From ancient times messaging infants is a daily routine in a normal household. Generally, a “high-risk infant” is a baby who needs a greater degree of monitoring and care compared to a healthy infant who was born full term. Studies report that Massage therapy has led to weight gain in preterm babies, an increase in bone density and better and faster limb mobility. But a high-risk baby is to be dealt with greater care and caution. Infants born prematurely may be underweight, with less developed mental ability as well as neuromusculoskeletal and movement-related dysfunctions.¹ Almost 70% of prematurely born babies suffer from cognitive deficits, learning disabilities, attention problems, behavioral problems, and neuropsychological deficits when they reach school age.²

A three-round Delphi technique was designed to study, understand and develop an infant massage program, especially for high-risk infants to increase the bonding and attachment process. It comprised of 5 phases including a literature review on the high-risk infants in phase 1, phase 2 was Delphi Process Round One which involved Item Generation; phases 2 and 3 were designed based on the responses of phase 1. The number of participating infants reduced from 14 in the first round to 8 round three. The study resulted in the agreement of different massage strokes, which were included in the initial survey. A 10-minute routine message was recommended with the repetition of each stroke three times, six additional strokes added in round two. Round 3 confirmed the strokes from the round one and round two surveys and finally 19 massage strokes were included to be implemented in the program. The sensory inputs are lower in high-risk infants. The study also suggested the inclusion of other sensory stimulation during massage routine such as visual and/or auditory stimulation. This could include eye contact between the kid, skin to skin contact, also singing and talking softly to the infant quietly with different facial expressions. These may help to increase vocalisations, smiles, eye contact and approach behaviors in the infant who might be having difficulty in responding to the mother due to the nature of their medical condition.²

Thus, the study recommends routine messaging three times a day, if the infants are comfortable. Further, the massage session should be completed by putting the resting hands on each part of the body being message and naming them, saying thank you to the infant for accepting the massage and dressing the infant. Uses of oils, creams that do not harm the pores of the skin were recommended. Finally, hugging and cuddling the baby who enhances the emotional bonding and attachment through touch and makes the baby feel joyous and happy giving mental security and satisfaction.

References:

1. Tiffany Field, M. D., and Maria Hernandez-Reif. Preterm Infant Massage Therapy Research: A Review. Infant Behav Dev. 2010 Apr; 2010, 33(2): , 115–124.
2. Lauren Michelle Perks, G. R., Pragashnie Govender, . Therapists’ consensus on an infant massage programme for high-risk infants from resource constrained contexts: a delphi study. South African Journal of Occupational Therapy. 2020, 50(3): , 72-82.