Silence and Massage for Newborn and Mother

In 1986, Tiffany Field, Ph.D. at the University of Miami, showed that premature newborns who were massaged for fifteen minutes three times daily in the hospital following delivery regained their birth weight and left the hospital stronger than control babies who weren’t massaged.

In fact, the massaged newborns gained 47% more weight than the infants with standard care, and weighed more even eight months later, when they had scores on mental and motor tasks that reflected better development as well.

When this research came across my desk, I took it as an affirmation, because a few years earlier our center had implemented a program for postpartum mothers and babies as prescribed by Ayurveda, the health science of the Vedic civilization and the forerunner of modern medicine. Trained technicians follow the guidelines of the ancient texts, going daily for six weeks to the homes of new parents to give the baby and the recovering mother a warm sesame oil massage called abhyanga, a Sanskrit term.

The advantages for the mother are more rapid recovery from the trauma of pregnancy and delivery including improved elasticity of the abdominal skin and muscles and prevention of stretch marks, a quicker return to ideal weight, improvement of lower back pain, prevention of postpartum blues and improved energy.

For the baby, the advantage is gentle stimulation of his largest organ, the skin, together with its thousands of nerve receptors per square inch. The skin at this point in the baby’s tender life is also the most sensitive sense organ. Since the skin is the interface between our sterile interior and the hostile world of microbes, it is also the baby’s largest immune organ. Massage turns out to be a potent stimulator of the immune system, a phenomenon mediated in part by the stimulation of immune cells through hormones regulated by the nervous system. No wonder the ancient physicians gave mother-baby massage so much importance!

Science aside, the results have been evident to all involved: a smoother, gentler period of transition. This brings up another purpose of these six weeks. For the mother it is a time to rest and be cared for in order to heal quickly and have energy to nurse and care for others. The job of close family and friends is to see that the mother never feels overwhelmed.

For the newborn it is a time to habituate her tender nervous system to a new world of sounds, colors, shapes and smells, a radical change from life in the womb. Ayurveda holds that these first six weeks are the time for the baby to cultivate a settled, focused nervous system that will not be unduly excitable or distractible. The Ayurvedic way is for the baby to spend these six weeks indoors in a quiet environment free from bright lights and many strangers. This also helps insure he will not pick up a cold during this delicate time. I’ve often wondered on seeing a five day old infant in a sling around her mother’s neck amid the chaos of a supermarket checkout line, whether this practice might initiate the nervous system imbalance underlying the epidemic in our schools of problems with attention, behavior and stress.

Mother-baby massage is easy and enjoyable. Prepare a few towels, a baby bathtub or sink pre-filled with extra warm water (it will cool), a plastic bottle with warm, cold-pressed sesame oil (heat 2-4 ounces to about 104 degrees in a saucepan on the stove; it only takes a few seconds). Massage the baby first because she will usually sleep during the mother’s massage. Take off rings and bracelets and file your nails smooth before you start. Skip the massage if the baby has congestion, fever or diarrhea, but if she is colicky, massage may be just what is needed.

Pick a warm room without drafts. You can use a table, but most mothers prefer to do the massage on the floor with their backs leaning against the wall and the baby between their legs or on their laps. Keep her on a cotton towel or pillowcase because you will rarely encounter anything as slippery as your baby coated with oil! Scrupulously avoid getting sesame oil in her eyes; it is harmless but can irritate for a few minutes. If she has a rash, massage those areas first with ghee (clarified butter) and avoid rubbing them with the sesame oil later. Use long strokes on the long bones and circular motions on the joints. There need not be much pressure. Talk or sing softly to her as you massage; she has already been able to recognize your voice for months even though she’s new to you. The baby’s massage can last 5-10 minutes.

Start with baby on her back facing you so you make eye contact. Oil your hands and begin with the head. Make gentle circles with your palms over the entire head except the face, without putting pressure on the fontanels. The ears are massaged softly with your fingers. Allow your fingertips to slide up and down the neck and shoulders. Then apply oil with a side-to-side sweeping motion to the forehead, lips and chin, and with circles on the cheeks. Continue with the chest and sides of the trunk with the baby still on her back. Go up and down the trunk, as well as up through the arms to the fingers. Attend to each arm individually as well, making circles on the shoulders, elbows and wrists, up and down on the arm and forearm. Use your thumbs on the palms and give a gentle pull to the fingers. To help expel gas, make light circles in a clockwise direction on the abdomen.

The legs are massaged with the palms like the arms: first with full sweeping strokes from buttock to toes, and then progressively downwards, with circles on the hips, knees and ankles and long up-and-down strokes on the thigh and lower leg. The feet get extra attention in an Ayurvedic abhyanga: use your thumb on the soles and take the feet and ankles between your palms. Pull softly on the toes.With the baby on her belly (either on the pillow or on your lap), make long strokes up and down the back. Spend extra time here, since this is one of the most soothing parts of the abhyanga. After the massage and before applying the diaper, the baby can have some passive exercise: gentle bending the knees to the chest to aid elimination and expel gas; crossing the extended arms and legs; and gentle, straight-leg raising (slowly, like yoga postures) to develop suppleness.

You don’t need soap for the bath unless you can find a good reason. The sesame oil is a good solvent, and leaving a thin film of sesame oil will soothe and protect the skin. Similarly, shampoos are not needed much for a newborn, once every week or two. If the father wants to give the baby another massage in the evening before bed, it is good for both of them. Use less oil and just a warm sponge bath may be all that is needed before bed. You can also massage the feet and fontanel with a little sesame oil at bedtime if the baby is not sleeping well or colicky.

Now it’s Mum’s turn. Her massage is best done by another woman or by the father, but if that is impossible, she can just do it herself. It ideally lasts 15–30 minutes, but if time is a constraint, even five minutes is enjoyable and beneficial. Skip the scalp if you are pressed for time and cannot shampoo. Sit on a beach towel in the bathroom. Start with the head and move downwards to the toes. Massage the scalp vigorously, and apply oil to the face, spending extra time on the ears. Use the same technique as for the baby, up and down on the bones, circles on the joints.

Avoid the usual temptation to apply deep pressure. After delivery, the mother is helped by a lighter massage than the therapeutic massage used for muscle stiffness. This is not a time for deep bodywork; think of it as a technique for soothing and pampering the nervous system. Spend extra time on the feet and abdomen. Use a clockwise motion.

Don’t forget the breasts. Sesame oil soothes the nipples and has natural antimicrobial properties that help prevent mastitis. If the nipples are chapped and tender, apply ghee. Babies love the taste of clarified butter and don’t mind the sesame oil. Follow the massage with a hot tub bath and a few minutes rest while baby is still sleeping.

Plan before the delivery to create a restful, silent environment for yourself and your baby. Well begun is half done.

Jay Glaser, MD is a board certified internist in Massachusetts.