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The Effect of Infant Massage on Infant Weight Gain

Authors:
The Effect of Infant Massage on Infant Weight
Gain
1st I A Anggarini
Lecturer of the Midwifery Study
Program
STIKes Muhammadiyah Palembang
Palembang, Indonesia
anggiinge@gmail.com
4th L Susanti
Lecturer of the Midwifery Study
Program
STIKes Muhammadiyah Palembang
Palembang, Indonesia
2nd R Andriani
Lecturer of the Midwifery Study
Program
STIKes Muhammadiyah Palembang
Palembang, Indonesia
3rd C Purwanti
Lecturer of the Midwifery Study
Program
STIKes Muhammadiyah Palembang
Palembang, Indonesia
AbstractSome of the benefits of baby massage include
increasing appetite, doubling the benefits of exclusive
breastfeeding, increasing body weight, increasing
endurance, making babies sleep more soundly, and fostering
attachment between parents and children. This research
aims to determine the effect of infant massage on weight gain
in infants at the Independent Practice of Midwife Zuniawati
and Misni Herawati in 2019. This study uses a quantitative
approach; the method used in this study is a quasi-
experimental type of pre-posttest control group design. The
population is newborns in PMB Zuniawati and Misni.
Sample 30 treated 30 controls. The sampling technique was
purposive sampling. The mean difference between before
and after being given a baby massage in the intervention
group was 263.33 gr. The difference in the mean between
before and after the control group increased by 78.33 gr. The
increase in infant weight in the intervention group was
higher than in the control group. Statistical test results were
significant differences between the weight gain of infants
before and after treatment both in the treatment group and
the control group.
KeywordsInfant, Massage, Weight Gain
I. INTRODUCTION
Riskesdas (2013) stated nationally, the prevalence of
underweight in 2013 was 19.6 percent, consisting of 5.7
percent of poor nutrition and 13.9 percent of
undernutrition. When compared with the national
prevalence rate in 2007 (18.4%) and in 2010 (17.9%), it
appears to be increasing. Changes are mainly in the
prevalence of malnutrition, from 5.4 percent in 2007, 4.9
percent in 2010, and 5.7 percent in 2013. One thing that
can be done in dealing with weight problems is regulating
diet or nutrition. One of the causes of weight problems is
a child's decreased appetite. This can be overcome by
giving supplements or vitamins to children or stimulation
and stimulation. One of the stimuli and stimuli
recommended is a baby massage.
Baby massage can be classified as a touch stimulation
application because, in baby massage, there are touch
elements in the form of affection, attention, voice or
speech, eyesight, movement, and massage. This
stimulation will stimulate the development of the structure
and function of brain cells (Soedjatmiko, 2006).
Currently, there have been many studies that state that
baby massage has many benefits, both physically and
emotionally. Some of the benefits of baby massage are
including increasing appetite, doubling the benefits of
exclusive breastfeeding, increasing body weight,
increasing endurance, making babies sleep more soundly,
and fostering attachment between parents and children.
Some studies say baby massage can stimulate the vagus
nerve, where this nerve increases intestinal peristalsis so
that emptying of the stomach increases, thereby
stimulating the baby's appetite. On the other hand,
massage also increases blood circulation and increases
cell metabolism; from the series, the baby's weight will
increase. Roesli cites Field and Scafidi research that is in
premature infants who performed massage 3 x 10 minutes
for 10 days, weight gain every day 20% -47% and in term
infants aged 1-3 months massaged 15 minutes, twice a
week for six weeks, gaining weight is better than not
getting a massage. From the description above, looking at
weight problems and the benefits of baby massage on
weight loss and the results of several previous studies, the
author is very interested in research to study the effect of
baby massage on changes in baby's weight. The authors
hope this research will be useful for parents and even
energy workers. Medical in helping to improve the quality
of health, because baby massage certainly has many
conveniences and benefits and can be done by all groups
from the upper or middle to lower classes. The purpose of
this study was to determine the effect of infant massage
on weight gain in infants at the Independent Practice of
Midwife Zuniawati and Misni Herawati in 2019.
II. METHOD
This research uses a quantitative approach; the method
used in this study is a quasi-experimental type of pre-
posttest control group design. The study population was
Advances in Health Sciences Research, volume 27
Proceedings of the 1st International Conference on Science, Health, Economics,
Education and Technology (ICoSHEET 2019)
Copyright © 2020 The Authors. Published by Atlantis Press B.V.
This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 403
newborn babies at PMB Zuniawati and Misni H. The
sample of this study was 30 treatments 30 controls. The
sampling technique was purposive sampling. In the baby
massage treatment group will be carried out by midwives
who have been certified to do baby massage, baby
massage is carried out for ten consecutive days from the
time the baby is born until the 10th day with a duration of
30 minutes each massage session using VCO (Virgin
Coconut Oil). Researchers will conduct a home visit to
measure weight gain in infants and evaluate infant
massage that has been done on day 10. Secondary data
were obtained from patient status at PMB Zuniawati and
Misni Herawati, whereas the control group was not
massaged. Mothers included in the control group will be
given leaflets about daily care for newborns. After the
research took place, the researchers gave counseling and
demonstrations regarding infant massage to the control
group, so that both respondents still received benefits
related to this study. The baby's weight was measured
using a manual scale OneMed Baby Scale OD 230.
III. RESULT
A. Characteristics of Respondents through Univarible
Analysis
Univariable analysis results, which are seen from
several variables, obtained a description of the
characteristics of the research subjects treatment groups
who were given baby massage and the control group who
were not given baby massage.
TABLE 1.FREQUENCY DISTRIBUTION OF
RESPONDENT CHARACTERISTICS
Variable
N
%
Baby massage
Given Baby Massage
No baby massage
30
30
50,0
50,0
Mother's age
Low risk
High risk
54
6
90,0
10,0
Parity
Primipara
Multipara
28
32
46,7
53,3
Level of education
Low
High
4
56
6,7
93,3
The characteristics of the respondents in this study
were mostly at a low-risk age of 54 (90.0%). The majority
of parity, namely multipara, is 32 (53.3%), for the
majority of high education level is 56 (94.4%), and for the
sex of the majority of respondents are female 32 (53.3%).
B. Bivariable Analysis
The bivariable analysis was carried out to determine the
relationship between independent variables, namely
infant massage giving to the dependent variable, namely
weight gain in infants.
1) Differences in infant weight before and after
treatment in the treatment and control groups
TABLE 2. PAIRED T. TEST FOR DIFFERENCES IN INFANT WEIGHT BEFORE AND AFTER TREATMENT IN THE TREATMENT AND
CONTROL GROUPS
Variable
weight gain
95% CI
t-test
p value
Pre test
Post test
Mean±SD
Mean±SD
Intervention
group
3.510±682,9
3.773,3±662,3
-263,3
-313,8- (-212,8)
-10,67
0,001
Control group
3.570±752,1
3.648±707,2
-78,33
-125,79- (-30,88)
-3,37
0,028
In table 4.2 shows that in the treatment group, the
average weight gain of infants before being given a baby
massage was 3,510 gr and after being given a baby
massage, the baby gained weight on average increased to
3,773.3 gr. The difference in mean between before and
after being given a baby massage is 263.3 gr. In the control
group, the average baby's weight gain previously was
3,570, and after it was found, the average increased was
3,648 gr. It has seen the difference in the mean between
before and after an increase that is equal to 78.33 gr. In
the statistical test results obtained p value of 0.001 in the
intervention group and 0.02 in the control group, it can be
concluded that there is a significant difference between
the baby's weight gain before and after treatment.
2) Comparison of infant weight gain in the treatment and control groups
TABEL 3. INDEPENDENT T-TEST FOR GIVING INFANT MASSAGES TO BABY'S WEIGHT GAIN
Variable
weight gain
Mean
Δ
Mean
95 % CI
t-test
p value
Intervention
group
-263,33±135,2
-185,0
-252,80 -(-117,20)
-5,46
0,001
Control group
-78,33±127,1
From the results of the independent t-test, statistical
test p-value was 0.001. The results of the statistical tests
showed that there were significant differences in the two
study groups. The mean difference in mean in the group
that got baby massage was -263.33 while in the group that
didn't get baby massage, the mean difference was -78.33.
While the mean difference between the two groups
was -185.0 and there was a difference in weight gain in
Advances in Health Sciences Research, volume 27
404
the treatment group giving infant massage compared to
the control group (95% CI: -252.80 - (117.20).
IV. DISCUSSION
A. Differences in infant weight before and after
treatment in the treatment and control groups
Weight is a general description of nutritional status. A
newborn neonate will be weighed within a few minutes
after birth. The results of these bodyweight measurements
are the basis for monitoring changes in body weight
during the neonatal period. Changes in body weight
during the neonatal period occur as a result of fluid
transfer from intracellular to extracellular. Increased
extracellular fluid in neonates causes salt and water
diuresis in the first 48-72 hours excessive extracellular
fluid production results in physiological weight loss in the
first week of life. Loss of fluids in neonates must be
balanced by providing adequate nutrition to prevent
dehydration or lack of calories. (Beckmann, B et al., 2014)
Baby's weight is the result of an increase or decrease
in all tissue in the body, including bones, muscles, fat,
body fluids, and others. The baby's weight is used as the
best indicator to determine the nutritional condition and
growth and development of children. According to WHO
(2003), adequate body weight gain in the 2nd week for
babies is 15gr / day. Exactly the weight gain for the age of
the baby who was born quite months (37 to 40 weeks) is
30 gr/day or will reach 250-300 gr/week. The Indonesian
Pediatrician Association (IDAI) states if a newborn baby
will experience weight loss in the first week of life. For
babies who get formula milk, then the weight loss is 5
percent, whereas for babies who are breastfed, then the
weight loss is more significant, which is 7 percent. All that
can happen in the first 72 hours of life, and After that, the
weight will go back up before the age of two weeks.
Data on the positive effects of baby massage, mostly
derived from the results of studies on premature babies
conducted since 1970 at the Touch Research Institutes at
the Miami Medical Scholl, according to Dr. Tiffani Field
and colleagues in Roesli (2001), massage in premature
babies will have a positive impact including increasing the
baby's weight 47% more days.
The activity of the vagus nerves influences the
mechanism of absorption of food Field and Schanberg's
(1986) research in Roesli (2007) shows that infants who
are massaged have an increase in vagus nerve tone (the
10th brain nerve) which will cause an increase in the
levels of the absorption enzymes in gastrin and insulin.
Thus, the absorption of food will be better. That is why
the weight of a baby who is massaged increases more than
those who are not massaged. The next study was carried
out by Diego et al. (2005), which states that massage
therapy in premature infants can increase infant weight
gain, increase vagal tone and gastric motility during and
immediately after massage. Gastric totality and vagal tone
are significantly related to body weight. Besides, the
activity of the vagus nerve increases the volume of ASI.
Food absorption is better because the increased activity of
the vagus nerve causes the baby to starve quickly so that
it will nurture more often to the mother. As a result, more
milk will be produced. As is known, more milk will be
produced if more and more are requested. In addition,
mothers who massage their babies will feel calmer, and
this has a positive impact on increasing the volume of
milk.
Factors that influence changes in weight for infant
massage are breastfeeding, gestation period, and neonatal
excretion. Several factors can increase the baby's weight
in addition to infant massage, namely: child nutrition,
child health, immunization, genetic, housing,
environmental sanitation, chromosomal abnormalities,
socio-economics, medicine. (Beckmann, B et al., 2014)
This is by the research of Juwitasari et al. (2018) about the
effect of massage on bodyweight improvement in 0-12
Month-Old babies. So that the average difference between
the two values is 0.3313, it can be concluded that there is
an increase in the baby's weight after the intervention.
Another study by Dewi et al. (2011) about the Effect of
massage stimulation on weight gain in full-term infants.
The result was that the median weight gain in the massage
group was 1230 grams, while in the control group, it was
830 grams (P = 0.028).
B. Comparison of infant weight gain in the treatment
and control groups
Karbasi et al. (2013) state that infant massage can
effectively be used as a way to increase a baby's weight
and is a safe non-medical measure if done. These results
are in line with research by Field et al. (2004), which
showed that the increase in body weight in the group of
term infants who were massaged for one month was 1130
grams, meaning that the weight gain was approximately
37.67 grams per day.
Research by Dewi et al. (2011) about the Effect of
massage stimulation on weight gain in full-term infants.
Massage stimulation is done by the mother once a day for
four weeks. Massage stimulation was given to 30 term
infants and their weight gain compared to 31 control
infants who did not receive massage. The result, weight
gain in term infants in the massaged group, was
significantly higher than in the control group after four
weeks.
Baby massage has been known as a solution to
facilitate the growth and development of babies that have
an impact on optimizing blood flow, normalizing the
heartbeat, maintaining digestion, and enhancing
immunity. Massage interventions will maintain adequate
nutrition by increasing the absorption of macronutrients
and micronutrients by stabilizing basal metabolism and
inducing insulin and adrenaline secretion and preventing
cortisol secretion. Baby massage causes an increase in
vagus nerve activity and will stimulate digestive
hormones, including insulin and gastrin. Insulin plays a
role in metabolism, causes an increase in carbohydrate
metabolism, glycogen storage, synthesis of fatty acids,
amino acid synthesis of protein synthesis. So insulin is an
important anabolic hormone that works in various tissues,
including liver, fat, and muscle. Increased insulin and
gastrin can stimulate function digestion so that absorption
Advances in Health Sciences Research, volume 27
405
of food juices becomes better. Better intake of food will
cause the baby to starve quickly, and therefore, babies are
more likely to breastfeed. As a result, milk production will
be more. (Juwitasari et al., 2017)
In a Review of Randomized Controlled Trials of
Massage in Preterm Infants, most studies have shown
significantly higher daily or overall weight gain during the
study period in the massage group compared to the control
group while some studies did not show statistically
significant differences in weight gain between the two
groups (Anna and Niemi K, 2017).
Other research The Effect of Massage on Weight Gain
of Low-Weight Hospitalized Infants: A Randomized
Clinical Trial, as many as 45 LBW neonates were
randomly allocated into the experimental and control
groups. Three times a day for 15 minutes, each session is
given in 5 days for the experimental group. Infant weights
were measured in both groups on day 5. The result of
weight gain in the experimental group was significantly
higher than in the control group. This study was a
randomized clinical trial. (Johari et al., 2016).
V. CONCLUSION
There are differences in the baby's weight before and
after the intervention is given both in the treatment group
and the control group. There is a difference in birth weight
gain in babies given massage compared to the control
group.
ACKNOWLEDGMENTS
Thanks to the chairman of the Muhammadiyah
Palembang STIKes, the Head of the P2M institution, that
has provided the funding for this research through the
Hibah STIKes MP.
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Insufficiently strong evidence from trials to show that massage improves growth and development in premature and low birth weight babies. Babies in neonatal intensive care units are subject to noise, bright light and a reduced amount of touch they would normally get from their mother. Massage has been recommended to promote growth and development of preterm (born before 34 weeks) and low birth weight babies. Massage can be combined with rocking, talking and eye contact and given by non-medical care givers, including parents. The review found several trials that seemed to show a positive effect of massage on weight gain, but these trials had scientific flaws. Massage seems safe for medically stable infants
Article
This study attempts to evaluate the impact of massage therapy on sleep behaviour in infants born with low birth weight (LBW) in St. Petersburg, Russia. Fifty infants (22 boys, 28 girls) who were born in St. Petersburg between 2000 and 2002 and defined as LBW babies (<2500g at birth) were enrolled onto the study at the age of 2 months. Of these, 41 (19 boys, 22 girls) were light and pre-term infants (gestational age < or =36 weeks), and 9 (3 boys, 6 girls) born light at term. The control group consisted of 50 healthy infants born with LBW who were cross-matched with an experimental group of babies and controlled for gender, gestational age, weight and date of birth. The groups were also matched for proximal geographical distribution in the city. Babies in the experimental group were assigned massage intervention therapy that include gentle rubbing, stroking, passive movements of the limbs and other means of kinaesthetic stimulation performed by professionals until the infant is 8 months old. The findings suggest that 8-month-old LBW infants who received massage intervention were less likely to snore during sleep, required less feeding on waking-up at night, and appeared more alert during the day. These apparent correlations remained significant after adjustment was made for major potential confounders. No statistically significant difference was found in sleep behaviour between LBW infants exposed to massage therapy who were either born pre-term or at term. It is suggested that massage may be a valuable approach to improve quality of sleep and reduce sleep-disordered breathing in infants born with LBW. It is acknowledged that whilst this study does not represent a large sample, it is felt that the findings suggest further investigation and offer an insight into an area previously relatively unexplored.