WHY BABIES CRY AND HOW TO LISTEN

Babies cry for many reasons, and it is important to learn your baby’s personality and his or her different cries so that you can respond to them. There are cries that mean, “I need affection,” “I’m hungry,” “I’m in pain,” “I’m uncomfortable,” “I’m tired and cranky and don’t know how to get to sleep,” and still others that are simply “venting” all the stress the baby takes in, adjusting to the world of non-stop stimulation.

Each cry can and should be responded to appropriately. Each baby will differ in his or her need for physical affection. Some need to be held nearly all the time for the first months before crawling. Others are curious and independent almost immediately. To force an infant one way or another is to disempower her and disrupt the flow of chi she needs to become strong, healthy, and independent.

Some people think that babies who cry always need to be calmed and shushed, or, conversely, should be left alone to cry it out. Neither is true. Infants should never be left alone to cry, unheeded, but sometimes they need to cry in the safety of a parent’s arms, without being shushed, to discharge stress. After a certain period, when they sense they are being attended to, they calm and usually sleep much more deeply.

QUOTE 13_n

To be responsive to your baby, read up on the art of “Active Listening.” When you talk to your baby with a listening heart, he or she knows it and you can see the quality of their cries change. Locking with you eye-to-eye, you will see your baby moving her mouth as if trying to speak.

This is one of the most important reasons for pregnant women to massage their bellies, and to massage their infants regularly after birth. You learn, as nothing else can teach you, what your baby needs, and his cries and fusses don’t distress you so much as inform you of what you need to do to respond appropriately and thus allow your baby to grow and blossom like a well-tended flower in your garden.

My book, Infant Massage, a Handbook for Loving Parents, was the first, comprehensive book to introduce infant massage to the West. The nonprofit organization I founded in 1979, the International Association of Infant Massage (IAIM), has instructors in 71 countries. You can find an instructor and take a class — a great way to learn, have your questions answered, and be with other parents who value the crucial “fourth-trimester” bonding process.

CREATING A SAFE AND RESPONSIVE ENVIRONMENT FOR YOUR BABY

If you respond in the right way, you needn’t worry about when to wean, when to potty train, and all the other advice people want to give you. You will become an expert on your child, and you will naturally know and understand what she is ready to do and when. This gives you the confidence to listen to the experts and then go by your inner sense of what is right.

If you want to create a transition environment for your baby that imitates aspects of the in utero experience, you may want to get a baby pack that keeps your infant close to your body so he can hear your heartbeat and feel your warmth, your breathing, your rhythms.

BABY WEARING

Some pastel organza material draped over the cradle, can soften the light. Putting a warm cap on her head when going outdoors will prevent heat from escaping from her head. A baby monitor can help alert you to your baby’s sounds when she is sleeping and you are in another room. Other aids include a heartbeat simulator for the baby’s cradle and setting the volume low on your stereo or television.

SLEEPING TOGETHER

Some parents want to try family co-sleeping, which is a much-debated practice, particularly in the U.S. We practiced family co-sleeping until my youngest was around five years old. After doing a lot of research on this subject, I have concluded that the tales of accidental suffocation by “overlying” are real, but seem to be related to parents who co-sleep for convenience, who don’t take the precaution of removing any fluffy items from the bed, and/or they smoke.

When and if obstetricians and pediatricians give any information to new parents, co-sleeping is roundly discouraged. Unless expecting and new parents take the time to research the subject and 1) prepare, 2) find out what is the very best way for families to sleep together with a newborn, parents will be frightened and reject the notion, not realizing that sleeping together can reduce parental sleep deprivation and infant fussiness, irritability, and crying.

Dr. James McKenna, Director of the Center for Behavioral Studies of Mother-Infant Sleep at Notre Dame University says, “It is a curious fact that in Western societies the practice of mothers, fathers, and infants sleeping together came to be thought of as strange, unhealthy, and dangerous. Western parents are taught that ‘co-sleeping’ will make the infant to dependent on them, or risk accidental suffocation. Such views are not supported by human experience worldwide.”

FATHER SLEEPING

After having observed how families in India sleep together in a very small space, I wanted to do that with my family. This arrangement, in my experience, allowed me to breastfeed my babies without having to fully awaken. The warmth of my body, my heartbeat, and odor, was just right for them. We could respond quickly to cries, chokes, or other needs. The babies could nurse frequently, giving them more antibodies to fight disease and helping them transition from womb to room.

Dr. McKenna goes on to say, “Human infants need constant attention and contact with other human beings because they are unable to look after themselves. Unlike other mammals, they cannot keep themselves warm, move about, or feed themselves until relatively late in life. It is their extreme neurological immaturity at birth and slow maturation that makes the mother-infant relationship so important.”

Dr. John Medina, in his book Brain Rules for Baby, says, “During the attachment process, a baby’s brain intensely monitors the caregiving it receives. It is essentially asking such things as “Am I being touched? Am I being fed? Am I safe?” If the baby’s requirements are being fulfilled, the brain develops one way; if not, genetic instructions trigger it to develop in another way. It may be a bit disconcerting to realize, but infants have their parents’ behaviors in their sights virtually from the moment they come into this world. It is in their evolutionary best interests to do so, of course, which is another way of saying that they can’t help it. Babies have nowhere else to turn.”

One of my fondest memories is when we were sleeping with our little ones in a family bed. Once, in the middle of the night, my 18-month-old daughter awakened to nurse. She looked up into my face and patted my cheek. “I like you, Mommy, I like you,” she said, then closed her eyes to sleep with a sweet smile on her face. Every time I remember that moment my heart fills with love, joy, and gratitude that this child has come into my life. Now that she is an adult with her own little girl, I share these memories with her and it still has the effect of bringing us close.

Dr. McKenna agrees that these types of interaction are beneficial for both parents and infants. He says, “Studies have shown that separation of the mother and infant has adverse consequences. Anthropological considerations also suggest that separation between mother and infant should be minimal. Western societies must consider carefully how far and under what circumstances they want to push infants away from the loving and protective co-sleeping environment. Infants’ nutritional, emotional, and social needs, as well as maternal responses to them, have evolved in this environment for millennia.”

Often a baby’s crying can lead to and respond to marital discord. Dr. Medina goes on to say, “If the infant is marinated in safety— an emotionally stable home— the system will cook up beautifully. If not, normal stress-coping processes fail. The child is transformed into a state of high alert or a state of complete collapse. If the baby regularly experiences an angry, emotionally violent social environment, his vulnerable little stress responders turn hyper-reactive, a condition known as hyper-cortosolism. If the baby is exposed to severe neglect, like the Romanian orphans, the system becomes under-reactive, a condition known as hypo-cortisolism (hence, the blank stares). Life, to quote Bruce Springsteen, can seem like one long emergency.”

“Infants younger than 6 months old can usually detect that something is wrong. They can experience physiological changes— such as increases in blood pressure, heart rate, and stress hormones— just like adults. Some researchers claim they can assess the amount of fighting in a marriage simply by taking a 24-hour urine sample of the baby. Babies and small children don’t always understand the content of a fight, but they are very aware that something is wrong.”

Some parents reject co-sleeping because they are concerned about its impact on their sex lives. We found other rooms in the house suited quite nicely. This may not be an option everyone chooses, but I encourage you to read up on it before deciding. It can contribute immensely to the well-being of your whole family. My favorite book on the subject is The Family Bed by Tine Thevenin. I very much recommend Dr. Medina’s book, Brain Rules for Baby: How to Raise a Smart and Happy Child from Zero to Five.

Purchase Infant Massage, a Handbook for Loving Parents:
http://www.amazon.com/Vimala-Schneider-McClure-Infant-Massage–Revised/dp/B00N4EKZJK/ref=sr_1_2?s=books&ie=UTF8&qid=1438282581&sr=1-2&keywords=infant+massage+a+handbook+for+loving+parents+by+vimala+schneider+mcclure

Find an infant massage instructor in the U.S.:
http://www.infantmassageusa.org

The Importance of Skin Stimulation for Babies

Skin Stimulation Is Important for Mammals

Skin sensitivity is the earliest-developed and most fundamental functions of the body. Nurturing stimulation of the skin is, in fact, essential for adequate organic and psychological development, both for animals and for human beings. When asked what he thought of infant massage, anthropologist Ashley Montagu commented, “People don’t realize that communication for a baby, the first communications it receives and the first language of its development, is through the skin. If only most people had realized this they would have all along given babies the kind of skin stimulation they require.”

Behaviorally, mammals tend to fall into “cache” and “carry” types. The caching species leave their young for long periods while the mother gathers food. The infants must remain silent during those times so as not to attract predators, so they do not cry. For the same reason, they do not urinate unless stimulated by the mother. In addition, the young have internal mechanisms that control their body temperature. The mother’s milk is extremely high in protein and fat, and the infants suckle at a very fast rate.

In contrast, the carrying species maintain continuous contact with their infants and feed often. The babies suckle slowly, urinate often, cry when distressed or out of contact with the parent, and need the parent to keep them warm. The mother’s milk content is low in protein and fat, so infants need to suckle often. Humans are designed like the carrying species; in fact, human milk is identical in protein and fat content to that of the anthropoid apes, which are carrying species. Our infants need to be in close physical contact with us as much as possible.

No Colicky Kittens!

Physically, massage acts in much the same way in humans as licking does in animals. Animals lick their young and maintain close skin contact. Animal babies that are not licked, caressed, and permitted to cling in infancy grow up scrawny and more vulnerable to stress. They tend to fight with one another and to abuse and neglect their own young. Licking serves to stimulate the physiological systems and to bond the young with the mother. A mother cat spends more than 50 percent of her time licking her babies—and you will never see a colicky kitten! Without the kind of stimulation that helps their gastrointestinal system begin to function properly, newborn kittens die.

Scientists have seen behavior and responses in animals that parallel the growth and development of our own young, and these parallels are truly fascinating. In animals, the genitourinary tract will not function without the stimulation of frequent licking. Even the number of times a mother licks her young and the amount of time spent in each area are genetically determined.

Animals Benefit with Higher Immunity

When the infant mammal receives early skin stimulation, there is a highly beneficial influence on the immunological system. In one experiment, rats that were gently handled in infancy had a higher serum antibody standard in every case. More simply stated, these animals had a much greater ability to resist disease.

Equally important for our purposes was the behavior of these gentled rats. As Ashley Montagu wrote in Touching:
When handled, the gentled animals were relaxed and yielding. They were not easily frightened. . . . The researcher who had raised them . . . did so under conditions in which they were frequently handled, stroked, and had kindly sounds uttered to them, and they responded with fearlessness, friendliness, and a complete lack of neuromuscular tension or irritability. The exact opposite was true of the ungentled rats, who had received no attention whatever from human beings . . . these animals were frightened and bewildered, anxious and tense.

Among other important findings, rats that were gently handled for three weeks after weaning showed a faster weight gain than other rats under the same conditions, and those that were handled gently were physically much more resistant to the harmful effects of stress and deprivation.

In one study, rats with their thyroid and parathyroid glands (endocrine glands that regulate the immune system) removed responded remarkably to massage. In the experimental group, the rats were gently massaged and spoken to several times a day. They were relaxed, yielding, and not easily frightened, and their nervous systems remained stable. The control rats, which did not receive this type of care, were nervous, fearful, irritable, and enraged; they died within forty-eight hours. Another study with rats showed a higher immunity to disease, faster weight gain, and better neurological development among those that had been gently stroked in infancy.

Moving up the animal scale, dogs, horses, cows, dolphins, and many other animals have also shown remarkable differences when lovingly handled in infancy. The touch of the human hand improved the function of virtually all of the sustaining systems (respiratory, circulatory, digestive, eliminative, nervous, and endocrine) and increased “touchability,” gentleness, friendliness, and fearlessness. Writes Ashley Montagu: “The more we learn about the effects of cutaneous [skin] stimulation, the more pervasively significant for healthy development do we find it to be.”

Harry Harlow’s famous monkey experiments were the first to show that for infants, contact comfort is even more important than food. Infant monkeys were given the choice of a wire mother figure that provided food or a soft terry-cloth figure that did not provide food chose the terry-cloth mother figure. Human infants with failure-to-thrive syndrome exhibit the same type of behavior: though given all the food they need, they continue to deteriorate if they receive no intervention that involves emotional nurturing, contact comfort, and care.

In nearly every bird and mammal studied, close physical contact has been found to be essential both to the infant’s healthy survival and to the mother’s ability to nurture. In the previously mentioned studies with rats, if pregnant females were restrained from licking themselves (a form of self-massage), their mothering activities were substantially diminished. Additionally, when pregnant female animals were gently stroked every day, their offspring showed higher weight gain and reduced excitability, and the mothers showed greater interest in their offspring, with a more abundant and richer milk supply.

Skin Stimulation Is Important for Human Babies

Evidence supports the same conclusions for humans. Touching and handling her baby assists the new mother in milk production by helping stimulate secretion of prolactin, the “mothering hormone.” The process begun at the embryonic stage thus continues, allowing a natural unfolding of the baby’s potential within the safe and loving arms of his mother.
Nurturing stimulation of the skin—handling, cuddling, rocking, and massage—increases cardiac functions of the human infant. Massage stimulates the respiratory, circulatory, and gastrointestinal systems—benefits especially appreciated by the “colicky” baby and his parents.

A baby’s first experience with the surrounding environment occurs through touch, developing prenatally as early as sixteen weeks. Nature begins the massage before the baby is born. As opposed to the extremely short labors of most other animals, it has been suggested that a human mother’s extended labor helps make up for the lack of postpartum licking performed by other mammal mothers. For the human infant, the contractions of labor provide some of the same types of preparation for the functioning of his internal systems as early licking of the newborn does for other mammals.

Touch impacts short-term development during infancy and early childhood, and it has long-term effects as well. Through this contact, newborns are able to learn about their world, bond with their parents, and communicate their needs and wants. Eighty percent of a baby’s communication is expressed through body movement. When parents engage in appropriate touch, young children have an improved chance to successfully develop socially, emotionally, and intellectually.

Infants who experience more physical contact with parents demonstrate increased mental development in the first six months of life compared to young children who receive limited physical interaction. This improved cognitive development has been shown to last even after eight years, illustrating the importance of positive interactions. Infants who receive above-average levels of affection from their parents are shown to be less likely to be hostile, anxious, or emotionally distressed as adults.

Studies with premature babies using techniques similar to those taught in this book have demonstrated that daily massage is of tremendous benefit. Research projects at the University of Miami Medical Center, headed up by the Touch Research Institute’s founder, Dr. Tiffany Field, have shown remarkable results. In one study, twenty premature babies were massaged three times a day for fifteen minutes each time. They averaged 47 percent greater weight gain per day, were more active and alert, and showed more mature neurological development than infants who did not receive massage. In addition, their hospital stay averaged six days less. After many years of study and observation, the International Association of Infant Massage has established guidelines for using massage and holding techniques with premature babies.

Dallas psychologist Ruth Rice conducted a study with thirty premature babies after they had left the hospital. She divided them into two groups. The mothers in the control group were instructed in usual newborn care, while those in the experimental group were taught a daily massage and rocking regime. At four months of age, the babies who had been massaged were ahead in both neurological development and weight gain.

The natural sensory stimulation of massage speeds myelination of the nerves in the brain and the nervous system. The myelin sheath is a fatty covering around each nerve, like insulation around electrical wire. It protects the nervous system and speeds the transmission of impulses from the brain to the rest of the body. The process of coating the nerves is not complete at birth, but skin stimulation hastens the process, thus enhancing rapid neural-cell firing and improving brain-body communication.

In 1978 transcutaneous oxygen monitoring was developed, which enabled physicians to measure oxygen tension in the body through an electrode on the skin. It was discovered that hospitalized infants experienced tremendous upheavals in oxygen levels when subjected to stress. Touch Relaxation, holding techniques, and massage (as covered in my book Infant Massage: a Handbook for Loving Parents) have been found to mitigate these fluctuations, and these methods are being used in hospitals routinely now to help infants maintain a steady state through the stresses of diaper changes, heel sticks, and other intrusions.

New research demonstrates similar results every day, confirming what age-old tradition has told us: infants need loving touch. Lawrence Schachner, M.D., a professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami School of Medicine, advises that touch can benefit babies with skin disorders such as eczema. “It may furthermore improve parent-baby interaction,” he says. Dr. Tiffany Field concurs. She notes that loving touch triggers physiological changes that help infants grow and develop, stimulating nerves in the brain that facilitate food absorption and lowering stress hormone levels, resulting in improved immune system functioning. A report by the Families and Work Institute states that the vast majority of connections between brain cells are formed during the first three years of life. The report concludes that loving interaction such as massage can directly affect a child’s emotional development and ability to handle stress as an adult.

Loving skin contact and massage benefit mothers and fathers as well. In addition, research has shown that mothers whose pregnancies were filled with chronic stress often have babies who cry more and for longer periods than those whose pregnancies were peaceful and supported.
Men who make the effort to bond with their infants by giving the mother loving massages, talking and singing to the baby, feeling its movements in their partner’s belly, attending classes with their partner, and reading up on infant development and psychology tend to be more attentive and accomplished fathers.

Infant Massage, Bonding, Babywearing and Attachment

The Fourth Trimester

During my time of research in 1975-1976, I made many trips to the medical library, studying everything I could find regarding the effects of touch between parents and infants. I read through anatomy books and edited some of my massage routines, working with the babies’ internal organs.

For example, the tummy strokes follow the intestinal tract and colon, which helps strengthen these organs and they begin to do their work earlier than they might have; I discovered that many researchers and physicians called the first few months of life the “fourth trimester.” Newborns are helpless; they cannot get up and walk like many animals.

We are like kangaroos in this way; our babies need a few months more with the soothing touch of a parent’s massage, skin-to-skin contact, and carrying. Their gastrointestinal systems are not yet mature, and many infants experience “colic,” or painful gas and digestion. The elements of massage that help babies eliminate fecal matter and gas are the sweeping of palms down from rib cage to pelvis, and the clockwise strokes over the stomach that move trapped matter down and out.

Parent-Infant Bonding – A New Concept in 1976

In 1976, Dr.s Kennel and Klaus published their groundbreaking research on bonding. Their work inspired me so much, along with what I read in Montague’s research, I decided to massage my baby every day from the beginning. It was just the right timing — in our culture there was a kind of explosion of interest in, and acceptance of the importance of the elements of bonding and good birth practices. In September of 1976, I gave birth to my first child. I began massaging him, starting with the massage I had learned in India and gradually adding and revising strokes and the order of the strokes, and writing information that would become handouts in my classes later on. I took the notes that would be the foundation of my book, Infant Massage, a Handbook for Loving Parents

What is Bonding?

Bonding is a basic phenomenon that occurs throughout the universe. In terms of physics, it is established within the energy field from which particles arise. Two particles of energy brought into proximity spin and polarize identically, even when separated. Two living cells of a human heart brought into proximity begin to beat together. Throughout the animal kingdom and in human life as well, affectionate and tactile bonds between mother and young ensure healthy interaction and development for time to come. Proximity between parent and infant, via sensory experiences and loving interactions, brings them into an important synchrony with each other.

Imprinting

Animal researchers discovered imprinting long ago, when ethologist Konrad Lorenz showed that ducklings were biologically programmed to follow and bond with the first moving object they saw. Meanwhile, Harry Harlow and his associates studied monkeys and goats and found critical bonding times and elements that were important not only for the infant’s physical survival but for what we might call emotional health as well. Monkeys would abuse their infants if their own bonds as infants were disturbed.

In animals, the crucial period for bonding is usually a matter of minutes or hours after birth. The mother bonds with her infant through licking and touching, a type of massage, which in turn helps the infant to adjust physically to life outside the womb. If mother and infant are separated during this time and are subsequently reunited, the mother will often reject or neglect her young. As a result, the newborn may die for lack of the mother’s stimulation, even if fed by other means.  

The Elements of the Bonding Process

I was determined to include as many of the elements of bonding in our massage as possible: eye-to-eye contact, skin-to-skin contact, singing or humming to my baby, allowing natural odors, adding movements to maintain flexibility. The closeness of mother and baby allows the baby to smell the mother; a newborn baby can distinguish the smell of his or her mother from that of another mother. Parents can also recognize their baby from smell alone. Because of this important aspect of bonding, I decided to emphasize the use of unscented oil.

Resilience, as it relates to massage, is an indication of the quality of the bonding/attachment the baby develops with the parent or caregiver. It is through the elements of bonding that babies learn to be resilient, to bounce back from intense experiences.

MOMKISS2_m

The Difference Between Bonding and Attachment

In studies paralleling animal research, doctors John Kennell and Marshall Klaus, among others, have revealed that there is also a sensitive period for bonding in humans. The critical period seems less rigidly defined and may continue for months, even years, after childbirth. Another word often used in connection with bonding is attachment. While bonding is specific to birth and our connection with the animal kingdom, attachment happens over time and can occur between any two beings. 

Frank Bolton, in his book When Bonding Fails describes bonding as a one-directional process that begins in the biological mother during pregnancy and continues through birth and the first days of her baby’s life. Conversely, attachment is an interaction between parents and children, biological or not, that develops during the first year they are together and is reinforced throughout life. He describes it as the feeling that the other is “irreplaceable.”

Often these two terms are interchangeable, because in humans the bonding period is so loosely defined as to merge into the attachment process. Kennel and Klaus define bonding as “a unique relationship between two people that is specific and endures through time.” That definition could also apply to the word attachment.

Kennel and Klaus cited cuddling, kissing, and prolonged gazing as indicators of a developing bond. Dramatic evidence in their studies and others correlates the lack of early bonding and attachment with later abuse, neglect, and failure to thrive. Mothers who are separated from their babies during the newborn period are often more hesitant to learn and unskilled in basic mothering tasks. Even very short separations sometimes adversely affect the relationship between mothers and infants.

Lack of Bond Affects Babies in U.S.

Shockingly, new studies confirm that four out of ten babies born in the U.S. do not form a strong bond with either parent. In the early 70s, there was an upsurge of interest in birth and bonding, with parents choosing home births, rooming-in at hospital births, and learning infant massage and other things that brought parents and infants together. But unfortunately, that progress has decreased as time went on, in spite of the upsurge of programs like infant massage.

According to a study at Princeton University, 40 percent of infants in the U.S. live in fear or distrust of their parents, and that translates into aggressiveness, defiance and hyperactivity as they grow into adults. Of that number, 25 percent don’t bond with their parents because the parents aren’t responding to their needs. A tragic 14 percent find their parents so distressing that they avoid them whenever possible.

Sociologist Sophie Moullin of Princeton, lead author of the study, along with coauthors from Columbia University, analyzed more than 100 research projects, including data collected by a U.S. longitudinal study of 14,000 children born in 2001, to reach their conclusions. Yet critical, bonding, the researchers contend, is amazingly simple to achieve. The study notes,“When a parent responds to a child in a warm, sensitive and responsive way – picking up the child when he cries, and holding and reassuring him – the child feels secure that they can meet their needs.” 

Four Out of Ten Babies Do Not Form a Strong Bond

Incredibly, four out of ten infants born in the U.S. do not form a strong bond with either parent and, according to the authors of an article on the subject, “they will pay for that the rest of their lives.” Other research shows that simply touching, or caressing a newborn is critical to the infant’s sense of security. Infant massage, therefore, becomes an incredibly important art for parents to learn.

Usually it is the mother who is the central focus of studies like these, probably because the mother is often the main caregiver, especially in infancy. But a study at the University of Iowa two years ago concluded that “being attached to dad is just as helpful and being close to mom.” A similar study in 2012 from the Imperial College London found that fathers were especially important in helping the infant avoid behavioral problems later in life. If the father is remote or distracted, the child is more likely to be aggressive.

Infant Massage, Bonding, Babywearing and Attachment

The Fourth Trimester

During my time of research in 1975-1976, I made many trips to the medical library, studying everything I could find regarding the effects of touch between parents and infants. I read through anatomy books and edited some of my massage routine, working with the babies’ internal organs.

For example, the tummy strokes follow the intestinal tract and colon, which helps strengthen these organs and they begin to do their work earlier than they might have; I discovered that many researchers and physicians called the first few months of life the “fourth trimester.” Newborns are helpless; they cannot get up and walk like many animals.

We are like kangaroos in this way; our babies need a few months more with the soothing touch of a parent’s massage, skin-to-skin contact, and carrying. Their gastrointestinal systems are not yet mature, and many infants experience “colic,” or painful gas and digestion. The elements of massage that help babies eliminate fecal matter and gas are the sweeping of palms down from rib cage to pelvis, and the clockwise strokes over the stomach that move trapped matter down and out.

Parent-Infant Bonding – A New Concept in 1976

In 1976, Dr.s Kennel and Klaus published their groundbreaking research on bonding. Their work inspired me so much, along with what I read in Montague’s research, I decided to massage my baby every day from the beginning. It was just the right timing — in our culture there was a kind of explosion of interest in, and acceptance of the importance of the elements of bonding and good birth practices. In September of 1976, I gave birth to my first child. I began massaging him, starting with the massage I had learned in India and gradually adding and revising strokes and the order of the strokes, and writing information that would become handouts in my classes later on. I took the notes that would be the foundation of my book, Infant Massage, a Handbook for Loving Parents

What is Bonding?

Bonding is a basic phenomenon that occurs throughout the universe. In terms of physics, it is established within the energy field from which particles arise. Two particles of energy brought into proximity spin and polarize identically, even when separated. Two living cells of a human heart brought into proximity begin to beat together. Throughout the animal kingdom and in human life as well, affectionate and tactile bonds between mother and young ensure healthy interaction and development for time to come. Proximity between parent and infant, via sensory experiences and loving interactions, brings them into an important synchrony with each other.

Imprinting

Animal researchers discovered imprinting long ago, when ethologist Konrad Lorenz showed that ducklings were biologically programmed to follow and bond with the first moving object they saw. Meanwhile, Harry Harlow and his associates studied monkeys and goats and found critical bonding times and elements that were important not only for the infant’s physical survival but for what we might call emotional health as well. Monkeys would abuse their infants if their own bonds as infants were disturbed.

In animals, the crucial period for bonding is usually a matter of minutes or hours after birth. The mother bonds with her infant through licking and touching, a type of massage, which in turn helps the infant to adjust physically to life outside the womb. If mother and infant are separated during this time and are subsequently reunited, the mother will often reject or neglect her young. As a result, the newborn may die for lack of the mother’s stimulation, even if fed by other means.  

The Elements of the Bonding Process

I was determined to include as many of the elements of bonding in our massage as possible: eye-to-eye contact, skin-to-skin contact, singing or humming to my baby, allowing natural odors, adding movements to maintain flexibility. The closeness of mother and baby allows the baby to smell the mother; a newborn baby can distinguish the smell of his or her mother from that of another mother. Parents can also recognize their baby from smell alone. Because of this important aspect of bonding, I decided to emphasize the use of unscented oil.

Resilience, as it relates to massage, is an indication of the quality of the bonding/attachment the baby develops with the parent or caregiver. It is through the elements of bonding that babies learn to be resilient, to bounce back from intense experiences.

MOMKISS2_m

The Difference Between Bonding and Attachment

In studies paralleling animal research, doctors John Kennell and Marshall Klaus, among others, have revealed that there is also a sensitive period for bonding in humans. The critical period seems less rigidly defined and may continue for months, even years, after childbirth. Another word often used in connection with bonding is attachment. While bonding is specific to birth and our connection with the animal kingdom, attachment happens over time and can occur between any two beings. 

Frank Bolton, in his book When Bonding Fails describes bonding as a one-directional process that begins in the biological mother during pregnancy and continues through birth and the first days of her baby’s life. Conversely, attachment is an interaction between parents and children, biological or not, that develops during the first year they are together and is reinforced throughout life. He describes it as the feeling that the other is “irreplaceable.”

Often these two terms are interchangeable, because in humans the bonding period is so loosely defined as to merge into the attachment process. Kennel and Klaus define bonding as “a unique relationship between two people that is specific and endures through time.” That definition could also apply to the word attachment.

Kennel and Klaus cited cuddling, kissing, and prolonged gazing as indicators of a developing bond. Dramatic evidence in their studies and others correlates the lack of early bonding and attachment with later abuse, neglect, and failure to thrive. Mothers who are separated from their babies during the newborn period are often more hesitant to learn and unskilled in basic mothering tasks. Even very short separations sometimes adversely affect the relationship between mothers and infants.

Lack of Bond Affects Babies in U.S.

Shockingly, new studies confirm that four out of ten babies born in the U.S. do not form a strong bond with either parent. In the early 70s, there was an upsurge of interest in birth and bonding, with parents choosing home births, rooming-in at hospital births, and learning infant massage and other things that brought parents and infants together. But unfortunately, that progress has decreased as time went on, in spite of the upsurge of programs like infant massage.

According to a study at Princeton University, 40 percent of infants in the U.S. live in fear or distrust of their parents, and that translates into aggressiveness, defiance and hyperactivity as they grow into adults. Of that number, 25 percent don’t bond with their parents because the parents aren’t responding to their needs. A tragic 14 percent find their parents so distressing that they avoid them whenever possible.

Sociologist Sophie Moullin of Princeton, lead author of the study, along with coauthors from Columbia University, analyzed more than 100 research projects, including data collected by a U.S. longitudinal study of 14,000 children born in 2001, to reach their conclusions. Yet critical, bonding, the researchers contend, is amazingly simple to achieve. The study notes,“When a parent responds to a child in a warm, sensitive and responsive way – picking up the child when he cries, and holding and reassuring him – the child feels secure that they can meet their needs.” 

Four Out of Ten Babies Do Not Form a Strong Bond

Incredibly, four out of ten infants born in the U.S. do not form a strong bond with either parent and, according to the authors of an article on the subject, “they will pay for that the rest of their lives.” Other research shows that simply touching, or caressing a newborn is critical to the infant’s sense of security. Infant massage, therefore, becomes an incredibly important art for parents to learn.

Usually it is the mother who is the central focus of studies like these, probably because the mother is often the main caregiver, especially in infancy. But a study at the University of Iowa two years ago concluded that “being attached to dad is just as helpful and being close to mom.” A similar study in 2012 from the Imperial College London found that fathers were especially important in helping the infant avoid behavioral problems later in life. If the father is remote or distracted, the child is more likely to be aggressive.

THE EFFECTS OF BABY MASSAGE ON ATTACHMENT BETWEEN MOTHER AND THEIR INFANTS

A study was made from June 2008 to February 2010 in Turkey. There were 57 in the experimental group, 60 in the control group. Between the dates of the study, all healthy mothers giving birth for the first time and their healthy babies were included. Data were collected about their demographic characteristics and by using the Maternal Attachment Inventory (MAI). All mothers were assessed on the first and the last days of the 38-day study period. In the experimental group, the babies received a 15-minute massage therapy session everyday during the 38 days.

The MAI was developed to measure maternal affectionate attachment. This is the unique, affectionate relationship that develops between a woman and her infant. It persists over time, and is a key element of maternal adaptation (Muller, 1994). The MAI consists of 26 items representing maternal activities and feelings that indicate affection. Before development of the MAI, maternal affectionate attachment had been most frequently determined by observing the rate or pattern of maternal attachment behaviors (Muller). Observational measures, however, are time-consuming and generally difficult to apply in a clinical setting. In addition, there is little agreement that one behavior or group of behaviors constitutes evidence of maternal attachment. By direct measurement of mothers’ feelings through the MAI, these validity concerns in relation to interpreting mothers’ behaviors can be avoided. Although mothers’ feelings about their infants are not sufficient to define the complexity of mother–infant attachment, they are thought to be indicators of the probable presence of attachment.

For the study, massage techniques were a combination of effleurage and petrissage to the baby’s face, neck, shoulders, arms, chest, back, waist and legs. The effleurage consisted of smooth, long, rhythmic strokes up either side of the spine and out across the shoulders, with both hands working simultaneously, while the petrissage consisted of gentle kneading. Additionally, slow steady pressure was applied intermittently to the shoulders, neck, face, and lower back. All massages were demonstrated by the same trained person and mothers were advised to choose a moment when both she and her child are relaxed and calm; a half hour after the baby had eaten was recommended.

Baby massage education was given twice at the first home visit and the second home visit (15th day). The mother’s application of baby massage was observed at the second home visit and evaluated for correct technique. These babies received 15-minute massage sessions every day of the week for 38 days; the number of massage sessions are a minimum of 30 and a maximum of 38. The researcher followed a detailed visit-by-visit protocol to help women improve their health-related behaviors, the care of their baby, and observed the status of baby massage application. On the last day of the study, the MAI was filled out on the last home visit in the experimental group.

There was no significant difference found in the pretest mean value baseline of the MAI score in both groups. The posttest mean values of the MAI of the experimental group mothers were significantly higher than those of control group. There was a significant difference between groups. The results of the study have shown that baby massage is effective in increasing the mother–infant attachment.

When maternal attachment levels of experimental group mothers applying massage to their babies and control group mothers not applying massage to their babies were compared in posttest measurements, it was found that the maternal attachment of the group applying massage significantly higher. Maternal attachment of the control group also increased in the posttest measurement; however, this increase was very low when compared to the experimental group.

The relative youth of the mothers and the fact that they were undertaking the primary care of their first baby increased compliance with the study and attachment. This may explain the minor increase in maternal attachment behavior of mothers in the control group.

In Turkish culture, children are very precious and important. Women want to have a child as soon as they get married. If a woman does not have a baby, she is exposed to negative reactions from her husband and his family. Being a mother is very important, in particular, to have a male baby is extremely important. For this reason, it is expected that maternal attachment level naturally increases. The aim of this study was to determine how baby massage affects this increase. This result confirms the hypothesis of the study—baby massage strengthens the attachment between mother and baby. Most of the mothers in both groups were 26–35 years of age group, who are graduates of secondary school and not working. Traditionally, these women’s common goal is to get married and give birth to a child in the eastern part of Turkey. However, educated women have more roles than being a partner or a mother.

The first year of life is extremely important in terms of the baby’s psychological development. It is during this period, that the sense of basic trust is formed. The relationship between the mother and the baby has been the subject of several research studies (Muller-Nix et al., 2004; Zeanah, Borris, & Larrieu, 1997). Attachment is an emotional and expected condition between the mother and the baby that begins in the first days of life.

Attachment theory is an assessment of the response to the baby’s physical and emotional needs (Mills-Koonce et al., 2007). According to Mercer, maternal attachment begins during pregnancy and continues with delivery. Maternal attachment is a unique, tender loving relationship that develops between the mother and the baby; its consistency leads to the development of feelings of trust in the infant as a result. Postpartum attachment and care between the mother and the baby is important for the baby to lead a physical, spiritual, and emotional health in life.

Mothers have an important role as the primary caregiver. If the relationship between mother and baby is inadequate, the baby may have severe developmental and psychological problems (Brandt, Andrews, & Kvale, 1998). Attachment is therefore accepted as one of the fundamental processes in order to improve psychological development and to establish the baby’s relationship to the outside world (Wilson et al., 2000).

A healthy attachment is also of great importance in the determination of the baby’s character and habits. The first touches greatly strengthen attachment behavior (Kavlak & Şirin, 2007). The sense of touch is very important in the newborn period and infanthood for perceiving the environment. Proper stimulation of the baby’s sense of touch affects psychosocial development positively.

Massage is one of the easiest and most natural ways of establishing a sense of touch and eye contact which improves attachment between mothers and babies. The early contact between mother and her newborn gives confidence to the mother’s breastfeeding, in addition to developing the mother’s attachment behavior (Matthiesen, Ransjö-Arvidson, Nissen, & Uvnäs-Moberg, 2001).

Ferber et al. (2005) determined that mothers who applied massage to their premature infants achieved an easier interaction. Lee (2006) also reported that baby massage encourages the interaction between mother and baby. Moore and Anderson (2007) found that skin-to-skin contact between mother and infant affects the infants’ health, decreases their crying, and increases the mother–infant interaction. Onozawa, Glover, Adams, Modi, and Kumar (2001) reported that the mother–infant interaction was increased among those mothers who had performed massage on their infants.

In 2009, Kavlak and Şirin studied healthy babies and mothers to evaluate and determine validity and reliability of the Maternal Attachment Inventory (MAI) scale for the Turkish population. Moreover, Bal Yilmaz and Conk (2009) studied mothers who had 15-day-old healthy babies to investigate the effect of four months of massage application on sleep duration, growth and development of babies, and mothers’ anxiety levels. Bal Yılmaz and Conk reported that infants’ sleep duration was increased when their mothers spent more time with them and massaged them. In a study conducted with mothers who recently delivered healthy babies, İnal and Yıldız (2005) investigated the effect of massage applied for 6 months on the babies’ growth and mental-motor development. Inal and Yildiz found statistically significant results that infants who received massage gained more weight and increased their mental–motor development. In a study conducted with premature and low birthweight babies and their mothers, Sarıkaya Karabudak and Öztürk (2008) reported that regularly applied baby massage positively affected weight gain and the mental–motor development of babies.

Massage is one of the oldest forms of treatment in the world, having first been described in China during the second century B.C. and soon after in India and Egypt. Maternal attachment depends on two important factors; (a) interaction between mother and her baby and (b) sensual contact between them. Baby massage is the simplest and easiest way of communication, that makes contact between mother and her baby. In eastern Anatolia, Turkey, the families have many children. The mothers who live in this region generally avoid touching their babies. The main reasons are cold weather conditions, socioeconomic conditions, and swaddling. In addition, there is no work regarding the effects of massage on mother-infant attachment in Turkey up to now. For this reason, this work has been carried out to determine the applicability of baby massage in Turkish families and its effects on the level of maternal attachment. It is of note that the Turkish edition of Infant Massage, a Handbook for Loving Parents (Vimala McClure, Bantam/Random House, NY) has been in production in 2018.

Infant massage for primary caregivers and high-risk babies is now used more often. It is reported that massage regulates the baby’s sleep, respiration and urinary requirements; decreases colic and stress; and affects mother–infant interaction in a positive way. Studies have determined that mothers giving massage to premature babies have more interaction with their babies. In their studies, Moore and Anderson (2007) found that skin-to-skin contact between the mother and the baby in the early period affected the health status of baby, decreased crying and increased mother–infant interaction.

Infant massage is a simple, cheap and effective technique supporting infant development. It is accepted as a new practice that is gradually gaining popularity by being applicable to both the babies and their mothers; it can be performed independently. However, many mothers do not know that they can communicate with their babies by touch as they think that they may easily hurt their babies. Those mothers should be instructed by using various interactive methods such as tactile, visual, auditory contact. For those families who cannot have direct early contact with their baby for various reasons, nurses should advise them that this situation would not directly cause a problem. Their concerns should be alleviated because although early contact is a factor that strengthens attachment development, it is not an essential prerequisite.

The effects of massage in terms of mother–infant attachment and other general benefits for baby health should be considered; all medical personnel, especially nurses, should encourage mothers to apply massage to their babies. Encouraging the use of massage provides an important contribution to healthy babies. In the literature, the effects of baby massage on the maternal attachment levels in mothers with healthy infants and weight gain of preterm infants have been investigated. Mothers with babies who were born prematurely or had some defects or illness, have more risk of attachment deprivation. Accordingly, it might be suggested that nurses include baby massage among the routines of mother and baby care in both healthy and ill babies, and that facilitating baby massage and mother–infant attachment should be included in the internal training given to neonatal nurses as well as providing counseling to the mothers in this regard.

Infant Massage, Bonding, Babywearing and Attachment

The Fourth Trimester

During my time of research in 1975-1976, I made many trips to the medical library, studying everything I could find regarding the effects of touch between parents and infants. I read through anatomy books and edited some of my massage routine, working with the babies’ internal organs.

For example, the tummy strokes follow the intestinal tract and colon, which helps strengthen these organs and they begin to do their work earlier than they might have; I discovered that many researchers and physicians called the first few months of life the “fourth trimester.” Newborns are helpless; they cannot get up and walk like many animals.

We are like kangaroos in this way; our babies need a few months more with the soothing touch of a parent’s massage, skin-to-skin contact, and carrying. Their gastrointestinal systems are not yet mature, and many infants experience “colic,” or painful gas and digestion. The elements of massage that help babies eliminate fecal matter and gas are the sweeping of palms down from rib cage to pelvis, and the clockwise strokes over the stomach that move trapped matter down and out.

Parent-Infant Bonding – A New Concept in 1976

In 1976, Dr.s Kennel and Klaus published their groundbreaking research on bonding. Their work inspired me so much, along with what I read in Montague’s research, I decided to massage my baby every day from the beginning. It was just the right timing — in our culture there was a kind of explosion of interest in, and acceptance of the importance of the elements of bonding and good birth practices. In September of 1976, I gave birth to my first child. I began massaging him, starting with the massage I had learned in India and gradually adding and revising strokes and the order of the strokes, and writing information that would become handouts in my classes later on. I took the notes that would be the foundation of my book, Infant Massage, a Handbook for Loving Parents

What is Bonding?

Bonding is a basic phenomenon that occurs throughout the universe. In terms of physics, it is established within the energy field from which particles arise. Two particles of energy brought into proximity spin and polarize identically, even when separated. Two living cells of a human heart brought into proximity begin to beat together. Throughout the animal kingdom and in human life as well, affectionate and tactile bonds between mother and young ensure healthy interaction and development for time to come. Proximity between parent and infant, via sensory experiences and loving interactions, brings them into an important synchrony with each other.

Imprinting

Animal researchers discovered imprinting long ago, when ethologist Konrad Lorenz showed that ducklings were biologically programmed to follow and bond with the first moving object they saw. Meanwhile, Harry Harlow and his associates studied monkeys and goats and found critical bonding times and elements that were important not only for the infant’s physical survival but for what we might call emotional health as well. Monkeys would abuse their infants if their own bonds as infants were disturbed.

In animals, the crucial period for bonding is usually a matter of minutes or hours after birth. The mother bonds with her infant through licking and touching, a type of massage, which in turn helps the infant to adjust physically to life outside the womb. If mother and infant are separated during this time and are subsequently reunited, the mother will often reject or neglect her young. As a result, the newborn may die for lack of the mother’s stimulation, even if fed by other means.  

The Elements of the Bonding Process

I was determined to include as many of the elements of bonding in our massage as possible: eye-to-eye contact, skin-to-skin contact, singing or humming to my baby, allowing natural odors, adding movements to maintain flexibility. The closeness of mother and baby allows the baby to smell the mother; a newborn baby can distinguish the smell of his or her mother from that of another mother. Parents can also recognize their baby from smell alone. Because of this important aspect of bonding, I decided to emphasize the use of unscented oil.

Resilience, as it relates to massage, is an indication of the quality of the bonding/attachment the baby develops with the parent or caregiver. It is through the elements of bonding that babies learn to be resilient, to bounce back from intense experiences.

MOMKISS2_m

The Difference Between Bonding and Attachment

In studies paralleling animal research, doctors John Kennell and Marshall Klaus, among others, have revealed that there is also a sensitive period for bonding in humans. The critical period seems less rigidly defined and may continue for months, even years, after childbirth. Another word often used in connection with bonding is attachment. While bonding is specific to birth and our connection with the animal kingdom, attachment happens over time and can occur between any two beings. 

Frank Bolton, in his book When Bonding Fails describes bonding as a one-directional process that begins in the biological mother during pregnancy and continues through birth and the first days of her baby’s life. Conversely, attachment is an interaction between parents and children, biological or not, that develops during the first year they are together and is reinforced throughout life. He describes it as the feeling that the other is “irreplaceable.”

Often these two terms are interchangeable, because in humans the bonding period is so loosely defined as to merge into the attachment process. Kennel and Klaus define bonding as “a unique relationship between two people that is specific and endures through time.” That definition could also apply to the word attachment.

Kennel and Klaus cited cuddling, kissing, and prolonged gazing as indicators of a developing bond. Dramatic evidence in their studies and others correlates the lack of early bonding and attachment with later abuse, neglect, and failure to thrive. Mothers who are separated from their babies during the newborn period are often more hesitant to learn and unskilled in basic mothering tasks. Even very short separations sometimes adversely affect the relationship between mothers and infants.

Lack of Bond Affects Babies in U.S.

Shockingly, new studies confirm that four out of ten babies born in the U.S. do not form a strong bond with either parent. In the early 70s, there was an upsurge of interest in birth and bonding, with parents choosing home births, rooming-in at hospital births, and learning infant massage and other things that brought parents and infants together. But unfortunately, that progress has decreased as time went on, in spite of the upsurge of programs like infant massage.

According to a study at Princeton University, 40 percent of infants in the U.S. live in fear or distrust of their parents, and that translates into aggressiveness, defiance and hyperactivity as they grow into adults. Of that number, 25 percent don’t bond with their parents because the parents aren’t responding to their needs. A tragic 14 percent find their parents so distressing that they avoid them whenever possible.

Sociologist Sophie Moullin of Princeton, lead author of the study, along with coauthors from Columbia University, analyzed more than 100 research projects, including data collected by a U.S. longitudinal study of 14,000 children born in 2001, to reach their conclusions. Yet critical, bonding, the researchers contend, is amazingly simple to achieve. The study notes,“When a parent responds to a child in a warm, sensitive and responsive way – picking up the child when he cries, and holding and reassuring him – the child feels secure that they can meet their needs.” 

Four Out of Ten Babies Do Not Form a Strong Bond

Incredibly, four out of ten infants born in the U.S. do not form a strong bond with either parent and, according to the authors of an article on the subject, “they will pay for that the rest of their lives.” Other research shows that simply touching, or caressing a newborn is critical to the infant’s sense of security. Infant massage, therefore, becomes an incredibly important art for parents to learn.

Usually it is the mother who is the central focus of studies like these, probably because the mother is often the main caregiver, especially in infancy. But a study at the University of Iowa two years ago concluded that “being attached to dad is just as helpful and being close to mom.” A similar study in 2012 from the Imperial College London found that fathers were especially important in helping the infant avoid behavioral problems later in life. If the father is remote or distracted, the child is more likely to be aggressive.

WHY BABIES CRY AND HOW TO LISTEN

Babies cry for many reasons, and it is important to learn your baby’s personality and his or her different cries so that you can respond to them. There are cries that mean, “I need affection,” “I’m hungry,” “I’m in pain,” “I’m uncomfortable,” “I’m tired and cranky and don’t know how to get to sleep,” and still others that are simply “venting” all the stress the baby takes in, adjusting to the world of non-stop stimulation.

Each cry can and should be responded to appropriately. Each baby will differ in his or her need for physical affection. Some need to be held nearly all the time for the first months before crawling. Others are curious and independent almost immediately. To force an infant one way or another is to disempower her and disrupt the flow of chi she needs to become strong, healthy, and independent.

Some people think that babies who cry always need to be calmed and shushed, or, conversely, should be left alone to cry it out. Neither is true. Infants should never be left alone to cry, unheeded, but sometimes they need to cry in the safety of a parent’s arms, without being shushed, to discharge stress. After a certain period, when they sense they are being attended to, they calm and usually sleep much more deeply.

QUOTE 13_n

To be responsive to your baby, read up on the art of “Active Listening.” When you talk to your baby with a listening heart, he or she knows it and you can see the quality of their cries change. Locking with you eye-to-eye, you will see your baby moving her mouth as if trying to speak.

This is one of the most important reasons for pregnant women to massage their bellies, and to massage their infants regularly after birth. You learn, as nothing else can teach you, what your baby needs, and his cries and fusses don’t distress you so much as inform you of what you need to do to respond appropriately and thus allow your baby to grow and blossom like a well-tended flower in your garden.

My book, Infant Massage, a Handbook for Loving Parents, was the first, comprehensive book to introduce infant massage to the West. The nonprofit organization I founded in 1979, the International Association of Infant Massage (IAIM), has instructors in 71 countries. You can find an instructor and take a class — a great way to learn, have your questions answered, and be with other parents who value the crucial “fourth trimester” bonding process.

CREATING A SAFE AND RESPONSIVE ENVIRONMENT FOR YOUR BABY

If you respond in the right way, you needn’t worry about when to wean, when to potty train, and all the other advice people want to give you. You will become an expert on your child, and you will naturally know and understand what she is ready to do and when. This gives you the confidence to listen to the experts and then go by your inner sense of what is right.

If you want to create a transition environment for your baby that imitates aspects of the in utero experience, you may want to get a baby pack that keeps your infant close to your body so he can hear your heartbeat and feel your warmth, your breathing, your rhythms.

BABY WEARING

Some pastel organza material, draped over the cradle, can soften the light. Putting a warm cap on her head when going outdoors will prevent heat from escaping from her head. A baby monitor can help alert you to your baby’s sounds when she is sleeping and you are in another room. Other aids include a heartbeat simulator for the baby’s cradle and setting the volume low on your stereo or television.

SLEEPING TOGETHER

Some parents want to try family co-sleeping, which is a much debated practice, particularly in the U.S. We practiced family co-sleeping until my youngest was around five years old. After doing a lot of research on this subject, I have concluded that the tales of accidental suffocation by “overlying” are real, but seem to be related to parents who co-sleep for convenience, who don’t take the precaution of removing any fluffy items from the bed, and/or they smoke.

When and if obstetricians and pediatricians give any information to new parents, co-sleeping is roundly discouraged. Unless expecting and new parents take the time to research the subject and 1) prepare, 2) find out what is the very best way for families to sleep together with a newborn, parents will be frightened and reject the notion, not realizing that sleeping together can reduce parental sleep deprivation and infant fussiness, irritability, and crying.

Dr. James McKenna, Director of the Center for Behavioral Studies of Mother-Infant Sleep at Notre Dame University says, “It is a curious fact that in Western societies the practice of mothers, fathers, and infants sleeping together came to be thought of as strange, unhealthy, and dangerous. Western parents are taught that ‘co-sleeping’ will make the infant to dependent on them, or risk accidental suffocation. Such views are not supported by human experience worldwide.”

FATHER SLEEPING

After having observed how families in India sleep together in a very small space, I wanted to do that with my family. This arrangement, in my experience, allowed me to breastfeed my babies without having to fully awaken. The warmth of my body, my heartbeat and odor, was just right for them. We could respond quickly to cries, chokes, or other needs. The babies could nurse frequently, giving them more antibodies to fight disease and helping them transition from womb to room.

Dr. McKenna goes on to say, “Human infants need constant attention and contact with other human beings because they are unable to look after themselves. Unlike other mammals, they cannot keep themselves warm, move about, or feed themselves until relatively late in life. It is their extreme neurological immaturity at birth and slow maturation that makes the mother-infant relationship so important.”

Dr. John Medina, in his book Brain Rules for Baby, says, “During the attachment process, a baby’s brain intensely monitors the caregiving it receives. It is essentially asking such things as “Am I being touched? Am I being fed? Am I safe?” If the baby’s requirements are being fulfilled, the brain develops one way; if not, genetic instructions trigger it to develop in another way. It may be a bit disconcerting to realize, but infants have their parents’ behaviors in their sights virtually from the moment they come into this world. It is in their evolutionary best interests to do so, of course, which is another way of saying that they can’t help it. Babies have nowhere else to turn.”

One of my fondest memories is when we were sleeping with our little ones in a family bed. Once, in the middle of the night, my 18-month-old daughter awakened to nurse. She looked up into my face and patted my cheek. “I like you, Mommy, I like you,” she said, then closed her eyes to sleep with a sweet smile on her face. Every time I remember that moment my heart fills with love, joy, and gratitude that this child has come into my life. Now that she is an adult with her own little girl, I share these memories with her and it still has the effect of bringing us close.

Dr. McKenna agrees that this types of interaction is beneficial for both parents and infants. He says, “Studies have shown that separation of the mother and infant has adverse consequences. Anthropological considerations also suggest that separation between mother and infant should be minimal. Western societies must consider carefully how far and under what circumstances they want to push infants away from the loving and protective co-sleeping environment. Infants’ nutritional, emotional, and social needs as well as maternal responses to them have evolved in this environment for millennia.”

Often a baby’s crying can lead to and respond to marital discord. Dr. Medina goes on to say, “If the infant is marinated in safety— an emotionally stable home— the system will cook up beautifully. If not, normal stress-coping processes fail. The child is transformed into a state of high alert or a state of complete collapse. If the baby regularly experiences an angry, emotionally violent social environment, his vulnerable little stress responders turn hyper-reactive, a condition known as hyper-cortosolism. If the baby is exposed to severe neglect, like the Romanian orphans, the system becomes under-reactive, a condition known as hypo-cortisolism (hence, the blank stares). Life, to quote Bruce Springsteen, can seem like one long emergency.”

“Infants younger than 6 months old can usually detect that something is wrong. They can experience physiological changes— such as increases in blood pressure, heart rate, and stress hormones— just like adults. Some researchers claim they can assess the amount of fighting in a marriage simply by taking a 24-hour urine sample of the baby. Babies and small children don’t always understand the content of a fight, but they are very aware that something is wrong.”

Some parents reject co-sleeping because they are concerned about its impact on their sex lives. We found other rooms in the house suited quite nicely. This may not be an option everyone chooses, but I encourage you to read up on it before deciding. It can contribute immensely to the well-being of your whole family. My favorite book on the subject is The Family Bed by Tine Thevenin. I very much recommend Dr. Medina’s book, Brain Rules for Baby: How to Raise a Smart and Happy Child from Zero to Five.

Purchase Infant Massage, a Handbook for Loving Parents:
http://www.amazon.com/Vimala-Schneider-McClure-Infant-Massage–Revised/dp/B00N4EKZJK/ref=sr_1_2?s=books&ie=UTF8&qid=1438282581&sr=1-2&keywords=infant+massage+a+handbook+for+loving+parents+by+vimala+schneider+mcclure

Find an infant massage instructor in the U.S.:
http://www.infantmassageusa.org

 

INFANT MASSAGE: STRESS AND RELAXATION

Infant massage is one tool we have to help reshape our child’s interpretations of the world, to release her pain, grief, and fear, and to open her up to love and joy.

Touch meets a baby’s needs for physical contact, affection, security, stimulation, and movement. Skin-to-skin contact is especially effective, such as during breastfeeding, bathing, or massage. Carrying or babywearing also meets this need while on the go. Hugs, snuggling, back rubs, massage, and physical play help meet this need in older children.

In our great-grandmothers’ day, when a baby developed a fever, the outcome was uncertain. Each century’s children have been plagued with some debilitating disease. Though many contagions have been eliminated through improved environmental conditions and medicine, our century is characterized by a more subtle and insidious malady — stress.

Stress can begin to affect a baby even before he is born. The levels of stress hormones that are constantly present in a woman’s bloodstream directly affect her unborn infant, crossing the placenta to enter his own bloodstream. Studies have shown that prolonged tension and anxiety can hamper a pregnant woman’s ability to absorb nourishment. Her baby may be of low birth weight, hyperactive, and irritable.

If we understand that our experiences and reactions influence our own biochemistry by sending life-enhancing or fear-producing chemicals throughout our bodies, it is not difficult to understand that these chemicals are also sent through our unborn baby’s body. Her cells receive this “information” and program her structure accordingly. Thus, even before birth, a baby can unconsciously perceive the world as a place of anxiety and stress, to fight or be victimized by, or a place of safety and love, to enjoy and fully experience. This is not to say all is lost if life circumstances are less than perfect. Infant massage is one tool we have to help reshape our child’s interpretations of the world, to release her pain, grief, and fear, and to open her up to love and joy. As we evolve to be more conscious beings, we understand more deeply how important our mental states are, both to our own health and longevity and to our children’s health, longevity, intelligence, and ability to experience and give love and joy.

Babies born centuries ago in more primitive cultures had the advantage of extended families, natural environments, and relatively little change. Our children, born into a rapidly advancing technological world, must effectively handle stress if they are to survive and prosper. Thus must give them every opportunity, from conception on, to learn positive, adaptive responses to stress and to believe in their own power and adaptability.

We certainly cannot eliminate stress, nor would we wish to, for in the proper doses it is an essential component in the growth of intelligence. Let’s see how this works. In times of stress, the pituitary gland produces a hormone called ACTH (adrenocorticotropic hormone), which activates the adrenal steroids, organizing the body and brain to deal with an unknown or unpredictable emergency. In experiments with laboratory animals, this hormone has been found to stimulate the production of many new proteins in the liver and brain — proteins that are instrumental in both learning and memory. On being given ACTH, the animals’ brains grow millions of new connecting links between the neurons (thinking cells). These links enable the brain to process information.

The stress of meeting unknown situations and converting them into what is known and predictable is essential for our babies’ brain development. But stress is only part of the cycle that enhances learning. Without its equally important opposite — relaxation — stress can lead to overstimulation, exhaustion, and shock. When stress piles upon stress without the relief of an equal portion of relaxation, the body begins to shut out all sensory intake and the learning process is completely blocked. As neuroscientist Bruce Lipton described, between the two choices — protection-related or growth-promoting — protection-related biological behaviors kick in, thus preventing growth or learning.

How does this apply to infant massage? First, massage is one way we can provide our children with relaxing, joyful experiences. Through the use of conditioned response techniques similar to those developed for childbirth by Lamaze and others, we can teach our babies how to relax their bodies in response to stress. The ability to relax consciously is a tremendous advantage in coping with the pressures of growing up in modern society. If acquired early in life, the realization response can become as much a part of our children’s natural system as the antibodies that protect them from disease.

Stress is a natural part of an infant’s life, but often our babies are not able to benefit from it as much as they could. Our fast-paced society overloads them with input, but it is unacceptable for them to cry to release tension. This double bind leads to many frustrated babies with a lot of pent-up tension and anxiety.

Massage helps babies practice handling input and responding to it with relaxation. Watch an experienced mother massaging her baby. You will see both stress and relaxation in the rhythmic strokes and in the baby’s reactions. The infant experiences all kinds of new sensations, feelings, odors, sounds, and sights. The rumbles of his tummy, the warm sensation of increased circulation, the movement of air on his bare skin — all are mildly stressful to him. The pleasant tone of his mother’s voice, her smile and her touch are relaxing and relieve the discomfort of encountering these new sensations. The reassures him that the world outside the womb is, as Dr. Frederick Laborers says, “still alive, and warm, and beating, and friendly.”

A daily massage gradually raises an infant’s stimulation threshold. Babies who have difficulty handling stimulation gradually build tolerance. High-need babies begin to learn to regulate the manner in which they respond to stressful experiences, which reduces the level of tension they develop throughout the day. Colicky babies are calmed and able to relax their bodies so that tension doesn’t escalate their discomfort. A regular massage provides our babies with an early stress management program that will be valuable to them in years to come.

INTO ADULTHOOD

Psychologists study the types of attachments we form in our infant as predictors of the types of relationships we will have as adults. People whose infancy was secure, who were held and listened to, who had good eye contact with their parents, and who were generally cherished tend to have healthier relationships with others. Getting close to others is easy, and they have no problem with interdependency (the ability to depend on and be depended on, appropriately). They have happy, trusting relationships; their romances last the longest and end in divorce the least often of groups studied. On the other hand, babies whose attachment bonds are insecure or anxious are later less sympathetic to others and less effective in getting support and help from other people. Their relationships lack trust and intimacy; jealousy and commitment problems and fears undermine friendships as well as marriages. People whose bonds are constantly broken in infancy have a much greater risk of becoming sociopathic criminals in their adulthood unless they receive serious intervention at an early stage.

The bonds of trust and love, the lessons of compassion, warmth, openness, and respect that are inherent in the massage routine will be carried by your child into adulthood. Especially if your parenting practices reflect the same values of infant massage, your child will be more likely to respond to others with compassion and altruism and to experience life as a joyful adventure in which he has the opportunity to love and be loved — to help others and extend himself in genuine service to humanity.

© 2019 Vimala McClure

The Importance of Skin Stimulation for Babies

Skin Stimulation Is Important for Mammals

Skin sensitivity is the earliest-developed and most fundamental functions of the body. Nurturing stimulation of the skin is, in fact, essential for adequate organic and psychological development, both for animals and for human beings. When asked what he thought of infant massage, anthropologist Ashley Montagu commented, “People don’t realize that communication for a baby, the first communications it receives and the first language of its development, is through the skin. If only most people had realized this they would have all along given babies the kind of skin stimulation they require.”

Behaviorally, mammals tend to fall into “cache” and “carry” types. The caching species leave their young for long periods while the mother gathers food. The infants must remain silent during those times so as not to attract predators, so they do not cry. For the same reason, they do not urinate unless stimulated by the mother. In addition, the young have internal mechanisms that control their body temperature. The mother’s milk is extremely high in protein and fat, and the infants suckle at a very fast rate.

In contrast, the carrying species maintain continuous contact with their infants and feed often. The babies suckle slowly, urinate often, cry when distressed or out of contact with the parent, and need the parent to keep them warm. The mother’s milk content is low in protein and fat, so infants need to suckle often. Humans are designed like the carrying species; in fact, human milk is identical in protein and fat content to that of the anthropoid apes, which are carrying species. Our infants need to be in close physical contact with us as much as possible.

No Colicky Kittens!

Physically, massage acts in much the same way in humans as licking does in animals. Animals lick their young and maintain close skin contact. Animal babies that are not licked, caressed, and permitted to cling in infancy grow up scrawny and more vulnerable to stress. They tend to fight with one another and to abuse and neglect their own young. Licking serves to stimulate the physiological systems and to bond the young with the mother. A mother cat spends more than 50 percent of her time licking her babies—and you will never see a colicky kitten! Without the kind of stimulation that helps their gastrointestinal system begin to function properly, newborn kittens die.

Scientists have seen behavior and responses in animals that parallel the growth and development of our own young, and these parallels are truly fascinating. In animals, the genitourinary tract will not function without the stimulation of frequent licking. Even the number of times a mother licks her young and the amount of time spent in each area are genetically determined.

Animals Benefit with Higher Immunity

When the infant mammal receives early skin stimulation, there is a highly beneficial influence on the immunological system. In one experiment, rats that were gently handled in infancy had a higher serum antibody standard in every case. More simply stated, these animals had a much greater ability to resist disease.

Equally important for our purposes was the behavior of these gentled rats. As Ashley Montagu wrote in Touching:
When handled, the gentled animals were relaxed and yielding. They were not easily frightened. . . . The researcher who had raised them . . . did so under conditions in which they were frequently handled, stroked, and had kindly sounds uttered to them, and they responded with fearlessness, friendliness, and a complete lack of neuromuscular tension or irritability. The exact opposite was true of the ungentled rats, who had received no attention whatever from human beings . . . these animals were frightened and bewildered, anxious and tense.

Among other important findings, rats that were gently handled for three weeks after weaning showed a faster weight gain than other rats under the same conditions, and those that were handled gently were physically much more resistant to the harmful effects of stress and deprivation.

In one study, rats with their thyroid and parathyroid glands (endocrine glands that regulate the immune system) removed responded remarkably to massage. In the experimental group, the rats were gently massaged and spoken to several times a day. They were relaxed, yielding, and not easily frightened, and their nervous systems remained stable. The control rats, which did not receive this type of care, were nervous, fearful, irritable, and enraged; they died within forty-eight hours. Another study with rats showed a higher immunity to disease, faster weight gain, and better neurological development among those that had been gently stroked in infancy.

Moving up the animal scale, dogs, horses, cows, dolphins, and many other animals have also shown remarkable differences when lovingly handled in infancy. The touch of the human hand improved the function of virtually all of the sustaining systems (respiratory, circulatory, digestive, eliminative, nervous, and endocrine) and increased “touchability,” gentleness, friendliness, and fearlessness. Writes Ashley Montagu: “The more we learn about the effects of cutaneous [skin] stimulation, the more pervasively significant for healthy development do we find it to be.”

Harry Harlow’s famous monkey experiments were the first to show that for infants, contact comfort is even more important than food. Infant monkeys were given the choice of a wire mother figure that provided food or a soft terry-cloth figure that did not provide food chose the terry-cloth mother figure. Human infants with failure-to-thrive syndrome exhibit the same type of behavior: though given all the food they need, they continue to deteriorate if they receive no intervention that involves emotional nurturing, contact comfort, and care.

In nearly every bird and mammal studied, close physical contact has been found to be essential both to the infant’s healthy survival and to the mother’s ability to nurture. In the previously mentioned studies with rats, if pregnant females were restrained from licking themselves (a form of self-massage), their mothering activities were substantially diminished. Additionally, when pregnant female animals were gently stroked every day, their offspring showed higher weight gain and reduced excitability, and the mothers showed greater interest in their offspring, with a more abundant and richer milk supply.

Skin Stimulation Is Important for Human Babies

Evidence supports the same conclusions for humans. Touching and handling her baby assists the new mother in milk production by helping stimulate secretion of prolactin, the “mothering hormone.” The process begun at the embryonic stage thus continues, allowing a natural unfolding of the baby’s potential within the safe and loving arms of his mother.
Nurturing stimulation of the skin—handling, cuddling, rocking, and massage—increases cardiac functions of the human infant. Massage stimulates the respiratory, circulatory, and gastrointestinal systems—benefits especially appreciated by the “colicky” baby and his parents.

A baby’s first experience with the surrounding environment occurs through touch, developing prenatally as early as sixteen weeks. Nature begins the massage before the baby is born. As opposed to the extremely short labors of most other animals, it has been suggested that a human mother’s extended labor helps make up for the lack of postpartum licking performed by other mammal mothers. For the human infant, the contractions of labor provide some of the same types of preparation for the functioning of his internal systems as early licking of the newborn does for other mammals.

Touch impacts short-term development during infancy and early childhood, and it has long-term effects as well. Through this contact, newborns are able to learn about their world, bond with their parents, and communicate their needs and wants. Eighty percent of a baby’s communication is expressed through body movement. When parents engage in appropriate touch, young children have an improved chance to successfully develop socially, emotionally, and intellectually.

Infants who experience more physical contact with parents demonstrate increased mental development in the first six months of life compared to young children who receive limited physical interaction. This improved cognitive development has been shown to last even after eight years, illustrating the importance of positive interactions. Infants who receive above-average levels of affection from their parents are shown to be less likely to be hostile, anxious, or emotionally distressed as adults.

Studies with premature babies using techniques similar to those taught in this book have demonstrated that daily massage is of tremendous benefit. Research projects at the University of Miami Medical Center, headed up by the Touch Research Institute’s founder, Dr. Tiffany Field, have shown remarkable results. In one study, twenty premature babies were massaged three times a day for fifteen minutes each time. They averaged 47 percent greater weight gain per day, were more active and alert, and showed more mature neurological development than infants who did not receive massage. In addition, their hospital stay averaged six days less. After many years of study and observation, the International Association of Infant Massage has established guidelines for using massage and holding techniques with premature babies.

Dallas psychologist Ruth Rice conducted a study with thirty premature babies after they had left the hospital. She divided them into two groups. The mothers in the control group were instructed in usual newborn care, while those in the experimental group were taught a daily massage and rocking regime. At four months of age, the babies who had been massaged were ahead in both neurological development and weight gain.

The natural sensory stimulation of massage speeds myelination of the nerves in the brain and the nervous system. The myelin sheath is a fatty covering around each nerve, like insulation around electrical wire. It protects the nervous system and speeds the transmission of impulses from the brain to the rest of the body. The process of coating the nerves is not complete at birth, but skin stimulation hastens the process, thus enhancing rapid neural-cell firing and improving brain-body communication.

In 1978 transcutaneous oxygen monitoring was developed, which enabled physicians to measure oxygen tension in the body through an electrode on the skin. It was discovered that hospitalized infants experienced tremendous upheavals in oxygen levels when subjected to stress. Touch Relaxation, holding techniques, and massage (as covered in my book Infant Massage: a Handbook for Loving Parents) have been found to mitigate these fluctuations, and these methods are being used in hospitals routinely now to help infants maintain a steady state through the stresses of diaper changes, heel sticks, and other intrusions.

New research demonstrates similar results every day, confirming what age-old tradition has told us: infants need loving touch. Lawrence Schachner, M.D., a professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami School of Medicine, advises that touch can benefit babies with skin disorders such as eczema. “It may furthermore improve parent-baby interaction,” he says. Dr. Tiffany Field concurs. She notes that loving touch triggers physiological changes that help infants grow and develop, stimulating nerves in the brain that facilitate food absorption and lowering stress hormone levels, resulting in improved immune system functioning. A report by the Families and Work Institute states that the vast majority of connections between brain cells are formed during the first three years of life. The report concludes that loving interaction such as massage can directly affect a child’s emotional development and ability to handle stress as an adult.

Loving skin contact and massage benefit mothers and fathers as well. In addition, research has shown that mothers whose pregnancies were filled with chronic stress often have babies who cry more and for longer periods than those whose pregnancies were peaceful and supported.
Men who make the effort to bond with their infants by giving the mother loving massages, talking and singing to the baby, feeling its movements in their partner’s belly, attending classes with their partner, and reading up on infant development and psychology tend to be more attentive and accomplished fathers.

THE EFFECTS OF BABY MASSAGE ON ATTACHMENT BETWEEN MOTHER AND THEIR INFANTS

A study was made from June 2008 to February 2010 in Turkey. There were 57 in the experimental group, 60 in the control group. Between the dates of the study, all healthy mothers giving birth for the first time and their healthy babies were included. Data were collected about their demographic characteristics and by using the Maternal Attachment Inventory (MAI). All mothers were assessed on the first and the last days of the 38-day study period. In the experimental group, the babies received a 15-minute massage therapy session everyday during the 38 days.

The MAI was developed to measure maternal affectionate attachment. This is the unique, affectionate relationship that develops between a woman and her infant. It persists over time, and is a key element of maternal adaptation (Muller, 1994). The MAI consists of 26 items representing maternal activities and feelings that indicate affection. Before development of the MAI, maternal affectionate attachment had been most frequently determined by observing the rate or pattern of maternal attachment behaviors (Muller). Observational measures, however, are time-consuming and generally difficult to apply in a clinical setting. In addition, there is little agreement that one behavior or group of behaviors constitutes evidence of maternal attachment. By direct measurement of mothers’ feelings through the MAI, these validity concerns in relation to interpreting mothers’ behaviors can be avoided. Although mothers’ feelings about their infants are not sufficient to define the complexity of mother–infant attachment, they are thought to be indicators of the probable presence of attachment.

For the study, massage techniques were a combination of effleurage and petrissage to the baby’s face, neck, shoulders, arms, chest, back, waist and legs. The effleurage consisted of smooth, long, rhythmic strokes up either side of the spine and out across the shoulders, with both hands working simultaneously, while the petrissage consisted of gentle kneading. Additionally, slow steady pressure was applied intermittently to the shoulders, neck, face, and lower back. All massages were demonstrated by the same trained person and mothers were advised to choose a moment when both she and her child are relaxed and calm; a half hour after the baby had eaten was recommended.

Baby massage education was given twice at the first home visit and the second home visit (15th day). The mother’s application of baby massage was observed at the second home visit and evaluated for correct technique. These babies received 15-minute massage sessions every day of the week for 38 days; the number of massage sessions are a minimum of 30 and a maximum of 38. The researcher followed a detailed visit-by-visit protocol to help women improve their health-related behaviors, the care of their baby, and observed the status of baby massage application. On the last day of the study, the MAI was filled out on the last home visit in the experimental group.

There was no significant difference found in the pretest mean value baseline of the MAI score in both groups. The posttest mean values of the MAI of the experimental group mothers were significantly higher than those of control group. There was a significant difference between groups. The results of the study have shown that baby massage is effective in increasing the mother–infant attachment.

When maternal attachment levels of experimental group mothers applying massage to their babies and control group mothers not applying massage to their babies were compared in posttest measurements, it was found that the maternal attachment of the group applying massage significantly higher. Maternal attachment of the control group also increased in the posttest measurement; however, this increase was very low when compared to the experimental group.

The relative youth of the mothers and the fact that they were undertaking the primary care of their first baby increased compliance with the study and attachment. This may explain the minor increase in maternal attachment behavior of mothers in the control group.

In Turkish culture, children are very precious and important. Women want to have a child as soon as they get married. If a woman does not have a baby, she is exposed to negative reactions from her husband and his family. Being a mother is very important, in particular, to have a male baby is extremely important. For this reason, it is expected that maternal attachment level naturally increases. The aim of this study was to determine how baby massage affects this increase. This result confirms the hypothesis of the study—baby massage strengthens the attachment between mother and baby. Most of the mothers in both groups were 26–35 years of age group, who are graduates of secondary school and not working. Traditionally, these women’s common goal is to get married and give birth to a child in the eastern part of Turkey. However, educated women have more roles than being a partner or a mother.

The first year of life is extremely important in terms of the baby’s psychological development. It is during this period, that the sense of basic trust is formed. The relationship between the mother and the baby has been the subject of several research studies (Muller-Nix et al., 2004; Zeanah, Borris, & Larrieu, 1997). Attachment is an emotional and expected condition between the mother and the baby that begins in the first days of life.

Attachment theory is an assessment of the response to the baby’s physical and emotional needs (Mills-Koonce et al., 2007). According to Mercer, maternal attachment begins during pregnancy and continues with delivery. Maternal attachment is a unique, tender loving relationship that develops between the mother and the baby; its consistency leads to the development of feelings of trust in the infant as a result. Postpartum attachment and care between the mother and the baby is important for the baby to lead a physical, spiritual, and emotional health in life.

Mothers have an important role as the primary caregiver. If the relationship between mother and baby is inadequate, the baby may have severe developmental and psychological problems (Brandt, Andrews, & Kvale, 1998). Attachment is therefore accepted as one of the fundamental processes in order to improve psychological development and to establish the baby’s relationship to the outside world (Wilson et al., 2000).

A healthy attachment is also of great importance in the determination of the baby’s character and habits. The first touches greatly strengthen attachment behavior (Kavlak & Şirin, 2007). The sense of touch is very important in the newborn period and infanthood for perceiving the environment. Proper stimulation of the baby’s sense of touch affects psychosocial development positively.

Massage is one of the easiest and most natural ways of establishing a sense of touch and eye contact which improves attachment between mothers and babies. The early contact between mother and her newborn gives confidence to the mother’s breastfeeding, in addition to developing the mother’s attachment behavior (Matthiesen, Ransjö-Arvidson, Nissen, & Uvnäs-Moberg, 2001).

Ferber et al. (2005) determined that mothers who applied massage to their premature infants achieved an easier interaction. Lee (2006) also reported that baby massage encourages the interaction between mother and baby. Moore and Anderson (2007) found that skin-to-skin contact between mother and infant affects the infants’ health, decreases their crying, and increases the mother–infant interaction. Onozawa, Glover, Adams, Modi, and Kumar (2001) reported that the mother–infant interaction was increased among those mothers who had performed massage on their infants.

In 2009, Kavlak and Şirin studied healthy babies and mothers to evaluate and determine validity and reliability of the Maternal Attachment Inventory (MAI) scale for the Turkish population. Moreover, Bal Yilmaz and Conk (2009) studied mothers who had 15-day-old healthy babies to investigate the effect of four months of massage application on sleep duration, growth and development of babies, and mothers’ anxiety levels. Bal Yılmaz and Conk reported that infants’ sleep duration was increased when their mothers spent more time with them and massaged them. In a study conducted with mothers who recently delivered healthy babies, İnal and Yıldız (2005) investigated the effect of massage applied for 6 months on the babies’ growth and mental-motor development. Inal and Yildiz found statistically significant results that infants who received massage gained more weight and increased their mental–motor development. In a study conducted with premature and low birthweight babies and their mothers, Sarıkaya Karabudak and Öztürk (2008) reported that regularly applied baby massage positively affected weight gain and the mental–motor development of babies.

Massage is one of the oldest forms of treatment in the world, having first been described in China during the second century B.C. and soon after in India and Egypt. Maternal attachment depends on two important factors; (a) interaction between mother and her baby and (b) sensual contact between them. Baby massage is the simplest and easiest way of communication, that makes contact between mother and her baby. In eastern Anatolia, Turkey, the families have many children. The mothers who live in this region generally avoid touching their babies. The main reasons are cold weather conditions, socioeconomic conditions, and swaddling. In addition, there is no work regarding the effects of massage on mother-infant attachment in Turkey up to now. For this reason, this work has been carried out to determine the applicability of baby massage in Turkish families and its effects on the level of maternal attachment. It is of note that the Turkish edition of Infant Massage, a Handbook for Loving Parents (Vimala McClure, Bantam/Random House, NY) has been in production in 2018.

Infant massage for primary caregivers and high-risk babies is now used more often. It is reported that massage regulates the baby’s sleep, respiration and urinary requirements; decreases colic and stress; and affects mother–infant interaction in a positive way. Studies have determined that mothers giving massage to premature babies have more interaction with their babies. In their studies, Moore and Anderson (2007) found that skin-to-skin contact between the mother and the baby in the early period affected the health status of baby, decreased crying and increased mother–infant interaction.

Infant massage is a simple, cheap and effective technique supporting infant development. It is accepted as a new practice that is gradually gaining popularity by being applicable to both the babies and their mothers; it can be performed independently. However, many mothers do not know that they can communicate with their babies by touch as they think that they may easily hurt their babies. Those mothers should be instructed by using various interactive methods such as tactile, visual, auditory contact. For those families who cannot have direct early contact with their baby for various reasons, nurses should advise them that this situation would not directly cause a problem. Their concerns should be alleviated because although early contact is a factor that strengthens attachment development, it is not an essential prerequisite.

The effects of massage in terms of mother–infant attachment and other general benefits for baby health should be considered; all medical personnel, especially nurses, should encourage mothers to apply massage to their babies. Encouraging the use of massage provides an important contribution to healthy babies. In the literature, the effects of baby massage on the maternal attachment levels in mothers with healthy infants and weight gain of preterm infants have been investigated. Mothers with babies who were born prematurely or had some defects or illness, have more risk of attachment deprivation. Accordingly, it might be suggested that nurses include baby massage among the routines of mother and baby care in both healthy and ill babies, and that facilitating baby massage and mother–infant attachment should be included in the internal training given to neonatal nurses as well as providing counseling to the mothers in this regard.