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Year : 2014  |  Volume : 3  |  Issue : 3  |  Page : 142-143

Field's massage with oil decreases bilirubin levels in healthy fullterm newborns

Department of Pediatrics, King Abdulaziz Hospital, Al-Ahsa, Saudi Arabia

Date of Web Publication8-Sep-2014

Correspondence Address:
Sameer Y Al-Abdi
Department of Pediatrics, King Abdulaziz Hospital, Al-Ahsa
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4847.140396

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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

How to cite this URL:
Al-Abdi SY. Field's massage with oil decreases bilirubin levels in healthy fullterm newborns. J Clin Neonatol [serial online] 2014 [cited 2021 Oct 25];3:142-3. Available from: https://www.jcnonweb.com/text.asp?2014/3/3/142/140396

  Commentary On Top

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 Top

Baby massage has been linked to an ancient tradition in some African and Asian countries and recently finds its way to western world. [1],[2] It has been linked to several benefits, including stimulating early defecation. [3] 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 Top

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.


Massage group

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. [4]

Control group

standard care.


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.

Allocation concealment

The quasi-randomized, by its nature, precludes allocation concealment.


Not feasible.

  Results Top

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 Top

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. [5] 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 Top

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.  Back to cited text no. 1
2.Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: A review. Infant Behav Dev 2010;33:115-24.  Back to cited text no. 2
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.  Back to cited text no. 3
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.  Back to cited text no. 4
5.Dursun A, Zenciroglu A, Okumus N. Newborn massage and neonatal jaundice. Tohoku J Exp Med 2011;225:221.  Back to cited text no. 5


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