Infant massage and early development Abstract In this class you will learn techniques of infant massage that will help to establish better parent to child bonding and grow a happy baby in your home
Zhanna Root zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Table of Contents Infant Massage & Exercises .......................................................................................................................... 2 Infant Massage Routine ............................................................................................................................ 2 Legs: .......................................................................................................................................................... 3 Feet:........................................................................................................................................................... 4 Arms: ......................................................................................................................................................... 5 Tummy: (Use especially for colic, gas, constipation, etc.) ........................................................................ 6 Chest: ........................................................................................................................................................ 8 Face: .......................................................................................................................................................... 9 Back: ........................................................................................................................................................ 10 Infant Exercises ........................................................................................................................................... 11 Arms: ....................................................................................................................................................... 12 Leg stretches: .......................................................................................................................................... 12 Arms and legs: ......................................................................................................................................... 12 Abdominal exercises: (AFTER baby is sitting on her own) ...................................................................... 12 Special Needs Situations ............................................................................................................................. 13 Chest congestion ..................................................................................................................................... 13 Constipation: ........................................................................................................................................... 13 Diarrhea: ................................................................................................................................................. 13 Fever ....................................................................................................................................................... 13 Gas: ......................................................................................................................................................... 13 Hiccups .................................................................................................................................................... 13 Premature infants ................................................................................................................................... 14 Sinus congestion ..................................................................................................................................... 14 Teething .................................................................................................................................................. 14 Crying ...................................................................................................................................................... 14 Colic ......................................................................................................................................................... 15 The “5 S’s” technique step by step ............................................................................................................. 16 Infant massage tips ..................................................................................................................................... 19 Hands off!.................................................................................................................................................... 20 Recommended reading: ............................................................................................................................. 20
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Infant Massage & Exercises Infant Massage Routine First, begin with the realization that you will never give a “full body” infant massage. You will work in bits and pieces that correspond with your baby’s attention span and mood. Just like you wouldn’t want someone holding you down and massaging you against your will, you will also not do this to your baby. This is not to say that your baby will not let you give a full body massage, but generally speaking, it is more of a catch-as-catch-can proposition. Start with the areas of greatest need and expand from there as long as the baby is cooperative. Work in a warm environment that is free from distractions. Choose a time that your baby is awake and alert. If the baby is already falling asleep, he/she will probably not want to cooperate. Even though your baby can’t answer you, you should ask for permission, ask if they are enjoying the massage, etc. Cradle baby’s head on your feet as you sit on the floor in modified tailor position. If that is too strenuous on your knees or back, you can modify accordingly. You might wish to have a towel or cloth diaper underneath Baby, especially if you are doing this au natural. If you wish to use a massage agent, plain powdered cornstarch is the best choice, or vegetable oil. Avoid petroleum oils. Don’t put anything on Baby’s skin that you wouldn’t put in her mouth. The order that you work is not important, as long as you maintain some continuity and flow to your work. If you only get through a portion of it the first try, do different parts the next try, and so on. There are many different methods and techniques for infant massage, and none of them are right or wrong, as long as they are gentle, loving methods. Following is one simple method.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Legs: • Start by holding one foot, and perform effleurage (long smooth) strokes from the toe to hip. You can alternate hands with each stroke so that you can more easily cover the entire leg, front and back. • Next, you want to do petrissage (kneading) strokes. You can think of this as a very gentle “Indian burn” or as if you were gripping a baseball bat with just your fingers and lightly twisting. You want to make gentle twisting motions along the length of the long leg bones, first working below the knee only, then above knee only. Because you are doing a gentle twisting/squeezing motion, you don’t want to put any torque on the knee joint, so be sure to have both hands either above or below the knee. • Repeat several effleurage strokes from toe to hip.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Feet: • Perform gentle thumb compressions over the entire bottom of the foot, then follow up with gentle thumb-over-thumb strokes to the entire bottom surface of the foot. • Make tracing thumb-over-thumb strokes between the metatarsals (foot bones) on the top of Baby’s foot • Do each toe, individually, with gentle squeezing/twisting movements • Do more compressions and/or thumb-over-thumb strokes along the arch of the foot • Gently stretch ankle bone by grasping baby’s foot and circling it clockwise and then counterclockwise, so you get some flexion and extension, eversion and inversion
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Arms: The arms are done almost identically to the legs: • Long smooth strokes from wrist to shoulder • “Indian burn” or “baseball grip fingers” to first the forearm only, then upper arm only, being sure not to twist the elbow joint • Finish with more effleurage • Hands: like feet: compressions, trace metacarpals, fingers, wrist • Wrist range of motion stretches
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Tummy: (Use especially for colic, gas, constipation, etc.) • Make clockwise circles on your baby’s tummy to begin to stimulate digestion • Colon finger walking – this is using finger pressure to walk your way around the baby’s colon to help move gas or feces through the colon. Always make sure you are using clockwise pressure, although you will progress in a counterclockwise manner. You will start with the descending colon, then the transverse colon, then the ascending colon. Once you have gotten to the appendix area, sweep the entire colon clockwise to return to the starting position. To make this more visual, imagine that there is a clock on your baby’s tummy, with the 12 being at the sternum and the 6 being near the pubic bone. You will start at about 4:00 with pressure to 5:00, then from 3:00 with pressure to 4:00, from 2:00 with pressure to 3:00, 1:00 to 2:00, 12:00 to 1:00, continuing until you are at about 7:00 to 8:00. Then trace from 7:00 all the way to 5:00.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
• I Love You stroke – this is another way to do the colon, but with three larger strokes rather than the smaller clock strokes. You would start at the baby’s left ribs and stroke down toward her hip, then from the baby’s right side to the left side all at a level about even with the bottom of her sternum and following back down the left side toward the hip, then from her right hip up to the ribs. From the baby’s perspective, this will be like drawing an “I”, then an “L”, then a “U” on her tummy. (Remember, from your perspective it will look more like an “I”, “upside-down L”, and “upside-down U”). • If you want to encourage the passage of gas, or if you think there might be more goodies to come out into the already dirty diaper before you put on a new one, you can encourage this by lifting the baby’s left leg and pressing it into her torso. This causes the rectum to straighten and puts pressure on the descending colon, which will promote release of gas or feces.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Chest: • With flat hands, making a smooth stroke from sternum to ribs and to pectoralis, similar to smoothing open the pages of a book. You can also make a large x motion across your baby’s torso with alternating hands (i.e.: one going from lower right to upper left while the other goes from lower left to upper right) • Placing your fingertips along the ribcage, compress gently and make circular motions, being aware if you are tickling the baby, in which case you should omit this move. • Placing both hands (fingertips) on the sternum, move hands in opposite directions to trace the shape of a heart from the sternum, around the pecs/ribs, to navel
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Face: • With thumbs, smooth out from center of face to lateral borders at the chin, upper lip, below eyes, eyebrows, and several passes to cover forehead. Avoid the cheek area so as not to produce the rooting reflex (your baby’s instinct to find the nipple when it’s cheek is touched.) Give extra attention to the jawbone since baby uses the jaw muscles extensively while feeding. You can also do fingertip compression circles all along the hair as if shampooing, being gentle over the fontanels. Don’t forget to massage the baby’s ears – they generally love it, and it is calming to them. • The heart shaped stroke you did on the chest can also be done on the face, starting at the forehead and ending at the chin.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Back: This can be done with one hand while the other is holding the baby in the football carry or over your shoulder, or with two hands if you can lay in a bed or recliner with the baby resting at your shoulder. • Start with your thumb and index finger, making a series of compression circles from the base of occiput progressing all the way down to sacrum. You can repeat this concept a second time, going from neck to bottom, but this time using more of your whole hand rather than just the two fingers. • Make long effleurage (Petting) strokes from head to toe • Criss-cross hands making x strokes like you did on the chest.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Infant Exercises As baby is learning head control: Promote isometric exercise of neck muscles by putting baby on the floor, firmly grasp baby by her upper arm/shoulder and lift just enough to protract the chin but without lifting head off floor. Often you will see the baby’s neck muscles strain to lift the head. Hold three to five seconds, repeat several times. Do gentle neck massage when finished. Head control test: If you are not sure if your baby has head control, hold baby with its spine to your chest. If baby’s head is touching your chest, it has good head control. If the head tilts forward, it does not yet have control.
Once the baby has head control, to help it learn to roll over: Place one hand on the baby’s hip, take the opposite shoulder/arm and begin to roll baby toward the side you are stabilizing at the hip. Hold several seconds, repeat. Do each side. After baby is already rolling over on its own, and is ready to learn to sit up: Similar to the roll over, but this time as you stabilize the hip, take the baby’s arm/shoulder and pull the baby into a partial sitting position with a semi-circular motion.
You should also do a series of exercises as follows, making the motions rhythmic and game-like, with sounds, funny faces, blowing on baby, etc. to make it fun. Be creative, and alternate your motions to correspond with the baby’s actions if baby is joining in the fun.
Only do these techniques of the baby is cooperating. Never disrespect your baby by forcing movements that it is not willing to participate in. For example, if your baby is tightly holding its arms over its chest, then reinforce that motion by placing your hands on the outside of the arms and gently pressing in toward the chest, in effect, helping your baby do the motion it is doing on its own. If you need to move your baby’s arms or legs, such as to dress or diaper her, and her arms are held tightly to the chest or her legs held firmly, you might try to encourage your baby to release the motion by holding her hand or foot in one of your hands, and using your other hand to gently pat her arm or leg. Often this will encourage your baby to release the tension and allow you to move the limb. If your baby is cooperating, here are some fun exercises designed to develop coordination and right-left brain synergy.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Arms: • Alternate both arms out to sides like a cross, then arms crossed over chest like a self-hug, alternating which arm is on top in the crossed over chest position. Perform at least three times. • Similarly, stretch both arms over head, then toward feet, overhead, toward feet. • Take baby’s opposite hand to shoulder (right hand to left shoulder, left had to right shoulder, repeat at least three times.) • Take baby’s opposite hand to hip, switch sides. Anytime you are doing cross body movements like this, you are helping the development of the right and left brain and coordination. Leg stretches: • Gently bring the legs apart, then crossed over each other (with right on top, then with left on top). Apart, together, apart, together, rhythmically and playfully. • Touch opposite shoulder with toes, right foot to left shoulder, then left foot to right shoulder. • Grasp both thighs and gently medially and later all rotate the femur. • Cross baby’s feet and bring knees to chest (beware of gas or worse, remember how this was done to promote movement in the colon!!) • Bicycle the baby’s legs
Arms and legs: • Alternate bringing both right limbs up, then both left limbs up, repeat several times. • Simulated crawling with opposite limbs up (right leg and left arm, switch) • Opposite limbs together above tummy (right toes to left hand, then left toes to right hand)
Abdominal exercises: (AFTER baby is sitting on her own) • Obliques: Tilt baby to left or right, and they will try to come back to center, contracting their oblique abdominal muscles as they do so • Rectus: Tilt baby backward slightly. They will contract their abs as they try to sit upright. Tilt baby forward slightly. They will contract their back muscles to bring themselves upright.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Special Needs Situations When your baby is ill, check with your pediatrician for recommendations. Massage techniques for some conditions can help greatly, but don’t let this replace recommended healthcare for your infant if the condition persists.
Chest congestion: You can use the normal chest routine, adding a touch of eucalyptus essential oil to a vegetable oil, or using a commercial product such as Vicks or Mentholatum. To help pull mucus away from the baby’s lungs, you can do cupping on the chest and back. Just cup your hands or simply use one or two fingers per hand, and do a gentle, rhythmic tapotement (tapping) on the chest and back to help loosen mucus.
Constipation: Perform the normal abdominal routine of the massage, always in a clockwise direction.
Diarrhea: To attempt to slow diarrhea, you can gently massage the tummy in a counterclockwise direction.
Fever: If you are trying to bring down a baby’s fever, you can use gentle but brisk massage strokes, using warm water instead of oil. You are working to bring warmth to the skin, which will cool as the water evaporates.
Gas: See colic and constipation Hiccups: Caused by a spasm in the glottis and diaphragm, often impacting the phrenic nerve (the nerve to the diaphragm), hiccups can sometimes be eased in a variety of techniques. Often, burping the baby is helpful, which might require giving water or breast milk first to assist the burping process. From a massage standpoint, a gentle pressure at the level of the phrenic nerve might be helpful. The phrenic nerve has three branches that originate between cervical vertebras three, four, and five. Gentle pressure and massage at the side of the neck at these levels, working down toward the sternum, night be helpful in releasing the spasm of the diaphragm.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Premature infants: Many of the initial studies performed by Touch Research Institute were on premature infants, with remarkable results. You want to touch your baby as much as possible, but it can be difficult through incubators, medical tubes, and exposure to very tiny areas of skin. If the room is bright and noisy and you want to try to calm the baby, make any efforts you can to shield excess light and noise from your baby, such as placing a towel over one end of the incubator to decrease the glare, and playing a gentle tape of soft music with a maternal heartbeat at a low volume. You should also talk and sing to your baby, as she knows your voice and will find it reassuring. Early touch might be as simple as just placing your warmed hands against any exposed skin, or gently holding a single limb, while doing slow, deep breathing. Keep eye contact if possible, and verbally tell your baby to relax. When you are able to perform actual massage, use some of the strokes you learned, but modify by using a single finger or two when massaging very tiny areas. Keep your pressure gentle but firm, as too light of a stroke can cause stimulation rather than relaxation (the tickle response). Do avoid sites where IVs are attached, and either avoid or be extra gentle over the preemie’s sensitive stomach and fragile ribs.
Sinus congestion: downward strokes along the side of the nose and outward along the cheekbone can help release sinus congestion. You can also use gentle pressure with two fingers, one of each side of the nose, and progress downward. Begin along the side of the nose just under the eyes, and press gently for five to ten seconds, then move down slightly, and repeat the pressure. Continue this pressure down the entire length of the nose. When you get to the nostril level, continue the pressure outward along the cheekbones.
Teething: Full body massage in general can help sooth, as can the gentle massage of the cheek and jaw area of the face. Coolness on the gums can alleviate some of the discomfort. Teething rings that can be placed in the refrigerator may be of some benefit. You may also wish to gently massage the gums with any product made to reduce teething pain, but keep a very light touch.
Crying: Once you have determined that all of your baby’s needs are met, and the baby continues to cry for no discernable reason, the “5 S’s” shown as part of the colic routine are helpful.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Colic: Defined as a spasm in any hollow to tubular soft organ accompanied by pain, infantile colic can be relieved by the abdominal routine of the massage, as shown previously. A technique that can follow the massage is the “5 S’s”: Swaddle your baby tightly in a receiving blanket, to replicate the tightness of the womb, hold your baby close to your body with him lying on his side (either facing your body or with his back to your body), gently sway back and forth in a soothing rhythm, make a shushing sound, and if you are comfortable in allowing your baby to use a pacifier, allow him to suck on it as you do this process. This routine has shown to relax even the fussiest babies. A “football carry” (holding the baby on its tummy) also puts gentle pressure on the abdominal organs, which might be helpful.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com The “5 S’s” technique step by step
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Infant massage tips It’s important to keep pressure light to avoid discomfort: close your eyes and press your fingertips on your eyelids. This is the right level of pressure.
Before you begin, make sure your hands are clean, all jewelry is removed and that your nails are neat and smooth.
Lay your baby on a flat soft surface, like a towel or change mat on the carpet in a quiet and warm room with no draughts.
Many parents massage before or after the bath and before bedtime as this helps baby relax. But as long as your baby enjoys it, and feels calm and relaxed, anytime that suits your family’s routine is good, except after a feed when her stomach needs to settle.
Don't attempt massage if you are feeling stressed or agitated or if your baby is upset. And if your baby doesn’t seem to enjoy receiving the massage, stop. If she’s still not in the mood, try again another time.
If baby has been sitting in one position for a long time (for example a long car journey) a gentle buttocks massage moving hands from the spine outwards downwards towards her leg can help circulation.
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com
www.happy-baby-massage.com
Hands off!
Massage is suitable for almost all babies, but don't massage if your baby is:
overtired, unwell or has a fever
just been fed
has any cuts, bruises or skin complaints
cries or seems upset by it
had immunizations in the last 48 hours
had surgery or has any broken bones
Recommended reading: The Happiest Baby on the Block, by Dr. Harvey Karp Infant Massage--Revised Edition: A Handbook for Loving Parents , by Vimala Schneider McClure
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Phone: (484) 881-3005
Email: zhanna@happy-baby-massage.com