Infant massage on the neonatal unit

This leaflet gives you information about infant massage on the neonatal unit and how you can administer this appropriately and safely.

Touch is a vital part of a newborn infant`s development. It supports communication, bonding, physical and emotional development. Within the neonatal unit, we use massage to support parents to provide positive touch experiences whilst reinforcing parent-infant bonding.

There are many pieces of research highlighting the benefit of infant massage for your infant and you.

These include supporting;

• Interaction, bonding and attachment, emotional regulation
• Supports mental health and production of happy hormones in the infant and their parents (Oxytocin)
• Physical development and health
• Relief from pain
• Relaxation and stress management
• Improving parent confidence

We recognise parents are an essential part of their infant`s care on the neonatal unit. An infant can sense and recognise their parents touch, voice and scent. Massage creates an opportunity to support the bonding process, which is why parent involvement in this is key.

Infant massage should always be led by the infant and therefore it is important to understand an infant`s individual like and dislikes and when they are telling you they need a break (behavioural cues). You can ask your therapist for more information about early infant communication.

When to massage your infant?

• They are in a calm and alert state
• They are showing you through their behaviour that they are relaxed.
• You can introduce massage at a regular time during the day e.g. for a short time as part of the nappy change routine if your infant likes to have some clothes off time or as a step in a wash and bedtime routine.

When not to massage your infant?

When they are:

• Asleep
• Hungry
• Crying
• Raised temperature or known infection

Discuss with your therapist first if:

• Your infant is on continuous feed.
• They have had recent/new surgery
• They have any skin conditions/bruises/fractures/open wounds.
• Had a vaccination in last 3 days
• Just had a full feed

Showing respect and asking permission

By asking your infant for their permission to massage them, you are building their trust in you and showing respect for their body. By starting the massage routine in the same way each time your infant will begin to understand and anticipate what will follow.

Your neonatal therapist will show you ways that you can asking your infant`s permission and observe their response as part of the massage routine. For example, by rubbing hands together to warm palms, making a swish sound, show your infant your open hands (double high five) whilst asking them: ‘Do you want a massage?’

If your infant begins to display stress signals during the massage it is important to pause, slow down or stop.

Preparing for the massage

• Prepare your environment; collect any additional towels or clothing needed for after the massage.
• Ideally remove your rings and tie your hair back if required
• Massage can be performed over a vest or baby grow or you can remove your infant’s clothes after the permission routine.

Use of oil

For massage on the neonatal unit, the use of oil is not essential. Your neonatal therapists will guide you on when this appropriate to use.

If you are using oil, it should be:

• Cold pressed, organic vegetable oil such as sunflower oil
• Free from perfumes or essential oils as these can cause irritation and overstimulation.

Many infant massage products such as lotions/oils contain artificial chemicals and have added fragrances we do not recommend the use of.

This information is based on the International Association of Infant Massage (IAIM) guidance and is only appropriate for babies who have reached their due date or are older (post term age).

Contacts/further information

If you have any questions about Infant massage, please contact: Cath Ward, Neonatal Physiotherapist or Jane Fenton-Smith, Neonatal Occupational Therapist - email CUH Nicu Therapy (opens in a new tab).

References/sources of evidence

• Click here for the International Association of Infant Massage (IAIM) website (opens in a new tab)
• Abdallah, B., Badr, L. and Hawwari, M., 2013. The efficacy of massage on short and long term outcomes in preterm infants. Infant Behavior and Development, 36(4), pp.662-669.
• Field, T., 2017. Newborn Massage Therapy. International Journal of Pediatrics and Neonatal Health, 1(2), pp.54-64.