|EBN SYNOPSIS - EVIDENCE-BASED NEONATOLOGY SYNOPSIS
|Year : 2014 | Volume
| Issue : 3 | Page : 142-143
Field's massage with oil decreases bilirubin levels in healthy fullterm newborns
Sameer Y Al-Abdi
Department of Pediatrics, King Abdulaziz Hospital, Al-Ahsa, Saudi Arabia
|Date of Web Publication||8-Sep-2014|
Sameer Y Al-Abdi
Department of Pediatrics, King Abdulaziz Hospital, Al-Ahsa
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Al-Abdi SY. Field's massage with oil decreases bilirubin levels in healthy fullterm newborns. J Clin Neonatol 2014;3:142-3
| Commentary On|| |
Chen J, Sadakata M, Ishida M, Sekizuka N, Sayama M. Baby massage ameliorates neonatal jaundice in full-term newborn infants. Tohoku J Exp Med 2011;223:97-102.
| Context|| |
Baby massage has been linked to an ancient tradition in some African and Asian countries and recently finds its way to western world. , It has been linked to several benefits, including stimulating early defecation.  Early defecation may decrease enterohepatic bilirubin circulation, which may translate into decreased rate and severity of neonatal hyperbilirubinemia. Effect of baby message on neonatal hyperbilirubinemia in full-term newborns has been assessed by one study only to date.
| Methods|| |
The study was a quasi-randomized control trial on healthy term newborns born between September and November 2006 in one Japanese hospital. Newborns born in every 2 days entered the control group and 1 day enter massage group.
There is no sample size calculation and a convenient sample of 42 full-term healthy newborns completed the study. In-hospital exclusive breastfeeding is standard in the study center.
Full-term healthy newborns that fulfilled all the following criteria:
- Gestational age: 37-41 weeks
- Birth weight: 2800-3600 g
- Apgar score>7.
Before enrollment (any of the following)
- Neonatal asphyxia
- Neonatal hemolytic diseases
- Presence of maternal obstetric complications.
After enrolment (any of the following)
- Requiring phototherapy
- Developing severe skin rash.
trained clinical staffs gave massage for 15-20 min 1 h after the morning and midday feed. The time frame of the massage was 1-5 th day of life (DOL). The message technique of Field et al. was used. 
Primary and secondary outcomes were not well specified. However, the aim of the study was to evaluate effect of baby message on bilirubin level reduction.
The quasi-randomized, by its nature, precludes allocation concealment.
| Results|| |
Sixty nine newborns fulfilled inclusion and primary exclusion criteria. Baseline characteristics of massage (N = 29) and control group (N = 40) were similar. Seven (24%) newborns in the massage group and 18 (45%) newborns in the controlled group required phototherapy treatment after enrolment; hence they were excluded.
Frequency of the stool in the first two DOL was significantly higher in the massage than the control groups. Transcutanous bilirubin levels in 2-5 th DOL were significantly lower in the massage than the control groups. Average of serum bilirubin level in 4 th DOL was less by 2 mg/dl (34 μmol/L) in the massage than control groups (11.7 ± 2.8 vs. 13.7 ± 1.7 mg/dl, P = 0.007).
| Commentary|| |
The results of the study are interesting and promising but its small size and likely selection bias preclude generalization. This study confirmed the authors' anticipation that phototherapy treatment would be less frequent among massage than control group (7/29 [24%] vs. 18/40 [45%]). Surprisingly, this observation has not been addressed or explained well even no statistical test was utilized to test this observation.  Perhaps, this was because the study was not powered to evaluate this observation. Based on this observation, 81 newborns will be required in each group to detect the difference in phototherapy requirement with 80% power and 5% level of significance. Nevertheless, this study should inspire future research in this field.
| References|| |
|1.||Kulkarni A, Kaushik JS, Gupta P, Sharma H, Agrawal RK. Massage and touch therapy in neonates: The current evidence. Indian Pediatr 2010;47:771-6. |
|2.||Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: A review. Infant Behav Dev 2010;33:115-24. |
|3.||Click R, Dahl-Smith J, Fowler L, DuBose J, Deneau-Saxton M, Herbert J. An osteopathic approach to reduction of readmissions for neonatal jaundice. Osteopath Fam Physician 2013;5:17-23. |
|4.||Field TM, Schanberg SM, Scafidi F, Bauer CR, Vega-Lahr N, Garcia R, et al. Tactile/kinesthetic stimulation effects on preterm neonates. Pediatrics 1986;77:654-8. |
|5.||Dursun A, Zenciroglu A, Okumus N. Newborn massage and neonatal jaundice. Tohoku J Exp Med 2011;225:221. |