Tactile stimulation in physically healthy infants: results of a systematic review

Abstract

Touch establishes powerful physical and emotional connections between infants and their caregivers, and plays an essential role in development. The objective of this systematic review was to identify published research to ascertain whether tactile stimulation is an effective intervention to support mental and physical health in physically healthy infants. Twenty‐two studies of healthy infants with a median age of six months or less met our inclusion criteria. The limited evidence suggests that infant massage may have beneficial effects on sleeping and crying patterns, infants’ physiological responses to stress (including reductions in serum levels of norepinephrine and epinephrine, and urinary cortisol levels), establishing circadian rhythms through an increase in the secretion of melatonin, improving interaction between mother‐infant dyads in which the mother is postnatally depressed, and promoting growth and reducing illness for limited populations (i.e. infants in an orphanage where routine tactile stimulation is low). The only other evidence of a significant impact of massage on growth in infants living in families was obtained from a group of studies regarded to be at high risk of bias which we have reported separately. There is no evidence of a beneficial effect on infant temperament, attachment or cognitive development. There is, therefore, some evidence of benefits on mother‐infant interaction, sleeping and crying, and on hormones influencing stress levels. In the absence of evidence of harm, these findings support the use of infant massage in the community, particularly in contexts where infant stimulation is poor. Further research is needed, however, before it will be possible to recommend universal provision.

Keywords:

• tactile stimulation
• infants
• systematic review

Notes

1. The strict criteria meant that certain studies were excluded, for example the RCT of Field et al. (2004), which compared infants who either received light pressure or moderate pressure massage was excluded because it did not meet the criteria of having a ‘no treatment’ control group.

2. This resulted in a the exclusion of a small number of studies, for example, one study (Scholz & Samuels, 1992) combined massage with another intervention (neonatal bathing) and in another the median age was above 6 months (Cullen, Field, Escalona & Hartshorn, 2000). It also resulted in a study where mothers were postnatally depressed (Onozawa et al., 2001) and another study where infants lived in orphanage (Kim et al., 2003) being included, as the infants were reported as healthy.