Table 3 Infant massage indications and appropriate populations.
From: The state of infant massage use in neonatal intensive care units
| Â | na (%) |
|---|---|
Infant-Centered goals for massage | n = 101 |
  Provide positive sensory experiences | 88 (87%) |
  Promote sleep and relaxation | 86 (85%) |
  Facilitate calm alert state/Enhance state regulation | 85 (84%) |
  Reduce pain | 85 (84%) |
  Improve infant tolerance to handling | 84 (83%) |
  Improve respiratory function | 84 (83%) |
  Improve skin texture | 83 (82%) |
  Address withdrawal symptoms | 82 (81%) |
  Improve feeding outcomes | 79 (78%) |
  Weight gain | 73 (72%) |
  Improve gastrointestinal issues | 73 (72%) |
  Control edema | 57 (56%) |
  Ease of diapering | 57 (56%) |
  Improve tone and movement | 53 (52%) |
  Improve bone density | 45 (45%) |
  Improve bilirubin levels | 34 (34%) |
  *Other (desensitization) | 1 (1%) |
Parent-centered goals for massage | n = 101 |
  Facilitate parent-infant interaction | 84 (83%) |
  Improving parent competence and responsiveness | 84 (83%) |
  Increase parent engagement | 74 (73%) |
Infant conditions and clinical presentations that indicate massage | n = 101 |
  Infants with challenges with state regulation | 82 (81%) |
  Late preterm (33-36 weeks BGA) | 78 (77%) |
  Hypertonia | 76 (75%) |
  Neurological conditions (e.g., hypoxic ischemic encephalopathy) | 62 (61%) |
  Hypotonia | 61 (60%) |
  Infants with occupational therapy orders | 60 (59%) |
  Infants with physical therapy orders | 51 (50%) |
  Congenital anomalies | 48 (48%) |
  Respiratory conditions | 45 (45%) |
  Very low birth weight/very preterm ( < 32 weeks BGA) | 31 (31%) |
  Infants with surgical conditions | 29 (29%) |
  Cardiac conditions | 28 (28%) |
  Extremely low birth weight/very preterm ( < 28 weeks BGA) | 23 (23%) |
  Other | 12 (12%) |
PMA of infant when massage is typically initiated | n = 90 |
|  | Range 27–26 weeks PMA |
| Â | 32.2 (1.4) |
Massage is appropriate at the following PMAs | Â |
 23 weeks PMA | n = 88 |
  Never | 84 (95%) |
  Sometimes | 4 (5%) |
 24 weeks PMA | n = 88 |
  Never | 82 (94%) |
  Sometimes | 5 (6%) |
 25 weeks PMA | n = 87 |
  Never | 83 (95%) |
  Sometimes | 5 (6%) |
 26 weeks PMA | n = 88 |
  Never | 78 (89%) |
  Sometimes | 10 (11%) |
 27 weeks PMA | n = 87 |
  Never | 75 (86%) |
  Sometimes | 12 (14%) |
 28 weeks PMA | n = 89 |
  Never | 61 (69%) |
  Sometimes | 23 (26%) |
  About half of the time | 5 (6%) |
 29 weeks PMA | n = 92 |
  Never | 54 (61%) |
  Sometimes | 27 (30%) |
  About half of the time | 8 (9%) |
 30 weeks PMA | n = 92 |
  Never | 41 (45%) |
  Sometimes | 32 (35%) |
  About half of the time | 12 (13%) |
  Frequently | 7 (7%) |
 31 weeks PMA | n = 93 |
  Never | 35 (38%) |
  Sometimes | 33 (35%) |
  About half of the time | 14 (15%) |
  Frequently | 11 (12%) |
 32 weeks PMA | n = 97 |
  Never | 5 (5%) |
  Sometimes | 25 (25%) |
  About half of the time | 26 (27%) |
  Frequently | 29 (30%) |
  Always | 10 (10%) |
 33 weeks PMA | n = 99 |
  Never | 2 (2%) |
  Sometimes | 17 (17%) |
  About half of the time | 23 (23%) |
  Frequently | 46 (46%) |
  Always | 11 (11%) |
 34 weeks PMA | n = 97 |
  Sometimes | 7 (7%) |
  About half of the time | 11 (11%) |
  Frequently | 61 (61%) |
  Always | 18 (18%) |
 35 weeks PMA | n = 97 |
  Sometimes | 5 (5%) |
  About half of the time | 6 (6%) |
  Frequently | 63 (65%) |
 Always | 23 (24%) |
 36 weeks PMA | n = 96 |
  Sometimes | 2 (2%) |
  About half of the time | 6 (6%) |
  Frequently | 59 (61%) |
  Always | 29 (30%) |
 37 weeks PMA | n = 93 |
  Sometimes | 2 (2%) |
  About half of the time | 3 (3%) |
  Frequently | 59 (63%) |
  Always | 29 (31%) |
 38 weeks PMA | n = 96 |
  Sometimes | 2 (2%) |
  About half of the time | 1 (1%) |
  Frequently | 61 (64%) |
  Always | 32 (33%) |
 39 weeks PMA | n = 96 |
  Sometimes | 2 (2%) |
  About half of the time | 1 (1%) |
  Frequently | 61 (64%) |
  Always | 32 (33%) |
 40 weeks PMA | n = 96 |
  Sometimes | 2 (2%) |
  About half of the time | 1 (1%) |
  Frequently | 58 (60%) |
  Always | 35 (36%) |
40+ weeks PMA | n = 96 |
  Sometimes | 2 (2%) |
  About half of the time | 2 (2%) |
  Frequently | 56 (58%) |
  Always | 36 (38%) |
Massage is appropriate in the following circumstances | Â |
 Within 72 hours for ELBW infant | n = 93 |
  Never | 87 (91%) |
  Sometimes | 6 (6%) |
 Chest tube | n = 89 |
  Never | 27 (30%) |
  Sometimes | 38 (43%) |
  About half of the time | 8 (9%) |
  Frequently | 14 (16%) |
  Always | 2 (2%) |
 ECMO | n = 87 |
  Never | 59 (68%) |
  Sometimes | 23 (26%) |
  About half of the time | 3 (3%) |
  Frequently | 2 (2%) |
 Endotracheal intubation | n = 92 |
  Never | 13 (14%) |
  Sometimes | 40 (43%) |
  About half of the time | 10 (11%) |
  Frequently | 25 (27%) |
  Always | 4 (4%) |
 Fragile bones | n = 92 |
  Never | 31 (34%) |
  Sometimes | 41 (45%) |
  About half of the time | 10 (11%) |
  Frequently | 10 (11%) |
  Always | 0 (0%) |
 During hypothermia | n = 91 |
  Never | 72 (79%) |
  Sometimes | 13 (14%) |
  About half of the time | 4 (4%) |
  Frequently | 2 (2%) |
 Non-invasive ventilation | n = 95 |
  Never | 10 (11%) |
  Sometimes | 27 (28%) |
  About half of the time | 16 (17%) |
  Frequently | 33 (34%) |
  Always | 9 (10%) |
Neonatal abstinence syndrome or neonatal opioid withdrawal syndrome | n = 97 |
  Never | 2 (9%) |
  Sometimes | 3 (3%) |
  About half of the time | 4 (4%) |
  Frequently | 52 (54%) |
  Always | 36 (37%) |
 Open wounds | n = 92 |
  Never | 57 (62%) |
  Sometimes | 31 (33%) |
  About half of the time | 2 (2%) |
  Frequently | 1 (1%) |
 Sepsis | n = 93 |
  Never | 75 (81%) |
  Sometimes | 11 (12%) |
  About half of the time | 3 (3%) |
  Frequently | 4 (4%) |
Infant body parts avoided during massage | n = 65 |
  Fragile bone, limb at risk of deep vein thrombosis; skin infection, rash, open wound | 16 (25%) |
  Abdomen/belly | 12 (18%) |
  Genitals | 7 (11%) |
  Limbs with intravenous or catheter lines (PIV, PICC) | 8 (12%) |
  Anterior chest | 6 (9%) |
  Belly button/umbilical area | 4 (6%) |
  Head | 4 (6%) |
  Face | 4 (6%) |
  Spine | 2 (3%) |
  A painful limb | 1 (2%) |
Safety issues observed during massage | n = 101 |
  Behavioral motor stress signs | 62 (61%) |
  Infant physiological instability | 36 (36%) |
  Respiratory changes | 14 (14%) |
  Temperature instability | 13 (13%) |
  Lines concerns (dislodgment, pulling) | 9 (9%) |
  Allergic response to medium | 6 (6%) |
  Skin safety | 4 (4%) |
  Other (movement of nasal prongs) | 1 (1%) |
