Review of Randomized Controlled Trials of Massage in Preterm Infants.

Anna-Kaisa Niemi

doi:10.3390/children4040021

Abstract

Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants.

Highlights

Preterm birth affects about 10% of infants born in the USA [1].Premature infants often spend weeks or months in intensive care unit due to immaturity and need for intensive medical care, with hospital stay often prolonged by feeding immaturity and slow weight gain
Other outcomes assessed in randomized controlled trials (RCTs) of massage in preterm infants include levels of transcutaneous bilirubin [3], sleep [4,26], calorie intake [5,17,19,30,33,34,35], vagal activity [5,19,24,26,29,30], gastric motility or number of stools [3,24,30], heart rate variability (HRV) [6,7,19,24,30], immunologic parameters [12], bone metabolism [11,32], changes in electroencephalogram (EEG) [13], behavior and/or neurodevelopment [14,15,23,26,28,29,31,34,35], pain [25], length of hospital stay [12,16,18] and levels of serum markers such as insulin-like growth factor I (IGF-1) [8,19], adiponectin [8], and serum triglycerides [9,27,31]
Most randomized controlled trials compared massage to standard care [2,3,4,6,7,8,9,11,12,13,14,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35], while some compared oil massage to massage without oil [10], tactile massage to kinesthetic stimulation [5] and massage to light still touch [15]