Physiologic and behavioral effects of gentle human touch on preterm infants. Effects of gentle human touch on preterm infants: pilot study results. Tactile/kinesthetic stimulation effects on preterm neonates. Patterns of physiologic and behavioral response of intermediate care preterm infants to intervention. Multimodal stimulation of the premature infant. Massage effects on cocaine-exposed preterm neonates. Maternally administered tactile, auditory, visual, and vestibular stimulation: relationship to later interactions between mothers and premature infants. Effects of prematurity and early intervention on responsivity to tactual stimuli: a comparison of preterm and full-term infants. The effects of tactile and kinesthetic stimulation on neonatal development in the premature infant.
The purpose of this study was to evaluate the effects of a gentle human touch (GHT) intervention provided to 42 preterm infants (27-33 weeks gestational age), for 10 min, three times daily for 10 days. There was no significant difference in mean HR levels or in percent of abnormal heart rate (HR) or O2 saturation comparing 10-min baseline (B), GHT, and 10-min post-touch (PT) phases. There were significantly lower levels of active sleep, motor activity, and behavioral distress during GHT compared to B and P phases. There were no differences among the 42 infants in the GHT group and 42 infants in a randomly assigned control group on any outcome variable including weight gain, morbidity status, or behavioral organization. The findings suggest that GHT generally is a safe and soothing type of touch to provide to young preterm infants, but that individual infant responses to touch need to be continuously monitored by NICU staff and parents. A pilot study was conducted to evaluate the effects of gentle human touch (GHT) provided for 15 minutes a day to preterm infants from day 7 to day 12 of life. The study suggested that GHT has no adverse effects on the oxygen saturation or heart rate levels of small preterm infants and that GHT has a soothing effect as evidenced by decreased levels of active sleep, motor activity, and behavioral distress. These results can provide NICU nurses with a basis for guiding parents in their early interactions with preterm infants in the NICU. Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements of the limbs for three, 15-minute periods per day for a 10 days. The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic stimulation may be a cost effective way of facilitating growth and behavioral organization even in very small preterm neonates. To determine the safety of a developmental intervention for use with preterm infants and feasibility of a time sampling procedure.
                An experimental design was used to test an intervention with clinically stable 33-34-week postconceptional age infants over a 4-day period. Repeated outcome measures included pulse rate, oxygen saturation levels, and infant behavioral state.
                The intervention resulted in significant differences in infant behavioral state with the experimental group achieving more alertness. Physiologic parameters remained within normal limits both during and after the intervention.
                The protocol was found to be safe for implementation with clinically stable preterm infants. Behavioral state findings suggest the potential for the intervention to promote alertness. Results suggest that changes in oxygen saturation and pulse rate were dependent upon changes in behavioral state. nan Thirty preterm cocaine-exposed preterm neonates (mean gestational age 30 wks, mean birth weight = 1212 g, mean intensive care unit duration = 18 days) were randomly assigned to a massage therapy or a control group as soon as they were considered medically stable. Group assignment was based on a random stratification of gestational age, birth weight, intensive care unit duration, and entry weight into the study. The treatment group (N = 15) received massages for three 15-minute periods 3 consecutive hours for a 10-day period. Findings suggested that the massaged infants (1) averaged 28% greater weight gain per day (33 vs 26 g) although the groups did not differ in intake (calories or volume), (2) showed significantly fewer postnatal complications and stress behaviors than did control infants, and (3) demonstrated more mature motor behaviors on the Brazelton examination at the end of the 10-day study period. Thirty-three mother-infant pairs were randomly assigned to one of three groups: control, talking, or interactive (RISS). The later treatment included massage, talking, eye contact and rocking. The intervention (RISS) was administered to determine whether mothers and their preterm infants who actively interacted with each other would differ on later maternal and infant behaviors. The talking and RISS treatments were administered at specified time intervals 24 hours after delivery. Prior to hospital discharge, mother-infant interaction was assessed during a feeding. Significant differences were identified among the three groups for maternal (p less than .03) and infant (p less than .05) behaviors. These results suggest that active maternal interaction with the premature infant may enhance specific components of mother-infant interaction. Cardiac and behavioral responses to a tactual stimulus were evaluated during the first sleep cycle for 3 groups of infants: 30 full terms, 30 nonintervened preterms, and 30 intervened preterms. Prior to testing, the latter group had received a regimen of multimodal sensory stimulation, which emphasized the tactual and vestibular modalities. The results showed that the intervention altered the preterms' sensory functioning mainly during active sleep. In this state, the full terms and the intervened preterms exhibited a significant cardiac acceleration to the stimulus, while the nonintervened preterms failed to do so. Similarly, the behavioral response of the intervened preterm more closely approximated that of the full terms. During quiet sleep the intervention did not affect either the cardiac or the behavioral response. In this sleep state, the full terms' cardiac response was that of monophasic acceleration, whereas both groups of preterms exhibited a biphasic response with a smaller initial acceleration which was followed by a deceleration below baseline. Behaviorally, the preterms responded less frequently and gave smaller responses than the full terms. Thus there were marked differences between preterms and full terms, and the intervention seemed to narrow this gap to some extent. The effects of tactile and kinesthetic stimulation on the neonatal development of 12 premature infants were investigated. Experimental infants received four 15-min periods of tactile and kinesthetic stimulation daily for 10 days. The control infants received only standard, routine nursery care. Data were collected daily on 8 dependent measures: weight, number of feedings, amount of formula intake, body temperature, respiration, heart rate, frequency of voiding, and frequency of stooling. The data analyses revealed significant differences in amount of formula intake and in weight at the end of the treatment period in favor of the experimental infants. Additionally, the experimental infants required significantly fewer feedings during the stimulation period. All others dependent measures were nonsignificant.
Evidence that massage for preterm infants is of benefit for developmental outcomes is weak and does not warrant wider use of preterm infant massage. Where massage is currently provided by nurses, consideration should be given as to whether this is a cost-effective use of time. Future research should assess the effects of massage interventions on clinical outcome measures, such as medical complications or length of stay, and on process-of-care outcomes, such as care-giver or parental satisfaction.