Effects of Infant Massage on Depressed Mood in Mothers of Preterm Infants

Background & Aims: According to statistics, about 10% to 12% of babies born in developing countries are preterm. Iran is among the countries with a high incidence of preterm birth. Some babies require care in a neonatal intensive care unit (NICU). Premature birth is an emotional crisis for parents, and the hospitalization of preterm infants in the NICU is a cause of many families' suffering. Mothers of preterm infants experience emotional shock and may express feelings such as a depressed mood. Approximately, 28 to 70% of the mothers of preterm infants experience significant degrees of stress. Parents of preterm infants often suffer much psychological distress due to enduring the infant's unknown clinical conditions in the NICU, observation of aggressive treatments, and not participating in infant care. Therefore, it is essential to pay attention to the mental health of mothers of preterm infants. Previous studies have revealed limited information on the mood and mental state of mothers of preterm infants. Most studies have examined the effects of massage on the physical and psychological state of preterm infants, but few studies have investigated the effect of massage on their mothers' moods. The purpose of this study was to investigate the impact of infant massage on depressed mood of mothers of preterm infants who were discharged from the NICU. Materials & Methods: In this quasi-experimental clinical trial which was conducted during October 2015-April 2016, 70 mothers and their preterm infants with fetal age of 32-37 weeks were assigned to one experimental and one control group. The study population was primiparous Iranian women whose preterm infants were hospitalized in the NICU for at least two days and were supposed to be discharged from the ward within the next 24 hours. A continuous sampling method was used so that on consecutive days in the morning shift, research samples were selected from eligible mothers and infants. After studying the infants' records and visiting a specialist, eligible mothers whose infants were ordered to be discharged within the next 24 hours were included in the study. The following cases were was done in the first 4 minutes by the researcher and in the second 4 minutes by the mother. After the intervention, the depressed mood was re-measured. In all stages of massage, in case of infant crying, urination, or defecation, tactile stimuli were stopped and then intervention continued. The control group received no intervention. Results: Out of 75 mother-infant dyad participating in the study, 70 completed the study. 5 cases withdrew from the study (three and two mother-infant dyad in the experimental and control groups, respectively). Three samples were excluded from the study due to readmission (two in the experimental group and one in the control group) and two samples were removed from the study due to discharge with the personal consent of the parents (one in each group). Out of 70 mother-infant dyad, 35 remained in each group. There was no significant difference between the two groups in terms of demographic characteristics. On the day of discharge, there was a significant difference in the mean scores of depressed mood between the experimental and control group (6.37 ± 3.54 and 9.34 ± 5.27, p=0/007, respectively). In addition, on the day of discharge, the mean of depressed mood significantly decreased in the two groups (p=0/001). Conclusion: The results showed that observing the infant massage and then performing this massage by the mother twice (once the day before discharge and once on the day of infant discharge) reduced the mean scores of their depressed mood compared to mothers in the control group. However, the mean score of depressed mood in both groups on the day of discharge significantly decreased compared to the previous day, which could be due to reduced anxiety of mothers in both groups when discharging their babies. Hospitalization the neonatal care unit simple, inexpensive, and accessible methods, tactile baby, the baby. these mothers' mental conditions under complex mental states is of great importance. Researches on maternal postpartum behaviors are related to the oxytocin and the placental corticotrophin - releasing hormone. One of the mechanisms of the effect of infant massage on the mother is its effect on the oxytocin. Oxytocin plays a crucial role in developing behaviors related to interpersonal relationships, including the emotional relationship between mother, infant, and child. Therefore, the mechanism of oxytocin action in the central nervous system and the occurrence of certain behaviors due to its effect has recently been considered by psychiatrists. Undoubtedly, identifying the mothers of infants with a depressed mood and providing support for these mothers will significantly reduce the incidence of postpartum depression. Training mothers on how to perform massage has an essential role in the mother's mental health and reduces the mother's mood disorders. Community-based health care must be at the forefront of care planning.