Last Updated on February 11, 2026 by MASSAGE Magazine
Shantala massage, an ancient form of infant massage from India, was found to influence cortisol levels in healthy infants, suggesting an effect on stress regulation.
For massage therapists who work with infants or educate parents in infant massage, this research offers insight into how structured touch may interact with the stress-response system. The study focused specifically on salivary cortisol as a marker of activity within the hypothalamic-pituitary-adrenal axis, often referred to as the HPA axis.
The findings were originally published in the Sao Paulo Medical Journal (September 2005, Vol. 123, No. 52, pp. 215–218).
Why Study Cortisol in Infants Receiving Massage?
Cortisol is commonly used as a biological marker of stress.
The HPA axis plays a central role in regulating the body’s response to stress. By measuring salivary cortisol, researchers can observe changes in adrenocortical function without invasive procedures. In infants, saliva collection offers a practical way to assess stress physiology.
The purpose of this study was to better understand how massage might influence the HPA axis in healthy four- to six-month-old infants.
Who Participated in the Study?
Researchers in Sao Paulo, Brazil, evaluated 11 healthy infants between four and six months old.
All infants were receiving care in a public nursery. The study examined how Shantala massage affected their salivary cortisol levels over time.
While the sample size was small, the design allowed researchers to closely monitor hormonal changes in response to a structured massage intervention.
What Did the Shantala Massage Involve?
The treatment followed a traditional Shantala massage sequence and was performed by a researcher.
The massage included:
- Circular fingertip movements on the face, starting at the forehead and moving toward the temples
- Sliding movements from temples to the mandible, and toward the nose, cheeks, jawbone and chin
- Synchronized movements along the legs from hip to foot, using light pressure and spiral motions
- Massage of each toe using the thumbs
- Sliding strokes along the arms from shoulders to fingertips
- Open palm strokes along the back and shoulders, moving from neck to hip and back again
Each infant received two 15-minute massages on two consecutive days. Massage was administered once in the morning and once in the afternoon.
How Were Cortisol Levels Measured?
Saliva samples were collected:
- Before each massage
- After each massage
- Several hours after treatment
The entire procedure was repeated after a one-week interval.
Researchers compared cortisol values at different times of day to observe patterns and changes.
What Changes Were Observed in Cortisol Levels?
During the initial two-day treatment period, mean cortisol levels were highest in the afternoon. After a one-week interval, cortisol levels were highest in the morning. The lowest cortisol values were recorded during nighttime measurements.
The authors suggested that these findings indicate a modification in salivary cortisol values following massage. Rather than showing only immediate effects, the results imply that Shantala massage may influence how the HPA axis responds over time.
The researchers concluded, “There was a modification in the salivary cortisol values following massage, thus reflecting possible adaptation of the HPA axis.”
What Does This Mean for Infant Massage Practitioners?
This study does not claim that Shantala massage eliminates stress. Instead, it suggests that structured infant massage may influence cortisol patterns and potentially affect stress-system regulation.
For therapists teaching infant massage or working in pediatric settings, this research supports the conclusion that touch contributes to physiological regulation, even in very young infants.
The study was designed primarily to better understand the relationship between massage and the HPA axis. While the sample size was limited, the findings contribute to a growing body of research exploring how therapeutic touch interacts with stress physiology.
For practitioners, this reinforces something many already observe: infants often appear calmer and less distressed following gentle, intentional massage. Research on cortisol and the HPA axis offers one possible explanation for that response, grounding traditional practices such as Shantala massage in measurable biological change.