Baby massage – do they need it?

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I get so used to seeing lists of the benefits of manual therapy that I sometimes get ‘benefits’ fatigue. I know from experience that most babies, children and adults enjoy hands-on therapy and research has shown that some conditions are objectively improved by treatment.

As an evidence-based practice, we have a healthy regard for research. Research has shown exercise is good for us to the extent that we now take for granted that we should exercise regularly for the good of our hearts. We now know smoking is bad for our hearts and lungs. Before the research demonstrated this indisputably, there was widely-held belief that smoking cleaned the lungs in the same way that it cures meat and fish, allowing them to be eaten raw…

But what about baby massage? Why would babies need it? Surely they’re made of such great new stuff they have no need for stress to be rubbed away! As it happens, research tends to concentrate on babies that have had a less than optimal start in life.

In 2004 one review found that massage of preterm and low birth weight babies increased the daily weight gain (by 5g per day) and also appeared to shorten the babies’ stay in hospital.1

More recently, research from an excellent source found that following massage for 5 days per week for a maximum of 4 weeks, until discharge from hospital, pre-term babies (aged 34-37 weeks) produced more of a particular type of immune cell (NK cell) compared with non-massaged babies. The massaged babies also gained more weight daily and were heavier at the end of the trial.2

These articles are specifically about preterm and low birthweight babies so we can’t necessarily assume the same improvements extend to full-term, normal birthweight babies.

In 2013 a systematic review collated evidence to identify whether infant massage could promote physical and mental health in low-risk infants. The review looked at a variety of outcomes and found that significant improvements were found in length, head circumference and gross motor development. Many other measures didn’t improve. Still, these three outcomes are worth having.3

The Back to Sleep programme, which has helped reduce SIDS by 50% has babies spending much less time on their tummies or sides in their first 6 months. The unaccustomed position can make babies cry, so mums may not encourage tummy time so much. The baby continues lying on its back for until he or she can roll or sit. Unfortunately this exacerbates the development of plagiocephaly and torticollis (flat head syndrome and neck asymmetry) in susceptible babies.

Baby massage classes that focus on movement, can help improve parent’s confidence with baby handling and also encourage more tummy time in fun and safe environment, which helps strengthen babies’ neck and back muscles, reducing the likelihood of developing postural asymmetry, and flat head syndrome.

There are alternatives to baby massage for good posture. Having baby lying on their tummy on you, or wearing your baby in a sling, dubbed ‘cuddle time’ helps keep them from lying them on their back all the time. Therefore, there isn’t any pressure on the back of their head and they are using their postural muscles to practice head control which also helps reduce flat head syndrome and encourages symmetrical neck movement.

Osteopathy can also help with postural asymmetry in babies. An article published by the department of paediatric neurology at a Children’s Hospital in Heidelberg found that following osteopathic treatment postural asymmetry was improved.4

So the evidence seems to point to massage being quite helpful in promoting health in high-risk babies, potentially helpful in low-risk babies particularly in motor development and growth. It isn’t the only answer to good motor development and weight gain, obviously, but it helps!

  1. Massage for promoting growth and development of preterm and/or low birth-weight infants. Update in Cochrane Database Syst Rev. 2004;(2):CD000390.
  2. A Randomized Placebo-Controlled Trial of Massage Therapy on the Immune System of Preterm Infants. PEDIATRICS 2012; 130:6 pp1549-1558].
  3. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane database systematic review Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.
  4. Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial DEV MED CHILD NEUROL Jan 2006; 48(1): 5-9
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