Applying Infant Massage Practices: A Qualitative Study - Early Intervention - June 2005

This study explored the dynamic interaction between a mother and her 11-month-old visually impaired infant before and after the mother was taught infant massage. After the mother learned infant massage, she had more appropriate physical contact with her infant, engaged with him within his field of vision, directly vocalized to him, and had a greater ability to read his cues; the infant's interactions were reciprocal and reflected more-secure attachment, and the infant demonstrated beginning awareness of self and space. Infant massage has long been a traditional practice, and traditional applications of it are usually passed down from one generation to the next. In the early 20th century, many "folk practices," such as infant massage, were discarded in the interest of scientific advancement. Today, however, modern science is rediscovering age-old treatments, and the field of medicine is incorporating these interventions into scientific protocols (Muscarella, 1996). Infant massage is one such treatment that is currently being explored by scientists, physicians, physiologists, child development specialists, and educators with encouraging results. Among the benefits attributed to infant massage are greater relaxation and body awareness; strengthened circulatory, hormonal, and digestive systems; and improved muscle tone and sleep patterns (Scafidi et al., 1990; Scafidi et al., 1986; Schneider, 1996). The International Association of Infant Massage (IAIM) teaches a http://www.afb.org/jvib/JVIB990605.asp (1 of 24)9/21/2005 3:57:57 PM Applying Infant Massage Practices: A Qualitative Study Early Intervention June 2005 specific method of infant massage that incorporates four main sources: Indian massage techniques, Swedish massage techniques, reflexology techniques for the foot, and stroke combinations and techniques developed by McClure (1998). The Indian and Swedish strokes are designed to balance one another; the Indian strokes, which involve movement toward the extremities, serve to release tension, while the Swedish strokes, which move toward the heart, increase circulation. Reflexology strokes are intended to stimulate the thousands of nerve endings in the foot that are connected to the rest of the body. The stroke combinations and techniques, as well as the names of the strokes, were adapted or designed by McClure on the basis of extensive medical research, experience, and practice. The massage protocol designed by McClure is specific and unambiguous. Practitioners are required to complete a rigorous training program and internship before they are awarded certification. Although variations of this protocol exist, for the purposes of this study, only the procedures sanctioned by IAIM were used. This qualitative study observed and documented the dynamics of attachment formation in an infant with low vision who received infant massage, focusing particularly on the possible effects that infant massage may have on the formation of attachment between the infant and his mother. By examining an instance in which the only disabling condition was visual impairment, this study differed from previous qualitative research. In this respect, if infant massage can be used as an intervention to promote attachment, developmental delays that are sometimes seen in these children may be prevented, and visually impaired infants may eventually attain greater social, emotional, and educational achievements. Review of the literature Importance of bonding http://www.afb.org/jvib/JVIB990605.asp (2 of 24)9/21/2005 3:57:57 PM Applying Infant Massage Practices: A Qualitative Study Early Intervention June 2005 Caregiver-infant bonding is a basic need of all healthy humans and animals. Bonding is a process of mutual communication and interplay that occurs between the infant and caregiver, in which trust and intimacy are developed that are critical for the infant's physical survival, as well as emotional and psychosocial health (Bell & Ainsworth, 1972; Bowlby, 1996; Dellinger-Bavolek, 1996; Harlow, 1958, 1959; Harlow & Harlow, 1962; Harlow, Harlow, & Hansen, 1963; Kennell & Klaus, 1982; Klaus & Kennell, 1976; Klaus, Kennell, & Klaus, 1996; Main, 1981; Restak, 1986). Bonding and attachment are reciprocal processes involving interaction between a caregiver and an infant in which both individuals are active participants. Presumably through a complex system of communication, the infant evokes responses from the caregiver, who is sensitive to these cues and responds appropriately. According to Crittenden (1983, 1985, 1999), the infant's and the caregiver's behaviors both seem to be significant. Whether an infant relies on input from the caregiver to appraise a situation depends on the quality of communication in the dyad (Recchia, 1993). Once mutual patterns and expectations are established, each partner contributes to maintaining the patterns; subsequent growth and development occur on the basis of these expectations. In sum, the dynamics of bonding or attachment formation appear to be crucial to an infant's healthy physical, emotional, and social development. Infant massage within sociocultural contexts Infant massage is a form of communication between a caregiver and an infant; messages enter a child's world through the caregiver and become part of the existing social context. Over time, these messages are integrated into caregiver-infant interaction, and, as a result, new patterns of communication http://www.afb.org/jvib/JVIB990605.asp (3 of 24)9/21/2005 3:57:57 PM Applying Infant Massage Practices: A Qualitative Study Early Intervention June 2005 emerge that may not have been available to the dyad before. As Pedrosa (1997, quoted in Pantoja, 1997, p. 48) stated, "What is usually called the social environment should be construed as a field of interactions, which is the founder of, and is founded by, the constitutive actions of human beings, and where information (meaning) creation and significant reciprocal communication take place." These fields of interaction are often handed down from generation to generation and thus exist within a larger cultural context that reflects values that may differ across cultures. In this study, infant massage, a social phenomenon, was used to create a field of interaction in which significant reciprocal communication took place within a larger field of interaction--the interactive contact between a female researcher of Caucasian northern European descent (the first author), a female interpreter of Latin-Caribbean descent, and a mother and infant of Mexican American descent. The interpreter was able to serve as a cultural informant. The literature on the Mexican American heritage has noted several important values that need to be recognized in any effort to understand Mexican American culture, such as la plática ("small talk") and simpatía (behaviors that encourage pleasant social relationships) (Jay, 1996). Although it is crucial not to make stereotypical generalizations about any group of people, it is also important to provide cultural insights into some basic characteristics of Mexican Americans (Jay, 1996) that are relevant to the present study. To capture the participants' perspective accurately, the methodology in this study took into consideration the cultural values and beliefs of Mexican Americans by engaging in culturally appropriate communication, such as simpatía and la plática, as well as employing a knowledgeable cultural information.