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The color, symbolizes the sun, the eternal source of energy. It spreads warmth, optimism, enlightenment. It is the liturgical color of deity Saraswati - the goddess of knowledge.

The shape, neither a perfect circle nor a perfect square, gives freedom from any fixed pattern of thoughts just like the mind and creativity of a child. It reflects eternal whole, infinity, unity, integrity & harmony.

The ' child' within, reflects our child centric philosophy; the universal expression to evolve and expand but keeping a child’s interests and wellbeing at the central place.

The name, "Maa Sharda;" is a mother with divinity, simplicity, purity, enlightenment and healing touch, accommodating all her children indifferently. This venture itself is an offering to her........

The Influence Of Touch And Massage On An Infant’S Development


This essay was written for National essay competition ‘Mind-apple’, organized by Indian Academy of Pediatricians in 2006

 

 

Since the beginning of life on this planet, all living organisms are undergoing the process of evolution. Human being has excelled this process by development of much complex biological and sensory systems. All animals have the ability to speak but only we have made use of this ability to develop beautiful languages. Isn’t it true, though unfortunately, that as we learn more complex things we forget to use or underestimate the simpler things. Today we use internet, phone, E-mail to communicate with people at a distance, but we forget one very handy mean of communication (i.e. touch in the form of a handshake, a kiss or a hug) to express ourselves to people right in front of us. Can you remember last when you as a father had hugged your ten years old son without any reason or carried your  one year old daughter on your shoulders just for fun. When have you last walked with your wife hand in hand? Or as a wife when did you last rub the back of your tired husband to give the peaceful sleep that night?

 

Touch is a very basic sensation. Touch is a primitive way of communication. It is also a basic requirement like food and water. All human being thrive for touch throughout life. We have heard about spiritual healers who cure the diseases just by a touch. We have heard the story of the magic touch of King Midas which turned everything to gold. In Ramayana, Lord Ram had rescued Ahalya from her curse by his sacred touch. Whether these stories are true? We are not certain. But one thing is for sure that a touch does make a difference!!!

 

The physiology of touch

Skin is the largest organ of the body. There are various receptors (nerve endings) in the outer layer of skin, the epidermis. These receptors sense light touch, deep touch, pain, hot and cold sensations, which are carried from periphery to the spinal cord through the posterior roots. Cerebral cortex acts as a processor; it analyses the different touch and decides how to respond.  A growth gene called C-fos becomes activated by the pressure receptors and helps physical growth.

 

Role of touch in infancy

The link between touch, growth and bonding begin in the womb. The embryo’s outer layer called the exoderm (ectoderm) senses the life by the movement of the amniotic fluid surrounding it. The future skin and the nervous system develop from this exoderm. When a parent lovingly places a hand on the mothers belly the fetus shows its reaction by increased movement, heart rate and breathing. This awareness follows the baby through birth and into the world where touch continues to play a key role in her development. Tactile senses get stimulated right from the birth. Baby is pulled out, picked up, rubbed and covered in warm clothes and put to mother’s breast. A newborn has limited access to other senses. Her visual acuity is incomplete. She has no language other than cry. She can hear everything but it does not give her much meaning. Only thing she perceives well is touch. She loves being wrapped in warm soft clothes, being cuddled in parents’ arm and put to mother’s breast. Breast feeding not only provides her the necessary nutrition but it also gives her the equally important sense of being nurtured and loved. It is the first step towards the bonding of mother-baby duo.

 

Rooming in, i.e. keeping the baby close to mother, our traditional practice, is the second step towards bonding. Kangaroo care is another such method named so by the way a kangaroo carries her offspring. The baby is left naked on the bare chest of the mother with a shirt or blouse around the baby and an additional blanket on the top. Kangaroo care helps reduce crying, increase weight gain, regulates heart and respiratory rate and maintains body temperature. It also promotes sucking by the baby and establishes early and successful breastfeeding.

 

Healthy touch is important for growth of both body and mind. In orphanages all other needs of babies are met with but they are deprived of the equally needed loving touch. Such babies become withdrawn and fall easy prey to diseases. Not only frequent touch but consistency in touch is important. A low birth weight baby who is not able to breastfeed, but is allowed  being cared by mother and to suck on empty breast (non nutritive sucking) of mother, shows rapid weight gain as compared to those left in the nursery only on timely gavage feeding schedule. Care should be taken when mothers are being allowed to handle sick babies. Apart from transmitting love it may transmit sepsis. In these situations touch can be restricted to hand holding or a gentle stroking.

 

A loving touch also helps healing. A colicky crying baby can be calmed down by gentle patting and rocking by a parent. Rubbing the back at the bed time decreases the stress hormone cortisol and allows better sleep and reduces aggressiveness. Studies have shown that pain during certain procedures like heel prick can be reduced by keeping the baby in close contact with a parent. Vaccination can be given while the baby is breastfeeding or lying down in the mother’s lap.

 

Touch is talk to a baby. For parents it is a way to convey love. Parents transmit their emotions through their touch to the baby. A mother who is relaxed and confident conveys the same to the baby. A mother who is stressed and anxious has a baby who is hypertonic and colicky. Intelligent babies differentiate the touch of mother from other care givers. Touch in different forms can arouse different sensations. A tickle can make the baby laugh, a pinch can make her cry and a gentle stroke can put her to sleep. A hand on shoulder can comfort and a hug can reduce fear, anxiety or loneliness. Touch from a father is also important. A father should allow the infant to sit in his lap, sway and waddle and let the baby climb over his body. He can also give Kangaroo care. Both sons as well as daughters need to be touched by parent of opposite sex as well. Infants who are often touched lovingly by both parents learn to differentiate healthy touch from bad touch. Memories of touch last long, up to adulthood. Parents who where more often touched in their own infancy, tend to do so more to their children.

 

One should be age specific in one’s touch. Younger infants love feathery strokes whereas older children love firm touch. A baby’s inherent love and desire for touch should be utilized as a mode of entertainment and learning as well. Different touch games can be played with the baby. Holding your baby close with your cheeks in contact with the baby’s cheek and swaying at the tune of a light soft music, playing peek-a-boo with baby’s hands on your eyes or vice versa, touching and naming parts of the baby’s body, reading a book with baby in your lap, etc. A baby should be provided with interesting toys to touch, feel and chew. Plastic cups of different sizes, tethers of different shapes and textures, vegetables and fruits chopped to long pieces that cannot be swallowed are good options for baby who is able to sit up and has just started teething. Variety in foods in form of variable temperature, consistency, textures can help to coax baby at meal time by gratifying her tactile and taste senses.

 

During the first year of life a baby has limited mode of learning, vision, hearing and touch. We show them colorful toys, talk to them but ignore the need of touch. In the initial months baby learns by putting things in mouth, then by touching them. We often deprive them of satisfying this natural urge by telling not to put that in mouth and not to touch this. On the contrary we should provide them the opportunity for all types of touch. We should allow her to explore the world with the tool of touch; the touch of sand and mud, the prickly raindrops, the softness of petals and the warmth of sunlight.

 

 

Baby massage

The love for being touched is God’s gift, whereas massage is a special technique, a modified touch, an innovative creation by man. It is beneficial to everyone at any age if done with proper knowledge and technique. For infants it acts as a fuel to energize the rapidly developing brain and body. It is not a new modality. Our ayrveda has mentioned a lot regarding its advantages, ingredients, technique and so on. It recommends massage from infancy to adulthood. Charak has said ‘as oiling the axis of a wheel helps better functioning, massaging the body strengthens it.’ Science and studies has only helped us rediscover and modify this age old practice. It is an art that is to be learned accurately to procure maximum advantages from it. Let’s discuss it in detail.

 

Requirements : Just as a delicious recipe requires an expert chef with good ingredients in proper proportions so does a massage. It requires a regular provider who is close to the baby, preferably a parent and an hour of the day when both baby and the provider are in a good mood with no hurry. A room or space that is isolated, warm, moderately lit or receiving indirect sunlight, added with a soft music make a perfect atmosphere. A thick soft mattress on which baby can be comfortably laid down naked and an oil of ones own choice completes the list.

 

When? It can be given before bath in older children but for babies less than five months, a massage followed by bath can be tiresome and hyper stimulating. Both can be separated by a sleep in between. A nighttime massage before sleep is also good if convenient to both baby as well as provider. Practically it can be done at any time of the day sparing the time immediately after meal or when the child is sleepy enough to resist it.

 

Why daily? Massaging should be done daily for its enormous advantages. Apart from this, making it a daily schedule help baby to know what to expect and it gives a regular practice to the provider to make him perfect. It also relieves boredom for the baby who has practically nothing to do apart from eating and sleeping. Making it a daily routine helps especially when the life of mother or baby is disturbed for a short time due to illness, separation etc. Restarting the routine will give the message that all is well again.

 

How long? It may take 20-30 minutes to massage all parts ritually. But don’t see the watch; go by your baby’s clock. Start initially with 5 minutes then gradually increase. Rapid limb movements or other sign of disinterest is a signal to stop.

 

Which oil? Coconut, sesame or olive oil is routinely used. Traditionally prepared oil is as good as the commercial oil. Coconut oil is best for preterm and low birth weight babies as it is proven to provide nutrition by transcutaneous absorption and it contains medium chain triglycerides which are better absorbed. Aurveda has recommended the use of oil according to the ‘prakruti’ of the child, olive oil for those with ‘cough’ prakruti, coconut oil for those with ‘pitta’ prakruti and sesame oil for those with ‘vaat’ prakruti. Older children may like application of lotion instead of oil.

 

How much pressure? Massaging should be done with the pressure which one would like to apply on the closed eyelids.

 

Technique: The art of massaging, like cooking, usually run from mother to daughter. Proper technique could also be learned from a trained person like the pediatrician or a nurse. The main aim of massaging is to stimulate the functions of all internal organs. For this the provider should know the location and functions of internal organs. He should know the difference between stroke and massage. Stroking is to touch the skin gently while massaging means to softly move the muscle under the skin. Before beginning one should be sure that the surface on which the baby is to be laid and the hands of the massager both should be warm. Beginning with the leg massage is easily accepted by the baby as legs are more often handled during changing of diapers. As the baby becomes acquainted with the massage of peripheries one should work up towards the centre of the body like the stomach, chest, face and back. Smaller areas should be massaged with fingers while larger areas should be massaged with palm. One should begin with supine position first. Hair and scalp should be massaged with the tip of fingers gently in circular fashion. On face, one should move from inward to outward on forehead, above the brows, on cheeks and on the lower jaw. Neck should be massaged down to chest in front and the shoulders behind. Nape of neck should be specially caressed as it gives relaxation and help improve memory. Hands and legs should be encircled by a ring of fingers and thumb and gently pressed from shoulder to fingers and thigh to toes respectively. At the same time exercise can be done by flexion, extension and rotation of all joints. Foot massage is very relaxing. Pressure on stomach should be in the form of gentle circular motion in clockwise direction. Then the baby should be laid on belly to rub the back above downwards. Important thing to be remembered is “Let the baby select the position and time. Talk, sing or look intensely at the baby. Put yourself into massaging, not just perform it mechanically.”

 

Often as the child grows older he wouldn’t accept the routine as convincingly. He might not sit steady or allow massaging certain parts. Do not force him. Give in to his choice. Toddlers often love application of lotion instead of oil. An older child may accept a night-time massage. It will help relaxation and induce better sleep.

 

Benefits of massage: It includes benefit to the baby and parents as well.

 

Benefits to the baby

Physical benefits:

  •  It helps weight gain. Especially in premature and low birth weight babies trans cutaneous absorption of oil, improved circulation and digestion, all in synergy helps in weight gain.
  • Improves the quality of sleep by reducing stress and increasing circulation in head.
  • Tones the digestive system, relives the constipation and colic and aids digestion by stimulation of vagus nerve.
  • Strengthens the immune system by increasing the circulation and decreasing the stress.
  • Enhances the neurological development by increasing myelination and alertness.
  • Massaging the sinuses and chest reduces the congestion. It facilitates easy breathing in asthmatic infants.
  • Through massaging child learn to tackle sensory input and develop tolerance.
  • It relives the discomfort and pain associated with teething by increasing the levels of endorphins.
  • It improves the texture and softness of skin
  • Abnormal physical conditions can be noticed when the baby is completely exposed and explored during massage.
  • Massaging the scalp induces sleep and improves hair growth.

Long term benefits:

  • Massage provides stress and relaxation, the balance of which physically and hormonally is essential for learning process.
  • It helps in release of stress for both parents and children. Especially for working parents it is a good activity to reattach with the baby after homecoming.
  • It helps baby differentiate good from bad touch.
  • It helps understand each other’s body language and better synchronization between body movements and speech.
  • It is a good opportunity for fathers too to bond with the baby.
  • It gives a good time and opportunity for parents to stimulate other senses by talking and singing at the time of massaging.

Social benefits:

  • Babies who are massaged during infancy grow up more open, alert, vocalizing and easy going.

 

Benefits to the mother

  • When a mother massages her baby there is increased prolactin secretion which is needed to produce breast milk.
  •  Helps emotional bonding with child
  •  To a mother of an adopted child it helps dually, by establishing breastfeeding and increasing the mutual bond.

 

Contraindications and cautions: Massage should not be done just after feeds, when infant is having hiccough, unhealed naval, wounds, skin infection, fracture, burns, and undiagnosed lumps. It should be done cautiously in premature and low birth weight babies. It is generally advised to postpone it in all babies till one month of age to allow the baby to mature enough physically and mentally to receive all its advantages and to reduce its ill effects. Side effects include skin rashes and clogging of pores. These are self-limiting and recurrence can be prevented by change of oil. Baby may appear tired if done for longer time. There are no ill effects if done with proper technique. An inexperienced cook can spoil the recipe. Vigorous pressure by over enthusiastic untrained person like a ‘dai’ can cause fractures, dislocation and muscle soreness, spasms and cramps.

 

 

Conclusion

How we function as adults depend on how we are nurtured in infancy. The bond created by loving touch carries a blue print for health and love that will be passed on to future generations. Our ancestors raised their children by keeping them close, frequently holding them, carrying them along in cloth carrier even while working, breastfeeding them and sleeping with them. This was not merely by chance or due to lack of resources. They instinctively knew its importance. Western countries had started the trend of separating baby from mother by introducing bottle feeding and forcing the baby to sleep away from parents. They invented the safety devices like infant chairs and car seats so that the infants can be fastened without holding them. By doing so they hoped of raising independent and self sufficient children. Is it merely a coincidence that at the time when they have started giving up the natural practices of child rearing, they have to face the increasing incidences of childhood depression, violence, and suicide? This is a point to ponder. We are lucky enough that in our blind race behind the western countries, we have realized in time the value of our traditional methods of being close to children.

 

A message to all parents “Infancy is the crucial age for development in all fronts: physical, mental and emotional.  Give the best possible start in infancy by providing the benefit of touch and massage.  Show your love to your child with your hands. Give him a hug, carry him, and kiss him. A touch in time gives smile, to you and your child. Don’t be touchy about touch. A ‘jaadu ki jappi’ always work a magic. Practice it not only with your children but to everyone around you. It will make the world around you a worthy place to live.”

 

Dr. NEEMA SITAPARA

MD (Ped), PGDip. (Adolescent Pediatrics)