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.

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: A HANDBOOK FOR LOVING PARENTS – NEW EDITION!

I am happy to announce that the new updated, expanded edition of Infant Massage: a Handbook for Loving Parents has been released by Random House. It is available on Amazon.com and from most bookstores.

CHAPTERS:

  1. Why Massage Your Baby?

  2. Your Baby’s Sensory World

  3. The Importance of Skin Stimulation

  4. Stress and Relaxation

  5. Bonding, Attachment, and Infant Massage

  6. The Elements of Bonding

  7. Attachment and the Benefits of Infant Massage

  8. Especially for Fathers

  9. Helping your Baby (and you) Learn to Relax

  10. Your Baby’s Brain

  11. Music and Massage

  12. Getting Ready

  13. How to Massage Your Baby

  14. Crying, Fussing, and Other Baby Language (including cues, reflexes and behavioral states

  15. Minor Illness and Colic

  16. Your Premature Baby

  17. Your Baby with Special Needs

  18. Your Growing Child and Sibling Bonding through Infant Massage

  19. Your Adopted or Foster Children

  20. A Note to Teen Parents

BACK MATTER INCLUDES:

References and Recommendations

Resources

Author Bio

Infants whose mothers have taken SSRI antidepressants are more likely to have decreased birth weight, gestational length

Source: Infants whose mothers have taken SSRI antidepressants are more likely to have decreased birth weight, gestational length

A new study, published in the International Journal of Epidemiology, has found that prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) has a significant association with lower birth weight and gestational length. This was found to be in cases where mothers had taken the drug for two or more trimesters.

Breast milk hormones found to impact bacterial development in infants’ guts: Intestinal microbiome of children born to obese mothers significantly different from those born to mothers of healthy weight

Source: Breast milk hormones found to impact bacterial development in infants’ guts: Intestinal microbiome of children born to obese mothers significantly different from those born to mothers of healthy weight

A new University of Colorado Anschutz Medical Campus study finds that hormones in breast milk may impact the development of healthy bacteria in infants’ guts, potentially protecting them from intestinal inflammation, obesity and other diseases later in life.

Preemies’ Brains Get Boost From Breast Milk

MRI scans found infants who drank more of it had more brain tissue, study found

Source: Preemies’ Brains Get Boost From Breast Milk

“The brains of babies born before their due dates usually are not fully developed,” explained senior investigator Dr. Cynthia Rogers, an assistant professor of child psychiatry at Washington University in St. Louis.

“But breast milk has been shown to be helpful in other areas of development, so we looked to see what effect it might have on the brain,” Rogers said in a university news release.

“With MRI scans, we found that babies fed more breast milk had larger brain volumes. This is important because several other studies have shown a correlation between brain volume and cognitive development,” she said.

Maternal singing during skin-to-skin contact benefits both preterm infants, mothers

Source: Maternal singing during skin-to-skin contact benefits both preterm infants, mothers

This is why we teach a lullaby to accompany infant massage (in the case of NICU, holding methods and “Resting Hands.”

Premature infants fed breast milk have better brain growth, study shows

The brains of premature infants fed a primary diet of breast milk grow faster than those who are fed formula, according to a small study at St. Louis Children’s Hospital.

Source: Premature infants fed breast milk have better brain growth, study shows

Babies whose diets included at least 50 percent breast milk from their own mothers or donors had more brain tissue by their expected due dates, brain scans showed. The 77 premature infants in the study had stayed in the hospital’s neonatal intensive care unit. They had all been born at least 10 weeks early.

Infants born prematurely may show less interest in others

Attention to other people is a fundamental role for social cognitive development in the early stages of life. However, infants born prematurely show a different attentional pattern.

Source: Infants born prematurely may show less interest in others

Attention to other people is a fundamental role for social cognitive development in the early stages of life. However, infants born prematurely show a different attentional pattern.

In a new study, a Kyoto University team found evidence that such babies are less interested in other people compared to infants born full-term, when tested at 6 and 12 months of age. This new study brings light to the links between premature birth, development of , and ultimately autism.

Recent studies illustrate that infants born prematurely are at more risk of autism.

Depression of either parent during pregnancy linked to premature birth

Source: Depression of either parent during pregnancy linked to premature birth

Depression in both expectant mothers and fathers increases the risk of premature birth, finds a study published in BJOG: an International Journal of Obstetrics and Gynaecology (BJOG).