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1ST ANNUAL VIRTUAL
INFANT MASSAGE
U.S. CHAPTER CONFERENCE
JUNE 7, 2022
THE SCIENCE OF INFANT MASSAGE
Mary Kay Keller, M.P.A., Ph.D., C.E.I.M., C.F.L.E.
Practitioner & Educator @marykaykeller.com
Board President Infant Massage USA 2022 - current
Critical Review Process
Infant massage benefits for infants and parents/caregivers:
A critical review.
This critical review process was achieved by a determined plan to complete a
rigorous review.
Mary Kay Keller, M.P.A., C.E.I.M. Doctoral Candidate of Family and Child Sciences
program in the College of Human Sciences at Florida State University accepted and
passed in lieu of the Preliminary Exam.
Statement of
the Problem
A wide range of social and health problems are attributed to
adverse childhood experiences (Centers for Disease Control
and Prevention, 1998).
Research indicates a lack of nurturing emotional and
physical experiences resulting in an inter-generational cycle
of child abuse and neglect, substance abuse, domestic
violence, and health related disorders (Center for Disease
Control and Prevention, 1998).
The longer an infant is deprived of nurturance the more
severe the attachment disorder (O’Conner & Rutter, 2000).
In so far as, parental competence contributes to increased
outcomes of child well-being (Coren, 2005) and can increase
the well-being of both parents or caregivers and children
(Coren, 2005), this review focused on one type of parenting
intervention, infant massage.
Critical Review Objectives
•Critical analysis of Infant Massage peer reviewed research.
•Analyze the results to determine what if any benefits there are of providing
infant massage to infants and their parents (caregiver).
•Report whether results are dependable and transferable for infants, parents
and caregivers of infants.
•Current and future application of Infant Massage as a Science Based
Practice.
•Implications for future research and policy development .
Historically
Previous Research indicated benefits for infants including:
infants exposed to substances in utero
infants at risk of child abuse and neglect
infants experiencing developmental delays
infants of teen parents
infants born prematurely
and infants of fathers
Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001;
Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et al., 2008;
Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
Critical Review Research Question
This critical review aimed to evaluate experimental and quasi-experimental
research previously published which focused on answering the question:
“Does providing infant massage benefit the infant
and the parents or caregivers?”
Critical Review Methods
Sample
The articles selected for this critical review were published research studies
targeting parents or caregivers who massaged infants.
Samples in these research studies were further reviewed to determine if there
was a description of any confounding variables such as whether or not an
infant developmental and/or physical disability was diagnosed.
Critical Review Methods
Inclusion/Exclusion Criteria
Only peer reviewed journal articles on Infant Massage, printed in English on
Infant Massage were included in this review.
All located studies were reviewed for adherence to rigorous standards as
accepted by the social science professional community and general accepted
practices in the field of social science.
Selection criteria was based upon the determination that articles had
independent findings, were articles whose objective was to research infant
massage as an intervention provided by caregivers or parents with measured
outcomes for the infant and/or parent/caregiver.
Critical Review Methods
The articles identified by the inclusion and exclusion criteria were critically
reviewed to determine the rigor, relevance and robustness of reliability
coefficients and validation studies based upon the appropriateness of the
statistical measurements selected for the methodological design of each
article.
In addition, criteria as described by Gibbs (2003) and Isaac & Michael (1995)
was applied to experimental and quasi-experimental designs.
Critical Review Methods
Outcomes
Quantitative experimental and quasi-experimental designed studies provide
the appropriate methodology to address the outcomes and results of this
research question.
Application
Qualitative methodological designs address formative evaluation, the processes
by which the intervention is applied, (Issac & Micheal, 1995).
Critical Review Part I
The first part of the review provides a
description of the systematically
identified research literature from
diverse fields of study.
Country
Setting
Experience
Massage Provider
Critical Review
Research Description - Location
Country Author Country Author
Australia Scholz & Samuels, 1992 Japan Fujita et al., 2006; Ohgi, 2004
Brazil Mendes & Procianoy, 2008 Mexico Gonzales et al., 2009
Canada Elliot et al., 2002 Russia Kelmanson & Adulas, 2005
Ecuador Jump et al., 2006 S. Korea Kim et al., 2003
Finland Huhtula et al., 2000 Turkey Arikan et al., 2007
India Arora et al., 2005; Mathai et al., 2003;
Sankaranarayanan et al, 2005
United Kingdom Gitu et al., 2002; Glover et al.,
2002; O’Higgins, 2008;
Onozawa, 2001
Israel Ferber et al., 2005; Ferber et al., 2002;
Ferber et al., 2002
USA Cullen et al., 2000; Diego et al.,
2007; Feij’o et al., 2006; Field et
al., 1996; Field et al., 1996; Field
et al., 1998; Massaro et al., 2009;
Pelaez-Nogueras 1996; Scafidi &
Field, 1995; Teti et al., 2009
Critical Review
Research Description - Setting
Setting Author
Childcare Center Field et al., 1998; Field et al., 1996
Home Arikan et al., 2007; Cullen et al., 2000; Elliot et al., 2002; Huhtula et al.,
2000; Ferber et al., 2002; Fujita et al., 2006; O’Higgins, 2008; Onozawa,
2001
Hospital Feij’o et al., 2006; Ferber et al., 2002; Field et al., 1996; Gitu et al., 2002;
Glover et al., 2002; Kelmanson & Adulas, 2005; Mendes & Procianoy,
2008; Ohgi, 2004; Scafidi & Field, 1995; Scholz & Samuels, 1992
NICU Arora et al., 2005; Diego et al., 2007; Ferber et al., 2005; Gonzales et al.,
2009; Massaro et al., 2009; Mathai et al., 2003; Sankaranarayanan et al,
2005; Teti et al., 2009
Observation room Pelaez-Nogueras, 1996
Orphanage Jump et al., 2006; Kim et al., 2003
Critical Review
Infant Participants Descriptions
Experience Author
Born Premature Arora et al, 2005; Diego et al., 2007; Feij’o et al., 2006; Ferber et al.,
2005; Ferber et al., 2002; Gitu et al., 2002; Gonzales et al., 2009;
Kelmanson & Adulas, 2005; Massaro et al., 2009; Mathai et al., 2003;
Mendes & Procianoy, 2008; Sankaranarayanan et al, 2005; Teti et al.,
2009
Cerebral Insults Ohgi, 2004
Colic Arikan et al., 2007; Huhtala et al., 2000; Elliot et al., 2002
Healthy Arikan et al., 2007; Cullen et al., 2000; Elliot et al., 2002; Ferber et al.,
2002; Field et al., 1996; Field et al., 1996; Field et al., 1998; Fujita. et
al., 2006; Glover et al., 2002; Huhtala et al., 2000; Onozawa, 2001;
Pelaez-Nogueras, 1996; Scholz & Samuels, 1992
Infant Diarrhea Jump et al., 2006; Kim et al., 2003
Maternal HIV Scafidi & Field, 1995
Maternal Depression Feij’o et al., 2006; Field et al., 1996; Fujita. et al., 2006 ; O’Higgins,
2008; Onozawa, 2001; Pelaez-Nogueras, 1996
Critical Review
Participants Descriptions
Massager Author
Elder Field et al., 1996
Father Cullen et al., 2000; Scholz & Samuels, 1992
Mother Arikan et al., 2007; Arora et al, 2005; Feij’o et al., 2006; Ferber et
al., 2002; Ferber et al., 2002; Fujita. et al., 2006; Glover et al., 2002;
Mendes & Procianoy, 2008; Ohgi, 2004; O’Higgins, 2008;
Onozawa, 2001; Pelaez-Nogueras, 1996; Teti et al., 2009
Mothers watched
While staff provided
Field et al., 1996
Parents Elliot et al., 2002; Gonzales et al., 2009; Huhtala et al., 2000
Professional Staff Diego et al., 2007; Ferber et al., 2005; Field et al., 1996; Field et al.,
1996; Gitu et al., 2002; Jump et al., 2006; Kelmanson & Adulas,
2005; Kim et al., 2003; Massaro et al., 2009; ; Mathai et al., 2003;
Sankaranarayanan et al, 2005; Scafidi & Field, 1995
Research
Infant massage was
indicated to increase the
frequency and quality of
engagement of fathers and
mothers with their infants
Cullen et al., 2000; Ferber et al., 2005;
Field et al., 1996; Onozawa et al., 2001;
Pardew, 1996; Scholz & Samuels, 1992
Research
Furthermore, mothers experiencing
depression showed less depression
after massaging their infants or
watching their infants massaged by
another caregiver
Feijo, Hernandez-Reif, Field,
Burns, Valley-Gray & Simco, 2006
Even volunteers who massaged
infants showed an increase in their
quality of lifestyle
Feijo et al., 2006
Parent
benefits
Baby
receives
massage
Baby
benefits
Parent
massages
infant
Critical Review Part II
The second part of the review provides an
integration of the identified research
literature and the rigor of the identified
research design.
Author
Design
Measurement
Analysis
Reliability and Validity Coefficients
Multiple Post-tests
Credentials
Critical Review - Methods
Author Measurement Design Analysis
strategy
Reliability &
Validity
Citations
Multiple
Post-tests
Detailed
description of
Infant Massage
Description of
Instructor’s
credentials
Arikan et al.,
2007
Physical (crying) Experimental Intention to
Treat
Reliability
Coefficient
Citations
Arora et al, 2005 Physical Experimental Attrition Rates X X
Cullen et al.,
2000
Interaction Experimental Validity Citation
References
X X
Diego et al.,
2007
Physical Experimental X X
Elliot et al., 2002 Physical &
Interaction
Experimental Reliability
Coefficient
Citations/
Validity Citation
References
X
Feij’o et al.,
2006
Interaction Experimental
Critical Review - Methods
Author Measurement Design Analysis
strategy
Reliability &
Validity
Citations
Multiple
Post-tests
Detailed
description of
Infant Massage
Description of
Instructor’s
credentials
Field et al., 1998 Interaction Quasi Intention to
Treat
X X
Field et al., 1996 Physical Experimental
Field et al., 1996 Interaction Experimental Reliability
Coefficient
Citations
X
Ferber et al.,
2005
Interaction Experimental Attrition Rates
Ferber et al.
2002
Physical Experimental Intention to
Treat
X
Ferber et al.,
2002
Physical Experimental X
Fujita et al.,
2006
Interaction Experimental Intention to
Treat
X
Critical Review - Methods
Author Measurement Design Analysis
strategy
Reliability &
Validity
Citations
Multiple
Post-tests
Detailed
description of
Infant Massage
Description of
Instructor’s
credentials
Gitu et al., 2002 Physical Quasi
Glover et al.,
2002
Both Quasi X
Gonzales et al.,
2009
Physical Experimental Attrition Rates Reliability
Coefficient
Citations
X
Huhtula et al.,
2000
Physical (crying) Experimental X
Jump et al., 2006 Physical Experimental Intention to
Treat/ Attrition
Rates
X X
Kelmanson &
Adulas, 2005
Physical Quasi
Critical Review - Methods
Author Measurement Design Analysis
strategy
Reliability &
Validity
Citations
Multiple
Post-tests
Detailed
description of
Infant Massage
Description of
Instructor’s
credentials
Kim et al., 2003 Physical
Experimental
Reliability
Coefficient
Citations/
Validity Citation
References
X X
Massaro et al.,
2009
Physical Experimental Attrition Rates X X
Mathai et al.,
(2003)
Physical Experimental X
Mendes &
Procianoy, 2008 Physical
Experimental Attrition Rates X
O’Higgins,
2008
Interaction Experimental X X
Ohgi, 2004 Physical Experimental
Critical Review - Methods
Author Measurement Design Analysis
strategy
Reliability &
Validity
Citations
Multiple
Post-tests
Detailed
description of
Infant Massage
Description of
Instructor’s
credentials
Onozawa, 2001 Interaction Experimental Intention to
Treat
Reliability
Coefficient
Citations
X X
Pelaez-Nogueras
1996
Interaction Experimental Reliability
Coefficient
Citations/
Validity Citation
References
X X
Sankaranarayana
n et al, 2005
Physical Experimental Attrition Rates Validity Citation
References
X X
Scafidi & Field,
1996
Physical Experimental Validity Citation
References
X
Scholz &
Samuels, 1992
Interaction Experimental Reliability
Coefficient
Citations
X X
Teti et al., 2009 Interaction Experimental Intention to
Treat
X
Critical Review
Research Outcomes
Additionally, numerous research studies showed positive
outcomes for infants of mothers experiencing depression. These
Outcomes included:
◦ engagement
◦ interaction
◦ relaxation
◦ relief from stress
◦ and stimulation of the physiological systems
◦ and increased sleep by infants who were massaged
Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001;
Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et al., 2008;
Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
Critical Review Part III
A summary review of the
literature and subsequent
conclusions are reported (Rothman,
Damron-Rodiques, Shenassa, 1994).
Critical Review Outcomes
Participants Outcomes
Infant Outcome Parent/Caregiver Outcome
Decrease in crying/colic Decreased symptoms of stress, anxiety & depression
Decrease in length of hospital stay
Increased caregiving activities
Decrease in Diarrhea
Increased interaction
Increased Interaction (Engagement &
Entrainment Behavior)
Improvements in Lifestyles
Increase in Physical Growth
Increased Self Efficacy
Increased Sleep Time Parent/Caregiver Outcome
Critical Review Research
In summary, research on infant massage has previously reported primary parents/caregiver outcomes as
increased sense of parental competency and positive infant care behaviors.
For the infant, primary outcomes reported include increased sleep time, relaxation, and relief from
stress.
Secondary outcomes reported include increased engagement cues and increased interaction between
the parent/caregiver and the infant who received the massage for both the infant and the
parent/caregiver.
Secondary outcomes also included increased engagement and interaction behaviors with the adult
Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996;
Mendes & Procianoy, 2008; O’Higgins et., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
Critical Review
Implications for Future Research
Infants initiating engagement behaviors
*Fathers increasing quality of interaction with infants
Mothers reporting less symptoms of depression after massaging or
watching infants be massaged
Volunteers reported increased social satisfaction after massaging
infants.
Critical Review Research
Limitations
CREDIBILITY - TRANSPARENCY
No study described generational or immigrant status, disability status, sexual orientation, gender
identity, or language preferences.
Limited sample sizes (No power analysis to determine, 21 studies)
Furthermore, studies not conducted over a longer period, such as 12 weeks, are not considered
longitudinal studies and limit generalizability.
Sixteen studies did not address intention to treat and/or attrition rates.
Healthy infants generalizable to health infants
Four did not randomly assigned and 24 did not blindly assign participants
Did not address limitations of designs or ecological validity
No hypothesis, did not explicitly identify the Dependent or Independent Variable
No operational definitions of the terms
No reliability coefficients or validity citations for the measurement tools
No justification of appropriateness of statistical analysis
Infant Massage protocol not described
Pre-, Post, Multiple Measurements testing interaction
Part IV
In the Critical Review conducted in 2010 the
Florida State University Dissertation
committee decided Qualitative Studies were
excluded from the Critical Literature Review
in order to focus on the Experimental and
Quasi-Experimental designs as the purpose
was to establish the validity and reliability
of Infant Massage Outcomes.
It was determined as a result of the CR
outcomes to conduct a Qualitative Research
project. Qualitative research explores
quality over quantity, in addition to
developing the theoretical framework in
which to view the results to illuminate the
outcomes.
Qualitative Research
A Qualitative Case Study: Fathers’ Experiences of Massaging Their Infants.
Mary Kay Keller, Dissertation Study 2013, Family and Child Sciences, College of Human
Sciences, Florida State University.
Mary Kay Keller, Ph.D, 2015, Publication. Journal of Behavioral and Social Sciences.
The research question posed in this study was: What if any, benefits did fathers perceive
from massaging their infants?
HISTORICAL
Nearly a century ago research indicated a high need for infant touch
57 years later, 1977 studies involving mother touching their infants were conducted.
Currently in 2010 a Literature review of 31 Research (RCT) Articles, only 2 were
focused on fathers massaging their infants 1992 & 2002
Qualitative Research
Attachment Theory
1940s Bowlby and 50s Ainsworth research theory to practice.
Attachment Theory is developed by researching mothers’ relationships to their
infants.
At no point in time has Attachment Theory updated to substantiate attachment to
fathers. One study attempted to update with fathers of Adolescents.
Bonding is a chemical physiological human response based upon the 5 senses, eye
contact, hearing, smell, taste, and touch.
Research Design
Qualitative Exploratory Pilot Study Case Study N=1
Subjects 5 Fathers
Exploration of fathers’ experiences massaging their infants Demographic survey,
Structured Interview, Self Report Diary and Observation
Qualitative Research
Data Collection
Screening
Demographic Survey
Stage 1
Structured Interview
Infant Massage Demonstration
Video Recording 5”
Stage 2
Fathers Massage Infants Daily
Record Massages 1 time each
week in a Diary
Stage 3
Structured Interview
Video Recording 5”
Review both videos
Record Reaction to Video
Review
Member Checking
Check Responses for accuracy
Appointment set:
Incentive
Family Infant Massage Demo
Qualitative Research Rigor
Qualitative Research
Assessing Research Quality and Rigor
Qualitative Term Strategy employed Strategy Met
Credibility
Internal Validity
Triangulation
Member checks
Time sampling
Interview, Self Report Diary & Observation
Interviews were reviewed by participants for
accuracy
Fathers also reviewed videotapes and responded
Interviews conducted 1st and 3rd week
Diaries were recorded in each week for 3 weeks
Transferability
External Validity
Provide thick description
Purposive sampling
Precise descriptions of the research design,
methodology and data reports
Research, coding and data memos
Five first time fathers of infants less than 5 months
Dependability
Reliability
Create an audit trail
Code-recode strategy
Triangulation
Research, coding and data memos
Code and recode strategy described in detail in
memo
Interview, Self Report Diary & Observation
Confirmability
Objectivity
Triangulation
Practice reflexivity
Negative Case Analysis
Interview, Self Report Diary & Observation
Research Memo documenting all decisions in
detail
Research position, attitude and perspective
disclosed
Providing examples of data that does not support
the outcomes.
Qualitative Research
CAQDASAtlas.ti
(Computer Assisted Qualitative Data Analysis Software)
• Large amounts of data
• Text, graphics, audio and video, & GPS
mapping
Visual analysis
tool
• Assists in developing primary elements and
interpretation of the meaning of the data into
useful knowledge.
Systematic
Qualitative Data
Analysis
• Increased validity at conceptual analysis stage
• Not limited to content or subject matter from
any discipline (Friese, 2012).
Dependable
Qualitative
Research
Qualitative Model of Analysis
(NCT) Noticing Collecting Thinking
Noticing
Collecting
Thinking
Noticing
Collecting
Thinking
Data Set Up
• DATA Collection
• Input data to
ATLAS.ti
• Demographic Data
• Diary Data Analysis
1st Iteration
Initial Codes/Surface
Content Analysis
• Initial Coding
• Process Coding
2nd Iteration
Pattern Variables
• In Vivo (literal)
Coding
• Pattern Coding
3rd Iteration
Application to Data
Set
• Theoretical Coding
• CODE MAPPING -
Fathers perceived
benefits of massaging
their infants
• Categories of Results
and Assumptions
• Exemplary(s),
(Anfara et al., 2002).
Qualitative Research
Code Mapping:
Three Iterations of Analysis
Qualitative Research
Participants 1 2 3 4 5
Age 35 22 36 27 22
Marital
Status
Married Living w
Partner
Married Married Living w
Partner
Race White Black Black White White
Level of
Education
Graduate College College College College
Annual
Income
$0-$25,000 $0-$25,000 $60,000+ $25,001-
$60,000
$0-$25,000
Infant Sex Male Female Male Male Male
Demographics
Activity Diary Data Analysis
Time of day:
Missed one day. Momma thinks he goes to bed better if massage is closer to bedtime. (Father
1, week 3). Afternoon [massaged] and in the evening for his stomach. (Father 3, week 3).
Duration:
Most importantly I tried to be as consistent as possible, but I did the massage 4 or 5 times a day
depending if she was in the mood. The more we did the massage for about 5 minutes I felt she
enjoyed it more. (Father 2, week 1)
I like shorter massages, actually he likes shorter massages. Now that I don’t feel like I have to
finish every position, I would say we are both enjoying the massages more. I am doing more
frequent but shorter massages. Especially on the changing table after a diaper change.
Massages don’t feel like a chore anymore, something I have to do. (Father 4, week 3)
Qualitative Research
Activity Diary Data Analysis
Body Part:
Baby only [fussed] once during his chest massages. (Father 1, week1)
He has been most receptive to back massage. Least receptive to chest massage.
(Father 3, week 2)
I noticed once when I was massaging his back his breathing started to slow down as if he
were more relaxed. Short stomach massages to help with gas. (Father 3, week 3)
It is notable to me that infant 4 was the only infant out of five that verbally protested
throughout the massage and that this father was the most verbal in both of the interviews.
Additionally, father 1 reported a change in his infant's eye contact during week two of the
massages. "This week I realized that on the days he didn't seem to be looking at me, he
would start to do so about a minute or two into the massage."
Qualitative Research
Qualitative Research
Fathers exhibited sustained long-term caregiving and initiated interaction with
their infants after learning to massage their infants.
 Opportunity - 91% of fathers are involved with the mother at the time of the birth
of the infant <50% by the time the child enters pre-school.
 Practice - When fathers are primary caregivers, trained and/or observe child care
activities they become more like the mother in their caregiving.
 Enjoyment – fathers who are involved in caregiving report higher satisfaction of
fathering.
Qualitative Research
Pattern coding
Fathers desire to relieve mothers’ stress.
Mother
gets time
to herself
Father
adjusts
time of day
ay
Father gets
one on one
time with
infante on
one time
Father
Massages
Infant
Infant
Qualitative Research
Pattern coding
Fathers desire to relieve infants’ stress.
Infant
responds
to
father’s
touch
Father adjusts
Father
adjusts
time of
day e of day
Father gets one
on one time
with the infant
one time
Father
Massages
Infant
Qualitative Research
Perceived Benefits
Fathers Perception
Parent
benefits
Baby
receives
massage
Baby
benefits
Parent
massages
infant
Qualitative Research
Matrix of Findings and Sources for Data Triangulation
Qualitative Research
Matrix of Findings and Sources for Data Triangulation
Qualitative Research
Matrix of Findings and Sources for Data Triangulation
Qualitative Research
Matrix of Findings and Sources for Data Triangulation
Qualitative Research
Implications for Future Research
1. what impact was there on the father/child dyad during the early years; what
were the mothers’ perceptions about the time the fathers spent with the infant
and their behaviors after the study.
2. replication of past studies to determine outcomes for father contributions
3. In The Ecology of Attachment in the Family, the authors postulate that
attachment does not hold exclusively to the parent-child dyad and can also be
applied to the family (Hill et. al,. 2003).
a. Non-resident fathers are less involved than resident fathers and had the same
attitudes of commitment to fathering as fathers who were resident fathers
however reported lower feelings of competence and satisfaction (Minton &
Pasley, 1996). Competence may be a key in factor influencing father
involvement (p.40).
b. Mothers reported less symptoms of depression regardless of whether they
massaged their infants or others massaged their infant.
Qualitative Research
Implications for Practice for Professionals
1. Bonding & attachment opportunities for fathers
Fathers showed a willingness to relieve the mothers of her care-giving
activities and felt competent in spending time with their infant. Fathers
reported feeling bonded and attached to their infants.
Additionally, fathers responded emotionally, report motivation and change
their attitudes when provided opportunity (Scholz & Samuels,2002).
Fathers greatly benefited from infant massage classes with other fathers
(Cheng, Volk & Marini, 2011).
2. Fathers contributions to the family
New fathers transitioning into a fathering role become stressed and this
negatively impacts the marital relationship which also may impact their
attachment to their infant (Green, Furrer & McAllister, 2007). Teaching
father IM increased their feelings of competence and sense of contribution.
Fathers responded with sensitivity to their infants needs.
Depression study.
Qualitative Research
Implications for Practice for Fathers
Fathers’ contribution are important to infant development.
Fathers need to actively seek opportunities for involvement.
It is equally important for fathers to understand that although their
relationship develops through different means than the mother it is just as
valid and impacts the infant.
Qualitative Research
Discussion
Contributions to the literature
Theoretical Framework
Credible Research Platform
rigorous qualitative design.
formalized qualitative processes
computer-assisted tool
Contributions to the literature
Confirmed Father Motivation for Parental Involvement
a. fathers desired involvement.
b. systemic barriers (do social support discourage father
involvement?)
Conclusion: Infant Massage needs to be included in Infant Care Giving and
Parent Education Services
Qualitative Research
Keller, M.K., 2015 A Qualitative Case Study: Fathers’ Experiences of
Massaging their infants. Journal of Behavioral and Social Sciences. v.2., 29-39.
Keller, M.K., 2013 Exploratory Case Study of Fathers who Massaged their
Infants. Dissertation in Child and Family Studies, Collage of Human Sciences,
Florida State University.
References
Arikan, D., Alph, H., Gozum, S., Orbak, Z. & Cifci, E. (2008) Effectiveness of massage., sucrose solution, herbal tea or hydrolysed formula in the
treatment of infantile colic. Journal of Clinical Nursing, 17. 1754-1761.
Arora, J., Kumar, A. & Ramji, S. (2005) Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates. Indian
Pediatrics, 42, 1092-1100.
Cullen, C., Field, T., Escalona, A., & Hartshorn, K. (2000). Father-infant interactions are
enhanced by massage therapy. Early Child Development and Care, 164, 41- 47.
Diego, M., Field, T., Hernandez-Reif, M., Deeds, O., Ascencio, A., & Begert, G. (2007) Preterm infant massage elicits consistent increases in vagal
activity and gastric motility that are associated with greater weight gain. Acta Pædiatrica, 96, 1588-1596.
Elliot, M., Reilly, S., Drummond, J., & Letourneau, N. (2002). The effect of different soothing interventions on infant crying and on parent-infant
interaction. Infant Mental Health Journal, 23, 310-328.
Feij’o, L., Hernandez-Reif, M., Field, T., Burns, W., Valley-Gray, S., & Simco, E. (2006). Brief report: Mother’s depressed mood and anxiety levels
are reduced after massaging their preterm infants. Infant Behavior & Development, 29, 476-480.
Ferber, S., Feldman, R., Kohelet, D., Kuint, J., Dollberg, S., Arbel, E., & Weller, A. (2005).
Massage therapy facilitates mother-infant interaction in premature infants. Infant Behavior & Development, 28, 74-81.
Ferber, S., Kuint, J., Weller, A., Feldman, R., Dollberg, S., Arbel, E., & Kohlet, D. (2002) Massage therapy by mothers and trained professionals
enhances weight gain in preterm infants. Early Human Development, 67, 37- 45.
Ferber, S., Laudon, M., Kuint, J. Weller, A. & Zisapel, N. (2002). Massage therapy by mothers enhances the adjustment of circadian rhythms to the
nocturnal period in full-term infants. Developmental and Behavioral Pediatrics, 23,( 6), 410-416.
Field, T., Grizzle, N., Scafidi, F., Abrams, S., & Richardson, S., Kuhn, C. & Shanberg, S. (1996). Massage therapy for infants of depressed mothers.
Infant Behavior and Development, 19, 109-114.
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excessive crying in infants with cerebral injuries. Archives of Disease in Childhood, 89. 212-216.
Onozawa, K., Glover, V., Adams, D., Modi, N., & Kumar, C. (2001). Research report: Infant
massage improves mother-infant interaction for mothers with postnatal depression. Journal of Affective Disorders, 63, 201-207.
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still-face interactions. Child Development, 67, 1780-1792.
Sankaranarayanan, K., Mondkar, J. Chauhan, M., Mascarenhas, B., Mainkar, A. & Salvi, R. (2005) Oil massage in neonates: an open randomized
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Scafidi, F. & Field, T. (1996). Massage therapy improves behavior in neonates born to HIV- positive mothers. Journal of Pediatric Psychology, 21
(6). 889-897.
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Behavioral effects 12 weeks after birth of the first baby: The Sunraysia Australia
Intervention Project. International Journal of Behavioral Development, 15, 67-81.
Teti, D., Black, M., Viscardi, P., O’Connell, M., Baker, L. & Heiss, C. (2009). Intervention with African American premature infants: four-month
results of an early intervention program. Journal of Early Intervention, 31. 146.

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The Science of Infant Massage 6.7.22.pptx

  • 1. 1ST ANNUAL VIRTUAL INFANT MASSAGE U.S. CHAPTER CONFERENCE JUNE 7, 2022 THE SCIENCE OF INFANT MASSAGE Mary Kay Keller, M.P.A., Ph.D., C.E.I.M., C.F.L.E. Practitioner & Educator @marykaykeller.com Board President Infant Massage USA 2022 - current
  • 2. Critical Review Process Infant massage benefits for infants and parents/caregivers: A critical review. This critical review process was achieved by a determined plan to complete a rigorous review. Mary Kay Keller, M.P.A., C.E.I.M. Doctoral Candidate of Family and Child Sciences program in the College of Human Sciences at Florida State University accepted and passed in lieu of the Preliminary Exam.
  • 3. Statement of the Problem A wide range of social and health problems are attributed to adverse childhood experiences (Centers for Disease Control and Prevention, 1998). Research indicates a lack of nurturing emotional and physical experiences resulting in an inter-generational cycle of child abuse and neglect, substance abuse, domestic violence, and health related disorders (Center for Disease Control and Prevention, 1998). The longer an infant is deprived of nurturance the more severe the attachment disorder (O’Conner & Rutter, 2000). In so far as, parental competence contributes to increased outcomes of child well-being (Coren, 2005) and can increase the well-being of both parents or caregivers and children (Coren, 2005), this review focused on one type of parenting intervention, infant massage.
  • 4. Critical Review Objectives •Critical analysis of Infant Massage peer reviewed research. •Analyze the results to determine what if any benefits there are of providing infant massage to infants and their parents (caregiver). •Report whether results are dependable and transferable for infants, parents and caregivers of infants. •Current and future application of Infant Massage as a Science Based Practice. •Implications for future research and policy development .
  • 5. Historically Previous Research indicated benefits for infants including: infants exposed to substances in utero infants at risk of child abuse and neglect infants experiencing developmental delays infants of teen parents infants born prematurely and infants of fathers Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et al., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
  • 6. Critical Review Research Question This critical review aimed to evaluate experimental and quasi-experimental research previously published which focused on answering the question: “Does providing infant massage benefit the infant and the parents or caregivers?”
  • 7. Critical Review Methods Sample The articles selected for this critical review were published research studies targeting parents or caregivers who massaged infants. Samples in these research studies were further reviewed to determine if there was a description of any confounding variables such as whether or not an infant developmental and/or physical disability was diagnosed.
  • 8. Critical Review Methods Inclusion/Exclusion Criteria Only peer reviewed journal articles on Infant Massage, printed in English on Infant Massage were included in this review. All located studies were reviewed for adherence to rigorous standards as accepted by the social science professional community and general accepted practices in the field of social science. Selection criteria was based upon the determination that articles had independent findings, were articles whose objective was to research infant massage as an intervention provided by caregivers or parents with measured outcomes for the infant and/or parent/caregiver.
  • 9. Critical Review Methods The articles identified by the inclusion and exclusion criteria were critically reviewed to determine the rigor, relevance and robustness of reliability coefficients and validation studies based upon the appropriateness of the statistical measurements selected for the methodological design of each article. In addition, criteria as described by Gibbs (2003) and Isaac & Michael (1995) was applied to experimental and quasi-experimental designs.
  • 10. Critical Review Methods Outcomes Quantitative experimental and quasi-experimental designed studies provide the appropriate methodology to address the outcomes and results of this research question. Application Qualitative methodological designs address formative evaluation, the processes by which the intervention is applied, (Issac & Micheal, 1995).
  • 11. Critical Review Part I The first part of the review provides a description of the systematically identified research literature from diverse fields of study. Country Setting Experience Massage Provider
  • 12. Critical Review Research Description - Location Country Author Country Author Australia Scholz & Samuels, 1992 Japan Fujita et al., 2006; Ohgi, 2004 Brazil Mendes & Procianoy, 2008 Mexico Gonzales et al., 2009 Canada Elliot et al., 2002 Russia Kelmanson & Adulas, 2005 Ecuador Jump et al., 2006 S. Korea Kim et al., 2003 Finland Huhtula et al., 2000 Turkey Arikan et al., 2007 India Arora et al., 2005; Mathai et al., 2003; Sankaranarayanan et al, 2005 United Kingdom Gitu et al., 2002; Glover et al., 2002; O’Higgins, 2008; Onozawa, 2001 Israel Ferber et al., 2005; Ferber et al., 2002; Ferber et al., 2002 USA Cullen et al., 2000; Diego et al., 2007; Feij’o et al., 2006; Field et al., 1996; Field et al., 1996; Field et al., 1998; Massaro et al., 2009; Pelaez-Nogueras 1996; Scafidi & Field, 1995; Teti et al., 2009
  • 13. Critical Review Research Description - Setting Setting Author Childcare Center Field et al., 1998; Field et al., 1996 Home Arikan et al., 2007; Cullen et al., 2000; Elliot et al., 2002; Huhtula et al., 2000; Ferber et al., 2002; Fujita et al., 2006; O’Higgins, 2008; Onozawa, 2001 Hospital Feij’o et al., 2006; Ferber et al., 2002; Field et al., 1996; Gitu et al., 2002; Glover et al., 2002; Kelmanson & Adulas, 2005; Mendes & Procianoy, 2008; Ohgi, 2004; Scafidi & Field, 1995; Scholz & Samuels, 1992 NICU Arora et al., 2005; Diego et al., 2007; Ferber et al., 2005; Gonzales et al., 2009; Massaro et al., 2009; Mathai et al., 2003; Sankaranarayanan et al, 2005; Teti et al., 2009 Observation room Pelaez-Nogueras, 1996 Orphanage Jump et al., 2006; Kim et al., 2003
  • 14. Critical Review Infant Participants Descriptions Experience Author Born Premature Arora et al, 2005; Diego et al., 2007; Feij’o et al., 2006; Ferber et al., 2005; Ferber et al., 2002; Gitu et al., 2002; Gonzales et al., 2009; Kelmanson & Adulas, 2005; Massaro et al., 2009; Mathai et al., 2003; Mendes & Procianoy, 2008; Sankaranarayanan et al, 2005; Teti et al., 2009 Cerebral Insults Ohgi, 2004 Colic Arikan et al., 2007; Huhtala et al., 2000; Elliot et al., 2002 Healthy Arikan et al., 2007; Cullen et al., 2000; Elliot et al., 2002; Ferber et al., 2002; Field et al., 1996; Field et al., 1996; Field et al., 1998; Fujita. et al., 2006; Glover et al., 2002; Huhtala et al., 2000; Onozawa, 2001; Pelaez-Nogueras, 1996; Scholz & Samuels, 1992 Infant Diarrhea Jump et al., 2006; Kim et al., 2003 Maternal HIV Scafidi & Field, 1995 Maternal Depression Feij’o et al., 2006; Field et al., 1996; Fujita. et al., 2006 ; O’Higgins, 2008; Onozawa, 2001; Pelaez-Nogueras, 1996
  • 15. Critical Review Participants Descriptions Massager Author Elder Field et al., 1996 Father Cullen et al., 2000; Scholz & Samuels, 1992 Mother Arikan et al., 2007; Arora et al, 2005; Feij’o et al., 2006; Ferber et al., 2002; Ferber et al., 2002; Fujita. et al., 2006; Glover et al., 2002; Mendes & Procianoy, 2008; Ohgi, 2004; O’Higgins, 2008; Onozawa, 2001; Pelaez-Nogueras, 1996; Teti et al., 2009 Mothers watched While staff provided Field et al., 1996 Parents Elliot et al., 2002; Gonzales et al., 2009; Huhtala et al., 2000 Professional Staff Diego et al., 2007; Ferber et al., 2005; Field et al., 1996; Field et al., 1996; Gitu et al., 2002; Jump et al., 2006; Kelmanson & Adulas, 2005; Kim et al., 2003; Massaro et al., 2009; ; Mathai et al., 2003; Sankaranarayanan et al, 2005; Scafidi & Field, 1995
  • 16. Research Infant massage was indicated to increase the frequency and quality of engagement of fathers and mothers with their infants Cullen et al., 2000; Ferber et al., 2005; Field et al., 1996; Onozawa et al., 2001; Pardew, 1996; Scholz & Samuels, 1992
  • 17. Research Furthermore, mothers experiencing depression showed less depression after massaging their infants or watching their infants massaged by another caregiver Feijo, Hernandez-Reif, Field, Burns, Valley-Gray & Simco, 2006 Even volunteers who massaged infants showed an increase in their quality of lifestyle Feijo et al., 2006 Parent benefits Baby receives massage Baby benefits Parent massages infant
  • 18. Critical Review Part II The second part of the review provides an integration of the identified research literature and the rigor of the identified research design. Author Design Measurement Analysis Reliability and Validity Coefficients Multiple Post-tests Credentials
  • 19. Critical Review - Methods Author Measurement Design Analysis strategy Reliability & Validity Citations Multiple Post-tests Detailed description of Infant Massage Description of Instructor’s credentials Arikan et al., 2007 Physical (crying) Experimental Intention to Treat Reliability Coefficient Citations Arora et al, 2005 Physical Experimental Attrition Rates X X Cullen et al., 2000 Interaction Experimental Validity Citation References X X Diego et al., 2007 Physical Experimental X X Elliot et al., 2002 Physical & Interaction Experimental Reliability Coefficient Citations/ Validity Citation References X Feij’o et al., 2006 Interaction Experimental
  • 20. Critical Review - Methods Author Measurement Design Analysis strategy Reliability & Validity Citations Multiple Post-tests Detailed description of Infant Massage Description of Instructor’s credentials Field et al., 1998 Interaction Quasi Intention to Treat X X Field et al., 1996 Physical Experimental Field et al., 1996 Interaction Experimental Reliability Coefficient Citations X Ferber et al., 2005 Interaction Experimental Attrition Rates Ferber et al. 2002 Physical Experimental Intention to Treat X Ferber et al., 2002 Physical Experimental X Fujita et al., 2006 Interaction Experimental Intention to Treat X
  • 21. Critical Review - Methods Author Measurement Design Analysis strategy Reliability & Validity Citations Multiple Post-tests Detailed description of Infant Massage Description of Instructor’s credentials Gitu et al., 2002 Physical Quasi Glover et al., 2002 Both Quasi X Gonzales et al., 2009 Physical Experimental Attrition Rates Reliability Coefficient Citations X Huhtula et al., 2000 Physical (crying) Experimental X Jump et al., 2006 Physical Experimental Intention to Treat/ Attrition Rates X X Kelmanson & Adulas, 2005 Physical Quasi
  • 22. Critical Review - Methods Author Measurement Design Analysis strategy Reliability & Validity Citations Multiple Post-tests Detailed description of Infant Massage Description of Instructor’s credentials Kim et al., 2003 Physical Experimental Reliability Coefficient Citations/ Validity Citation References X X Massaro et al., 2009 Physical Experimental Attrition Rates X X Mathai et al., (2003) Physical Experimental X Mendes & Procianoy, 2008 Physical Experimental Attrition Rates X O’Higgins, 2008 Interaction Experimental X X Ohgi, 2004 Physical Experimental
  • 23. Critical Review - Methods Author Measurement Design Analysis strategy Reliability & Validity Citations Multiple Post-tests Detailed description of Infant Massage Description of Instructor’s credentials Onozawa, 2001 Interaction Experimental Intention to Treat Reliability Coefficient Citations X X Pelaez-Nogueras 1996 Interaction Experimental Reliability Coefficient Citations/ Validity Citation References X X Sankaranarayana n et al, 2005 Physical Experimental Attrition Rates Validity Citation References X X Scafidi & Field, 1996 Physical Experimental Validity Citation References X Scholz & Samuels, 1992 Interaction Experimental Reliability Coefficient Citations X X Teti et al., 2009 Interaction Experimental Intention to Treat X
  • 24. Critical Review Research Outcomes Additionally, numerous research studies showed positive outcomes for infants of mothers experiencing depression. These Outcomes included: ◦ engagement ◦ interaction ◦ relaxation ◦ relief from stress ◦ and stimulation of the physiological systems ◦ and increased sleep by infants who were massaged Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et al., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
  • 25. Critical Review Part III A summary review of the literature and subsequent conclusions are reported (Rothman, Damron-Rodiques, Shenassa, 1994).
  • 26. Critical Review Outcomes Participants Outcomes Infant Outcome Parent/Caregiver Outcome Decrease in crying/colic Decreased symptoms of stress, anxiety & depression Decrease in length of hospital stay Increased caregiving activities Decrease in Diarrhea Increased interaction Increased Interaction (Engagement & Entrainment Behavior) Improvements in Lifestyles Increase in Physical Growth Increased Self Efficacy Increased Sleep Time Parent/Caregiver Outcome
  • 27. Critical Review Research In summary, research on infant massage has previously reported primary parents/caregiver outcomes as increased sense of parental competency and positive infant care behaviors. For the infant, primary outcomes reported include increased sleep time, relaxation, and relief from stress. Secondary outcomes reported include increased engagement cues and increased interaction between the parent/caregiver and the infant who received the massage for both the infant and the parent/caregiver. Secondary outcomes also included increased engagement and interaction behaviors with the adult Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
  • 28. Critical Review Implications for Future Research Infants initiating engagement behaviors *Fathers increasing quality of interaction with infants Mothers reporting less symptoms of depression after massaging or watching infants be massaged Volunteers reported increased social satisfaction after massaging infants.
  • 29. Critical Review Research Limitations CREDIBILITY - TRANSPARENCY No study described generational or immigrant status, disability status, sexual orientation, gender identity, or language preferences. Limited sample sizes (No power analysis to determine, 21 studies) Furthermore, studies not conducted over a longer period, such as 12 weeks, are not considered longitudinal studies and limit generalizability. Sixteen studies did not address intention to treat and/or attrition rates. Healthy infants generalizable to health infants Four did not randomly assigned and 24 did not blindly assign participants Did not address limitations of designs or ecological validity No hypothesis, did not explicitly identify the Dependent or Independent Variable No operational definitions of the terms No reliability coefficients or validity citations for the measurement tools No justification of appropriateness of statistical analysis Infant Massage protocol not described Pre-, Post, Multiple Measurements testing interaction
  • 30. Part IV In the Critical Review conducted in 2010 the Florida State University Dissertation committee decided Qualitative Studies were excluded from the Critical Literature Review in order to focus on the Experimental and Quasi-Experimental designs as the purpose was to establish the validity and reliability of Infant Massage Outcomes. It was determined as a result of the CR outcomes to conduct a Qualitative Research project. Qualitative research explores quality over quantity, in addition to developing the theoretical framework in which to view the results to illuminate the outcomes.
  • 31. Qualitative Research A Qualitative Case Study: Fathers’ Experiences of Massaging Their Infants. Mary Kay Keller, Dissertation Study 2013, Family and Child Sciences, College of Human Sciences, Florida State University. Mary Kay Keller, Ph.D, 2015, Publication. Journal of Behavioral and Social Sciences. The research question posed in this study was: What if any, benefits did fathers perceive from massaging their infants? HISTORICAL Nearly a century ago research indicated a high need for infant touch 57 years later, 1977 studies involving mother touching their infants were conducted. Currently in 2010 a Literature review of 31 Research (RCT) Articles, only 2 were focused on fathers massaging their infants 1992 & 2002
  • 32. Qualitative Research Attachment Theory 1940s Bowlby and 50s Ainsworth research theory to practice. Attachment Theory is developed by researching mothers’ relationships to their infants. At no point in time has Attachment Theory updated to substantiate attachment to fathers. One study attempted to update with fathers of Adolescents. Bonding is a chemical physiological human response based upon the 5 senses, eye contact, hearing, smell, taste, and touch. Research Design Qualitative Exploratory Pilot Study Case Study N=1 Subjects 5 Fathers Exploration of fathers’ experiences massaging their infants Demographic survey, Structured Interview, Self Report Diary and Observation
  • 33. Qualitative Research Data Collection Screening Demographic Survey Stage 1 Structured Interview Infant Massage Demonstration Video Recording 5” Stage 2 Fathers Massage Infants Daily Record Massages 1 time each week in a Diary Stage 3 Structured Interview Video Recording 5” Review both videos Record Reaction to Video Review Member Checking Check Responses for accuracy Appointment set: Incentive Family Infant Massage Demo
  • 35. Qualitative Research Assessing Research Quality and Rigor Qualitative Term Strategy employed Strategy Met Credibility Internal Validity Triangulation Member checks Time sampling Interview, Self Report Diary & Observation Interviews were reviewed by participants for accuracy Fathers also reviewed videotapes and responded Interviews conducted 1st and 3rd week Diaries were recorded in each week for 3 weeks Transferability External Validity Provide thick description Purposive sampling Precise descriptions of the research design, methodology and data reports Research, coding and data memos Five first time fathers of infants less than 5 months Dependability Reliability Create an audit trail Code-recode strategy Triangulation Research, coding and data memos Code and recode strategy described in detail in memo Interview, Self Report Diary & Observation Confirmability Objectivity Triangulation Practice reflexivity Negative Case Analysis Interview, Self Report Diary & Observation Research Memo documenting all decisions in detail Research position, attitude and perspective disclosed Providing examples of data that does not support the outcomes.
  • 36. Qualitative Research CAQDASAtlas.ti (Computer Assisted Qualitative Data Analysis Software) • Large amounts of data • Text, graphics, audio and video, & GPS mapping Visual analysis tool • Assists in developing primary elements and interpretation of the meaning of the data into useful knowledge. Systematic Qualitative Data Analysis • Increased validity at conceptual analysis stage • Not limited to content or subject matter from any discipline (Friese, 2012). Dependable Qualitative Research
  • 37. Qualitative Model of Analysis (NCT) Noticing Collecting Thinking Noticing Collecting Thinking Noticing Collecting Thinking
  • 38. Data Set Up • DATA Collection • Input data to ATLAS.ti • Demographic Data • Diary Data Analysis 1st Iteration Initial Codes/Surface Content Analysis • Initial Coding • Process Coding 2nd Iteration Pattern Variables • In Vivo (literal) Coding • Pattern Coding 3rd Iteration Application to Data Set • Theoretical Coding • CODE MAPPING - Fathers perceived benefits of massaging their infants • Categories of Results and Assumptions • Exemplary(s), (Anfara et al., 2002). Qualitative Research Code Mapping: Three Iterations of Analysis
  • 39. Qualitative Research Participants 1 2 3 4 5 Age 35 22 36 27 22 Marital Status Married Living w Partner Married Married Living w Partner Race White Black Black White White Level of Education Graduate College College College College Annual Income $0-$25,000 $0-$25,000 $60,000+ $25,001- $60,000 $0-$25,000 Infant Sex Male Female Male Male Male Demographics
  • 40. Activity Diary Data Analysis Time of day: Missed one day. Momma thinks he goes to bed better if massage is closer to bedtime. (Father 1, week 3). Afternoon [massaged] and in the evening for his stomach. (Father 3, week 3). Duration: Most importantly I tried to be as consistent as possible, but I did the massage 4 or 5 times a day depending if she was in the mood. The more we did the massage for about 5 minutes I felt she enjoyed it more. (Father 2, week 1) I like shorter massages, actually he likes shorter massages. Now that I don’t feel like I have to finish every position, I would say we are both enjoying the massages more. I am doing more frequent but shorter massages. Especially on the changing table after a diaper change. Massages don’t feel like a chore anymore, something I have to do. (Father 4, week 3) Qualitative Research
  • 41. Activity Diary Data Analysis Body Part: Baby only [fussed] once during his chest massages. (Father 1, week1) He has been most receptive to back massage. Least receptive to chest massage. (Father 3, week 2) I noticed once when I was massaging his back his breathing started to slow down as if he were more relaxed. Short stomach massages to help with gas. (Father 3, week 3) It is notable to me that infant 4 was the only infant out of five that verbally protested throughout the massage and that this father was the most verbal in both of the interviews. Additionally, father 1 reported a change in his infant's eye contact during week two of the massages. "This week I realized that on the days he didn't seem to be looking at me, he would start to do so about a minute or two into the massage." Qualitative Research
  • 42. Qualitative Research Fathers exhibited sustained long-term caregiving and initiated interaction with their infants after learning to massage their infants.  Opportunity - 91% of fathers are involved with the mother at the time of the birth of the infant <50% by the time the child enters pre-school.  Practice - When fathers are primary caregivers, trained and/or observe child care activities they become more like the mother in their caregiving.  Enjoyment – fathers who are involved in caregiving report higher satisfaction of fathering.
  • 43. Qualitative Research Pattern coding Fathers desire to relieve mothers’ stress. Mother gets time to herself Father adjusts time of day ay Father gets one on one time with infante on one time Father Massages Infant Infant
  • 44. Qualitative Research Pattern coding Fathers desire to relieve infants’ stress. Infant responds to father’s touch Father adjusts Father adjusts time of day e of day Father gets one on one time with the infant one time Father Massages Infant
  • 45. Qualitative Research Perceived Benefits Fathers Perception Parent benefits Baby receives massage Baby benefits Parent massages infant
  • 46. Qualitative Research Matrix of Findings and Sources for Data Triangulation
  • 47. Qualitative Research Matrix of Findings and Sources for Data Triangulation
  • 48. Qualitative Research Matrix of Findings and Sources for Data Triangulation
  • 49. Qualitative Research Matrix of Findings and Sources for Data Triangulation
  • 50. Qualitative Research Implications for Future Research 1. what impact was there on the father/child dyad during the early years; what were the mothers’ perceptions about the time the fathers spent with the infant and their behaviors after the study. 2. replication of past studies to determine outcomes for father contributions 3. In The Ecology of Attachment in the Family, the authors postulate that attachment does not hold exclusively to the parent-child dyad and can also be applied to the family (Hill et. al,. 2003). a. Non-resident fathers are less involved than resident fathers and had the same attitudes of commitment to fathering as fathers who were resident fathers however reported lower feelings of competence and satisfaction (Minton & Pasley, 1996). Competence may be a key in factor influencing father involvement (p.40). b. Mothers reported less symptoms of depression regardless of whether they massaged their infants or others massaged their infant.
  • 51. Qualitative Research Implications for Practice for Professionals 1. Bonding & attachment opportunities for fathers Fathers showed a willingness to relieve the mothers of her care-giving activities and felt competent in spending time with their infant. Fathers reported feeling bonded and attached to their infants. Additionally, fathers responded emotionally, report motivation and change their attitudes when provided opportunity (Scholz & Samuels,2002). Fathers greatly benefited from infant massage classes with other fathers (Cheng, Volk & Marini, 2011). 2. Fathers contributions to the family New fathers transitioning into a fathering role become stressed and this negatively impacts the marital relationship which also may impact their attachment to their infant (Green, Furrer & McAllister, 2007). Teaching father IM increased their feelings of competence and sense of contribution. Fathers responded with sensitivity to their infants needs. Depression study.
  • 52. Qualitative Research Implications for Practice for Fathers Fathers’ contribution are important to infant development. Fathers need to actively seek opportunities for involvement. It is equally important for fathers to understand that although their relationship develops through different means than the mother it is just as valid and impacts the infant.
  • 53. Qualitative Research Discussion Contributions to the literature Theoretical Framework Credible Research Platform rigorous qualitative design. formalized qualitative processes computer-assisted tool Contributions to the literature Confirmed Father Motivation for Parental Involvement a. fathers desired involvement. b. systemic barriers (do social support discourage father involvement?) Conclusion: Infant Massage needs to be included in Infant Care Giving and Parent Education Services
  • 54. Qualitative Research Keller, M.K., 2015 A Qualitative Case Study: Fathers’ Experiences of Massaging their infants. Journal of Behavioral and Social Sciences. v.2., 29-39. Keller, M.K., 2013 Exploratory Case Study of Fathers who Massaged their Infants. Dissertation in Child and Family Studies, Collage of Human Sciences, Florida State University.
  • 55. References Arikan, D., Alph, H., Gozum, S., Orbak, Z. & Cifci, E. (2008) Effectiveness of massage., sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic. Journal of Clinical Nursing, 17. 1754-1761. Arora, J., Kumar, A. & Ramji, S. (2005) Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates. Indian Pediatrics, 42, 1092-1100. Cullen, C., Field, T., Escalona, A., & Hartshorn, K. (2000). Father-infant interactions are enhanced by massage therapy. Early Child Development and Care, 164, 41- 47. Diego, M., Field, T., Hernandez-Reif, M., Deeds, O., Ascencio, A., & Begert, G. (2007) Preterm infant massage elicits consistent increases in vagal activity and gastric motility that are associated with greater weight gain. Acta Pædiatrica, 96, 1588-1596. Elliot, M., Reilly, S., Drummond, J., & Letourneau, N. (2002). The effect of different soothing interventions on infant crying and on parent-infant interaction. Infant Mental Health Journal, 23, 310-328. Feij’o, L., Hernandez-Reif, M., Field, T., Burns, W., Valley-Gray, S., & Simco, E. (2006). Brief report: Mother’s depressed mood and anxiety levels are reduced after massaging their preterm infants. Infant Behavior & Development, 29, 476-480. Ferber, S., Feldman, R., Kohelet, D., Kuint, J., Dollberg, S., Arbel, E., & Weller, A. (2005). Massage therapy facilitates mother-infant interaction in premature infants. Infant Behavior & Development, 28, 74-81. Ferber, S., Kuint, J., Weller, A., Feldman, R., Dollberg, S., Arbel, E., & Kohlet, D. (2002) Massage therapy by mothers and trained professionals enhances weight gain in preterm infants. Early Human Development, 67, 37- 45. Ferber, S., Laudon, M., Kuint, J. Weller, A. & Zisapel, N. (2002). Massage therapy by mothers enhances the adjustment of circadian rhythms to the nocturnal period in full-term infants. Developmental and Behavioral Pediatrics, 23,( 6), 410-416.
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