Bonding is a matter of reciprocal interaction. It depends upon a parent stimulating the infant with appropriate cues or signals, which trigger a response in the baby. The infant’s cues or signals then trigger further involvement by the parent, including eye contact, smiling, speech sounds, and body movements. The baby or young child with developmental impairments or delays sometimes cannot respond in the ordinary manner to parental cues. Interactional synchrony thus may be inhibited, which can lead to the parent feeling out of touch with her child. In addition, parents of babies with special needs are often overwhelmed by all of the information they need to absorb, by the therapies they are expected to carry out, and by the double bind of grieving and celebrating a new baby at the same time.
Parents’ emotional reactions to the discovery of a special need in their child differ greatly. They can include confusion, guilt, anger, wishful thinking, depression, intellectualization, and acceptance. These natural feelings can overlap and recur as parent and child adjust to their life together and to each new stage of the baby’s development.
Infant massage can be wonderful bonding tool for parents and children with special needs. While physiological benefits to accrue, the focus and goal of infant massage is the interaction and connection of these two people. It is something you do with your child rather than to your child. It is not another therapy but an opportunity to share your love. A daily massage connects parent and baby in a way that no other type of interaction can match. Babies with special needs benefit from this intimacy even more than other babies. Because some avenues of communication may not be open to them, their parents ned to know them well; the way the body feels when tense or relaxed, the look and feel of the abdomen when gassy or not, the difference between pain and tension. Often such parents need to be acutely aware of their infants’ bodies because life-threatening infections can arise. A parent who is attuned to the look and feel of her baby’s body at all times will more likely be able to detect toxicity in the early stages.
Of course, I cannot tell you how to best use massage with your child in various challenging situations since there are too many types of challenges, and within those categories may different babies with varying needs. What I can do is give you some general information and hints to start with, so you can then approach your baby’s physician, occupational therapist, or physical therapist with a basic knowledge of infant massage.
Before beginning a massage routine with your baby, check with the baby’s door and therapists. They will help you design the massage and relaxation sequence to suit your baby’s needs. Then, trust yourself. You know your child better than anyone else. You are his or her specialist, and a companion in a way to one else ever can be.
Developmental challenges such as cerebral palsy manifest in many different ways. The child’s physical therapist will use procedures that either inhibit (relax) or facilitate (stimulate) muscle tone according to the child’s state. Inhibition lessens muscle tone for babies with stiff, tense, tight musculature. Facilitation increases muscle tone for “floppy” muscles.
Inhibitory techniques may include slow stroking, gentle shaking, positioning, rocking, and neutral warmth while facilitating techniques may include icing, brushing, positioning, pressure, and vibration. The massage strokes in my book Infant Massage, a Handbook for Loving Parents, can be modified to either inhibit or facilitate. To inhibit, use long, slow, sweeping strokes and Touch Relaxation. To facilitate, use a more vigorous stroking and more playful interactions such as bouncy rhymes and songs.
The massage can be delivered in the same sequence as the “regular” massage, with the following changes. Stroking the bottom of the foot often causes a reaction of extension and tightening of the leg. If this occurs, in “Under Toes,” “Ball of Foot,” and “Thumb Press,”changes the stroke so that pressure is exerted on the outside rather than on the balls of the feet. The “Thumbs to Sides” stroke on the tummy is particularly helpful in improving and stimulating diaphragmatic breathing. Babies with developmental challenges often show signs of resistance when the shoulders are stroked. For the chest, begin with “Resting Hands,” then try just one stroke, such as the “Butterly” stroke across the chest, which includes the shoulder, and gradually increase the number of strokes as the child’s stimulation threshold increases. For the face, the “Smile” strokes and lip closure promotes good swallowing. These are particularly good for babies who drool and breathe through the mouth. The facial massage is an excellent prelude to oral stimulation and feeding therapy for the child who is sensitive around the mouth. When doing the “Colic Relief Routine,” do not hold the knees against the stomach for more than a count of five, so as not to inhibit respiration.
Babies who are tactile defensive — that is, hypersensitive and reactive to skin contact — benefit from firm pressure and stroking. Warm baths and brisk rubbing with a terrycloth towel before massage can increase acceptance of skin-to-skin massage.
According to cerebral palsy experts, a slow, firm stroke down the center of the back can increase brain organization. Do not stroke up the back against hair growth.
If your baby has a shunt or other type of bypass, her physical therapist will be able to tell you how much pressure is appropriate and how to work around these areas, even if at first the only thing you can do is use the “Resting Hands” technique on another part of the body such as the legs.
If your baby has had surgery, you can use massage, holding techniques, and “Touch Relaxation” with other parts of his body, with the support of his physician. Your loving touch and the security of it can be very important to your baby’s recovery.
© 2015 Vimala McClure