Most people would agree that, for the most part, childbirth is a happy event; however, it can also be traumatic, especially when a baby is born prematurely. The stress of the birthing experience can affect different bodily systems, including the heart.

However, a clinical study shows that infant massage can address the issue of heart rate variability and improve response to various stressors in preterm infants.


Infant Massage to Address Affected Development

In 2013, Sandra L. Smith, Ph.D., A.P.R.N., N.N.P.-B.C., associate professor and neonatal nurse practitioner track coordinator at the University of Louisville School of Nursing, conducted a study to see how massage might affect heart rate variability and, subsequently, autonomic nervous system development and function in premature babies.

According to the study, “The effect of heart rate variability in preterm infants,” which was published in the Journal of Perinatal Medicine’s Jan. 1, 2013, issue, when babies are born prematurely, normal development of the autonomic nervous system and the hypothalamic-pituitary-adrenal axis may be affected.

Physiological stressors that occur soon after birth may cause an exaggerated response that manifests as “blood pressure fluctuations, gaze aversion, apnea, bradycardia and color changes,” the study noted.

In this study, nine certified infant massage practitioners gave massage for 20 minutes twice a day for the 30-day duration of the study. Seventeen infants were in the massage group and 20 in the control group. The therapists used six soft-tissue compression strokes on the tops of the thighs to ankles and feet; the chest; the shoulders down the arms to the hands; from the crown to the neck; and down the back from the neck to the waist. The control group received no massage.


Improved Stress Response

At the end of the trial, findings indicated that the massage group showed an improvement in heart rate variability and autonomic nervous system function.

Smith noted that improving autonomic nervous system function helps promote appropriate responses to stressful events as well as “turning off” the stress response when the stressful event has passed.

“We do not know how long impaired stress responses last in preterm infants, as there is limited research in this area, but can surmise that it lasts into childhood and possibly adolescence given the research we do have on developmental delays that preterm infants exhibit later in life,” she said. “Additionally, we have no research on reversing or attenuating the stress response that is excessive in later life in children born preterm.”


Male vs. Female Infants

Both male and female premature infants were part of the infant massage study group, but more emphasis was placed on males.

“I discussed the male responses at greater length, although female results were also reported, because the female infants did not demonstrate the same response to the massage intervention,” Smith said. “Females did not appear to have the same developmental dysfunction as males, and this could be due to hormonal influences or the fact that preterm male infants have more co-morbid conditions than females.

“We just do not know the mechanisms responsible for that difference,” she added.