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Cochrane review of massage for
preterm infants:
A Cochrane review is a type of systematic summary
of the studies that have been done on a particular subject. A Cochrane
review published in 2004 titled “Massage for promoting growth and
development of preterm and/or low birth-weight infants” by Vickers et
al., reviewed all available randomized trials that had studied massage
in low birth-weight or preterm infants. They included studies of
infants less than 37 weeks gestational age or weighing less than 2500g
at birth. In the studies, the infants were randomly assigned to either
a treatment group, which received some form of systematic tactile
stimulation by human hands, or a control group which did not. To be
included in the Cochrane review, a study had to include at least one of
the following end points: weight gain, length of stay in the hospital,
behaviors or development. After analyzing all of the eligible studies,
Vickers et al. came to the following conclusions:
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Massage
interventions improved daily weight gain by an average of 5.1 grams
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Gentle, still touch
did not show a statistically significant daily weight gain
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Massage
interventions decreased the length of hospital stay by 4.5 days
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Massage may have a
slight positive effect on postnatal complications
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One study showed
improved weight gain as well as mental and motor development at 6
month follow-up
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No adverse effects
from the massage were noted
It should be noted that in almost all of the
studies reviewed, the infants in the study were healthy and medically
stable. Most of the studies excluded infants with congenital
abnormalities, those with serious infections, those on a ventilator,
and requiring intravenous feedings.
Critique:
Part of purpose of a Cochrane review is to comment
of the quality of the studies included. The authors of this review were
concerned about quality of some of the studies and about possible bias
in the reports. In many of the studies reviewed, the doctors, nurses,
and parents were aware of which infants were in the massage group or
control group. This knowledge could have influenced them, even
unintentionally, to treat the infants in one group differently than
those in the other group. The apparent changes in the infants’ weight
and readiness to be sent home could have been from this influence rather
than from the massage alone. Because of concerns such as these, the
authors of the article concluded that the evidence for massage was
weak.
It should be noted that this is more a critique of
how the studies were carried out, rather than a critique of the massage
itself. The authors concede that infant massage is “non-invasive, does
not require specialist equipment and can be implemented without undue
disruption to routine care procedures. For medically stable infants at
least, it seems to have a very low risk of adverse effects. Though
somewhat time consuming, massage can be undertaken by those without
extensive training, including parents.”
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