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