse (Assn. For Women’s Health, Obstetric &

Neonatal Nurses, 2012)

Mothers who use lots of gentle touch

and stroking with their baby appear to

reverse the negative impacts of

pre-natal depression on their

baby’s brain development (PLOSOne, 2012)

Infant massage appears to help

reduce crying, improve baby’s

sleep-awake patterns, and reduce

levels of toxic stress hormones in

the brain. (Cochrane Library, 2006).

Parents Need to Know:

Researchers and health practitioners widely agree that healthy touch, stroking and skin-to-skin contact is crucial for a baby’s early

brain, social and emotional development.

Based on all of this research, a lot of claims about the “benefits” of infant massage are made. However, there are many different

styles and types of infant massage education and information available.

So, even though the research looks good on the surface, not all infant massage information given parents reflects the research.

Knowing how to pick out good quality resources is crucial for parents who want safe and accurate information.

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W h a t E v e r y P a r e n t S h o u l d K n o w : T h e r e a r e 3 t y p e s o f B a b y M a s s a g e

Therapy-Based

Baby Massage

Used to treat physical problems or disabilities.

A focus on baby’s physical condition.

Uses deep pressure massage.

Massage done by a therapist.

Parents Need to Know:

Deep pressure can injure babies.

Carefully check qualifications of

any person offering to “do massage

therapy” on your baby.

Talk to your baby’s Physio or

Occupational Therapist first.

Rule-Based

Baby Massage

Applies massage strokes using a set of rules.

A focus on doing massage strokes and routines correctly.

Uses medium pressure massage.

Massage done by therapist or parent.

Parents Need to Know:

Rule-based baby massage uses

one-size-fits all strokes, routines

and approaches - regardless of the

baby or parent’s unique and

individual needs and preferences.

Cue-Based

Baby Massage

Uses massage, touch and other interactions to enhance parent-baby relationships.

A focus on the parent, the baby, and their relationship.

Uses medium-to-light pressure and other forms of touch depending on baby’s preferences.

Massage done by the parent.

Parents Need to Know:

Shows parents how to recognise

and understand their own baby’s

cues and body language.

Shows parents how to adapt and

adjust massage and touch in

response to their own baby’s

needs.

4

W h a t E v e r y P a r e n t S h o u l d K n o w :

I t i s S a f e s t t o L e a r n f r o m A T r a i n e d P e r s o n

Parents whose babies were

worse off had all learned baby

massage from a health

professional (nurse, social

worker, etc.) who did not

have any specific training in

baby massage education

Parents whose

babies were a lot

better off had learned

baby massage from

someone trained in

cue-based infant

massage

Some babies and parents were better-off after learning infant massage

Some babies and parents were worse-off after learning infant massage/

Based on the Evidence, Parents Need to Know:

Cue-based programs appear to be supported in the evidence as the best approach to learning infant massage.

Reviews of hundred of other studies (1, 2) confirm that doing a program with a health professional who has not been

formally trained in that particular program, can actually make things worse. Always carefully check the credentials of

someone who is teaching baby massage – even if they are a qualified health professional.

? No scientific studies have been conducted

to determine the safety or benefit of using

videos or online instructions to learn

baby massage.

In 2011, Medical Researchers from the University of Warwick conducted a study which compared the results of 8 different infant massage programs. The researchers were particularly interested in the impact of these programs on parent and infant mental health.

Parents whose babies

were the same - or a bit

better off – had learned

baby massage from an

instructor who trained in

rule-based infant

massage

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W h a t E v e r y P a r e n t S h o u l d K n o w :

Y o u a n d Y o u r B a b y B e l o n g T o g e t h e r While it might seem tempting to hand over the responsibility massage for your baby to someone who “knows all the strokes”, evidence shows there are no specific benefits of having a therapist massage your baby. In fact, many studies show that when someone “takes over” from you in this way, it can leave many parents with less confidence in themselves, which can have serious long-term consequences.

Based on the Evidence, Parents Need to Know:

Unless otherwise advised by a physiotherapist or occupational therapist for a physical condition your baby has; all of the evidence strongly

suggests the safest and most effective form of infant massage is done by parents with their own babies.

The safest and most effective way of learning massage is from someone who uses a doll to show you different techniques, rather than from

someone who likes to demonstrate directly on your baby.

Many studies have investigated the different ways

health professionals teach baby-care skills (such as

bathing, feeding, settling, nappy-changes...as well as

baby massage). These studies consistently find that

when a professional or educator

‘jumps in’ to do the baby-care

themselves* it can have many

negative effects on parents.

This style of “showing” parents

how to do things can often result

in long-term challenges in

parent-baby interactions,

development

and safety (1, 2, 3, 4, 5).

(*) these studies look at how professionals give information & education to parents, and how this impacts on parents &infant development. This is very different to having a trusted family member, friend, neighbour or volunteer help care for your baby when you are feeling tired or overwhelmed – which can be very beneficial! Please see the end of this book for where to get support or help if you need it

A S K I L L E D A N D S A F E baby massage educator will help

keep you and your baby

T O G E T H E R by using a

teaching doll to demonstrate different ways of

adapting massage and touch to

suit your own little person.

Plain and Simple!

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W h a t E v e r y P a r e n t S h o u l d K n o w :

P e r s o n a l F e e d b a c k i s I m p o r t a n t

Some baby massage programs and information sources only give you limited (or no) interaction with an Instructor. Others focus on getting the strokes “right”. Compared to these sorts programs, there are many studies showing that getting one-on-one support and feedback about how your baby uses cues and body language in response to your touch, is the key to getting good results from baby massage programs.

Based on the Evidence, Parents Need to Know:

Be a bit cautious of baby massage information that simply tells you to “stop massage if your baby doesn’t like it”. This is

not cue-based or evidence-based baby massage because it does not give you direct support you to see how your

own, individual baby uses lots of subtle ways to communicate when he or she has had enough.

Individualised support, is best given by a qualified Baby Massage Instructor who has been trained in observing and

understanding infant cues and in how to adapt touch in response to these cues.

In reviews of 100+ studies of parent-

baby programs, supporting parents to

understand their baby’s signals is a

KEY REQUIREMENT for positive infant development

outcomes (3, 4)

Best results are seen when parents are helped by

a baby massage instructor who is

TRAINED IN PARENT-INFANT OBSERVATION & who supports parents adjust massage and touch

to the individual personality and needs

of their own baby (2)

individualised feedback to parents about their own baby’s

cues and signals, helps improve

MENTAL HEALTH & COGNITIVE SKILLS for preterm babies (1, 2)

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W h a t E v e r y P a r e n t S h o u l d K n o w :

T i m i n g i s E v e r y t h i n g

You might already know that baby massage courses can run for anywhere between one and ten sessions. And there are dozens of videos claiming to show you how to do baby massage in anything from a few minutes through to an hour. But the research tells us a lot about how many sessions you need to give you the best results.

Based on the Evidence, Parents Need to Know:

An evidence-supported baby massage program will run for at least five face-to-face sessions.

Avoid programs that run for four or fewer sessions, as there is some evidence they may leave you open to

problems or risks.

A study looking at baby massage programs which were

the most safe & effective f o u n d

5 sess ions

was the minimum number needed

for parents to get the best results.

This finding is also supported numerous studies which consistently show that five seems to be the minimum number of sessions needed for most

parents & babies to benefit from parent-baby programs. Four or fewer sessions can, in fact, leave families open to more risks or problems (1, 2).

8

W h a t E v e r y P a r e n t S h o u l d K n o w :

S i x i s t h e M a g i c N u m b e r Most of the available research about infant massage education looks at learning infant massage in a group with other parents (rather than by yourself). One major study found there is an ideal group size for baby massage classes. This is one which is small enough to allow you to have lots of individualised support from the instructor, but big enough for you to meet and talk with some other new parents.

Based on the Evidence, Parents Need to Know:

Look for a baby massage program which officially limits the maximum number of families

attending to between 6 and 8 .

T h e s a m e s t u d y f r o m t h e W a r w i c k U n i v e r s i t y S c h o o l o f M e d i c i n e , c o m p a r i n g e i g h t d i f f e r e n t b a b y m a s s a g e p r o g r a m s , a l s o f o u n d :

6

8

9

Baby massage

programs with up to

six families attending

appeared to offer the

best quality

outcomes for

families. This was

particularly true when

parents were dealing

with extra struggles –

such as having a

baby who cried a lot,

or when the parent

was feeling

depressed.

Eight appeared to be the

maximum number of families

in a baby massage group that

had good quality outcomes.

Once group numbers got

to nine or more, the

benefits experienced by

parents and babies began

to decrease.

These “magic numbers” continue to be consistent

with research findings about many different sorts of

parent-baby programs (1, 2).

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W h a t E v e r y P a r e n t S h o u l d K n o w :

H o w Y o u & Y o u r B a b y F e e l M a t t e r s M o s t As we have seen so far, research studies can (and do) tell us a lot about what makes for “good quality” baby massage education and information for most families, in most situations. These are good sign-posts to look for. However, the best indicator of quality is how you feel about your experience of being taught baby massage, and how your own baby responds.

Based on Your Own Evidence, Parents Need to Know:

Answering “yes” to these questions is an important personal indicator of quality.

If you answer “no” to these questions, this may be your instincts (or your baby!) telling you

this is not the right sort of infant massage program for you – and you might be need to look

elsewhere.

Does the Instructor leave you feeling better about

yourself as a parent, and with a greater sense of

confidence in your own abilities?

Does your baby seem to enjoy the techniques your

are being shown? If not, does the instructor work with

you individually to find ways of adapting or changing

things until you find a way that suits your baby?

Do you feel welcome, respected, valued and

listened to by the instructor?

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W h a t E v e r y P a r e n t S h o u l d K n o w :

L e t C o m m o n S e n s e P r e v a i l Infant massage education is a form of health care education. And just like any other health or parenting service you use, you should look for all the typical indicators of quality.

Parents Need to Know:

Look for a baby massage instructor who is currently registered with an organisation that has all the “common

sense” characteristics of a good health care organisation.

Look for

a baby massage instructor who is

c u r r e n t l y r e g i s t e r e d with a specialist Association of Infant Massage.

Check that the organisation they are registered with has:

A clear Code of Conduct which its Baby Massage Instructors follow (see an example)

Requirements that their baby massage instructors have high-quality training in infant

massage (even if they are already a health professional with other qualifications).

Requirements that all of its educators keep up to date and participate in Ongoing Professional Development

An understandable Complaints Process (see an example).

Accreditation and Recognition from, and real partnerships with, other well-known

professional health care and parent-support organisations

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IAIM Australia maintains a directory of currently certified infant massage educators who deliver

infant massage education programs that meet the Association’s high quality standards.

The Australian Directory of Current Certified Infant Massage Instructors.

W h a t E v e r y P a r e n t S h o u l d K n o w :

F i n a l l y , I t H e l p s t o G e t H e l p

Feeling low, depressed or disconnected from your baby does not make you a “bad” parent –

it just means you might need a bit of extra help at this point in time. Don’t ignore the

signs...get in touch with one of the many organisations who can help. PANDA and

beyondblue have extensive directories of local services and resources to help you, your

baby and your family though depression or other low feelings, and to get out the other side.

If you feel worried that you might hurt yourself or your baby, or if you just need to talk

to someone, call Lifeline on 13 11 14

If you are worried or uncertain about some infant massage information or advice you have

been given, seen, read or watched, the International Association of Infant Massage Australia

may be able to advise you what you can do about your concerns. Please contact us on

support@iaim.org.au or on (02) 6262 4346

If you are feeling overwhelmed, exhausted or alone, you can get help:

MamaBake Groups meet regularly and provide practical support: “mother-to-mother.”

Your local Community Centre, Volunteer Centre or Child Health Nurse may know of a local

program where you can get a bit of extra help around the home.

If your baby was born prematurely or was hospitalised, The Miracle Babies Foundation will

provide invaluable support, information, resources and support.

Contact Playgroup Australia to see if any playgroups operate in your area.

Don’t forget to check with PANDA for local groups in your area supporting parents who are

feeling anxious, depressed or just generally a bit low.

Find an

infant

massage

program

Double-

check

Don’t do

it alone

Listen to

how you

feel...you

& your

baby are

worth it

?

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About IA IM Aust r a l ia Our goal at IAIM Australia is very simple: we want to give really good quality support

to parents so they can be confident in using nurturing touch and communication with

their babies.

We believe that when you are supported to use massage, touch, your voice ,

movement and many other forms of communication in a way that suits you & your

baby, the more empowered you will be as a parent to find your own way to give your

baby a loving, healthy and secure start in life.

We support parents by providing high-quality baby massage programs like The First

Touch Program. We also train health workers, teachers and parents how to deliver

this evidence-based program to families in their communities, neighbourhoods and

workplaces. All our work is underpinned by a core set of values that puts parents and

babies at the centre of everything we do.

If you have found this booklet helpful, please do consider... Passing it along or putting it on your website so that others may benefit

Making a tax-deductible donation to IAIM Australia so that we can continue our

life-changing work with families.

Becoming a supporter of IAIM Australia and receiving regular updates, news and

discounts.

IAIM Australia is a registered Children’s Charity,

Official Partner to the World Health Organisation Maternal, Newborn & Child Health Program and

Full Member of the Mental Health Council of Australia

Our vision is that, one day,

all children and parents will experience the lifelong benefits

that come from having early relationships

that are loving, healthy and secure.

www.iaim.org.au