Article feature for Mums on the Go http://www.mumsonthego.com.au/
Approximately one in seven women in Australia will experience postnatal depression, or nearly sixteen percent of women who have given birth. Mothers with postnatal depression often have problems interacting with their baby; they may seem over intrusive toward their baby, often interfering with their baby’s activities, leading to the baby becoming passive and withdrawn. Or mothers themselves may be withdrawn, not interacting with their baby (disengaged), smiling at or playing with their baby as much as other mothers. This may lead to baby becoming distressed, often indicated by excessive crying (Tronick et al 1998). Why is this of concern and what are the outcomes? Postnatal depression in the mother can interfere with the ability of the infant to form a secure attachment (to their mother) and compromises infant functioning (social, cognitive and emotional) in later years. Consequently, these infants may develop behavioural problems, a difficult temperament and elevated stress (cortisol) levels (Field 2007).
Ways in which infant massage may assist the mother-infant interaction include increasing a mother’s confidence, an understanding of her baby’s cues (non-verbal and verbal), relaxation for both mother and baby, and a release of the hormone/neurotransmitter oxytocin, which assists bonding (Glover et al 2002). K. Onozawa and colleagues (2001) in their study found that mothers’ who attended an infant massage course with the International Association of Infant Massage, reduced their postnatal depression EPDS (Edinburgh Postnatal Depression Scale) score and statistically improved the mother-infant interaction. In other studies, Tiffany Field PhD, director of the Touch Research Institute, has conducted research into the effects of postnatal depression on both mother and infant, as well as the benefits of (infant) massage (10).
Participating in infant massage classes has both psychological and physiological benefits. During infant massage classes, mothers are given time to observe their baby, and with the help of a certified infant massage instructor (CIMI), come to understand their baby’s cues, and how to massage their baby. The following are the four main categories of benefits (of infant massage) for the infant:
Relief: massage can help with colic, wind, constipation, growing pains, emotional stress.
Stimulation: stimulation of the Vagus nerve, which regulates the various systems of the body (circulatory, digestive, lymphatic, nervous, immune, respiratory), muscular development and tone.
Relaxation: improvement in sleep, increasing oxytocin and serotonin, decreasing stress hormones (cortisol and norepinephrine), regulation of behavioural states (sleep and awake cycle) and less hyperactivity.
Interaction: massage helps the promotion of bonding and secure attachment between mother and infant, verbal and non-verbal communication, feeling respected, loved and nurtured.
Although it has been suggested that further research and RCT’s (randomised controlled trials) with larger groups would be beneficial in testing more thoroughly the effectiveness of infant massage, it is certainly a positive activity that mothers with postnatal depression can do with their baby; one with many benefits.
Natalie is a certified infant massage instructor and state representative of the International Association of Infant Massage (IAIM). She is currently studying child psychology and her interests include perinatal and infant mental health research. www.idibidikids.com.au
References:
1) Black Dog Institute “Depression during pregnancy and the postnatal period” PDF
2) beyondblue website http://www.beyondblue.org.au/index.aspx?link_id=89
3) Benefits of infant massage for mothers with postnatal depression
Vivette Glover, Katsuno Onozawa and Alison Hodgkinson, Queen Charlotte's and Chelsea Hospital, Semin Neonatol 2002; 7: 495 500. http://www.careperinatologia.it/lavori/L32.pdf
4) K Onozawa, V Glover, D Adams, N Modi, R C Kumar. Infant massage improves mother-infant interaction for mothers with postnatal depression. Journal of affective disorders. 2001 Mar;63(1-3): 201-7
5) M Fujita, Y Endoh, N Saimon, S Yamaguchi. Effect of Massaging Babies on Mothers: pilot study on the changes in mood states and salivary cortisol level. Complimentary Therapies in clinical Practice 12, 181-185
6) M Weinberg, E Tronick. Emotional characteristics of infants associated with maternal depression and anxiety. 1998, American Academy of Pediatrics (Pediatrics)
7) V McClure, International Association of Infant Massage “Manual for Infant Massage Instructors” 2005
8) T Field (PhD). The Amazing Infant. Blackwell Publishing, 2007, p 104-8, 111-13
9) http://www6.miami.edu/touch-research/ The Touch Research Institute, Miami, U.S.A.
10) http://www6.miami.edu/touch-research/TRIDepression.html
11) Field, T., Grizzle, N., Scafidi, F. Abrams, S., Richardson, S., Kuhn, C., & Schanberg, S. (1996). Massage therapy for infants of depressed mothers. Infant Behavior and Development, 19, 107-112.
“The infants who experienced massage therapy compared to infants in the rocking control group spent more time in active alert and active awake states, cried less, and had lower cortisol levels, suggesting lower stress. Over the 6-week period, the massage-therapy infants gained more weight, showed greater improvement on emotionality, sociability, and soothability temperament dimensions, and had greater decreases in stress neurotransmitters/hormones (norepinephrine, epinephrine, and cortisol)”
Field, T., Diego, M., Dieter, J., Hernandez-Reif, M, Schanberg, S. Kuhn, C., Yando, R., & Bendell, D. (2004). Prenatal depression effects on the fetus and the newborn. Infant Behavior & Development, 27, 216-229.
Prenatal mood and biochemistry levels were assessed in women with and without depressive symptoms during their second trimester of pregnancy. At the neonatal period maternal and neonatal biochemistry, EEG and vagal tone levels were assessed, neonatal behavioral states were observed and the Brazelton neurobehavioral assessment was conducted. The mothers with depressive symptoms had higher prenatal cortisol levels and lower dopamine and serotonin levels. Mothers with depressive symptoms were also more likely to deliver prematurely and have low birthweight babies. The newborns of mothers with depressive symptoms had higher cortisol levels and lower dopamine and serotonin levels, thus mimicking their mothers’ prenatal levels.
