Effects of Mothers’ Infant Massage on Bilirubin Levels and Re-hospitalization for Hyperbilirubinemia: A Quasi-experimental Study

Authors

  • Nuthcharin Intanai MNS in Pediatric Nursing (Candidate), Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Tipawan Daramas Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Autchareeya Patoomwan Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2024.268257

Keywords:

Bilirubin level, Full-term infant, Hyperbilirubinemia, Infant massage, Nursing, Re-hospitalization

Abstract

Hyperbilirubinemia is a physiological health problem of newborn infants, mostly occurring in the first week of life, which can delay development or cause disabilities or death. Massaging newborn infants early after delivery can promote bilirubin excretion and reduce hyperbilirubinemia. This quasi-experimental study aimed to determine the effect of infant massage performed by mothers on bilirubin levels and re-hospitalization for hyperbilirubinemia. The study was conducted at an obstetrics and gynecology ward of a secondary hospital in Bangkok, Thailand. The participants were 30 paired full-term infants and mothers who met the inclusion criteria. The experimental group (n = 15) received body massage performed by their mother for 15 minutes twice a day for four consecutive days, while the control group (n = 15) received only usual care. The transcutaneous bilirubin levels were recorded at 6, 48, and 96 hours after birth. Data on re-hospitalization with hyperbilirubinemia were recorded on Day 7 after birth and analyzed using Fisher’s exact test, independent t-test, and repeated measures ANOVA.

The results revealed that the infants who received the massage had significantly lower mean bilirubin levels than those in the control group. However, there was no difference in the re-hospitalization with hyperbilirubinemia between the groups. In addition, the frequency of defecation on the first and fourth days in the experimental group was significantly greater than in the control group. The present study’s result indicated that mothers’ infant massage can help reduce bilirubin levels in full-term infants. The findings hold promise for nurses to integrate infant massage in training mothers at an early stage after birth for the prevention of hyperbilirubinemia in newborn infants. However, further testing with a larger sample size and randomized controlled trials are needed.

References

Satrom KM, Farouk ZL, Slusher TM. Management challenges in the treatment of severe hyperbilirubinemia in low- and middle-income countries: encouraging advancements, remaining gaps, and future opportunities. Front Pediatr. 2023;11:1001141. doi:10.3389/fped.2023.1001141.

Sukkar S, Lorusso G, Jananeh S, Harrison R, Martin MA, Grabois E, et al. Decreasing bilirubin serum tests in healthy newborns during birth hospitalization. Pediatrics. 2023; 151(6):e2022059474. doi:10.1542/peds.2022-059474.

Kumar V, Shrangi G, Jangid S, Yadav M, Verma MK. Association of cord serum albumin with neonatal hyperbilirubinemia among term-neonates. Int J Res Med Sci. 2020;8(6):2099-104. doi: 10.18203/2320-6012.ijrms20202250.

Rahayu KD, Hernawati Y, Agustiani I. Intervention to reduce bilirubin levels in newborn babies: a systematic review. Asian Comm Health Nurs Res. 2020;2(1):41-6. doi: 10.29253/achnr.2020.24141.

Hegyi T, Kleinfeld A. Neonatal hyperbilirubinemia and the role of unbound bilirubin. J Matern Fetal Neonatal Med. 2022;35(25):9201-7. doi:10.1080/14767058.2021.2021177.

Mrljak R, Arnsteg Danielsson A, Hedov G, Garmy P. Effects of infant massage: a systematic review. Int J Environ Res Public Health. 2022;19(11):6378. doi:10.3390/ijerph19116378.

Narale P, Shinde A, Mhaske SN, Waydande S. The beneficial effects of infant’s massage on jaundiced neonates receiving phototherapy. VIMS Health Sci J. 2023;10(1):1-6. Available from: https://doi.org/10.46858/vimshsj.10101

MohammedHamad NI, Helaly NM, Mohammed AA. Effect of Vimala massage on hyperbilirubinemia among full term neonates: a randomized controlled trial. IOSR-JNHS. 2021;10(5 Ser II):50-8. doi:10.9790/1959-1005025058.

Babaei H, Vakiliamini M. Effect of massage therapy on transcutaneous bilirubin level in healthy term neonates: randomized controlled clinical trial. Iran J Neonatol. 2018;9(4):41-6. doi: 10.22038/ijn.2018.28906.1386.

Charatvisitkul K, Chusak T. The effect of infant massage on the growth of infants and maternal-infant attachment of neonatal patient Sawanpracharak Hospital, Nakhon Sawan province. VRU Res Dev J Sci Tech. 2018;13(1):76-86. Available from: https://so06.tci-thaijo.org/index.php/vrurdistjournal/article/view/121186 (in Thai).

Niyomkar S, Sansiriphun N, Deeleua J, Wannachaiyakul S, Kunaviktikul W, Klunklin A. The effects of a regular infant massage program on infant growth. TRC Nurs J. 2021;14(2): 193-206. Available from: https://he02.tci-thaijo.org/index.php/trcnj/article/view/256636 (in Thai).

Songklin S, Teerarungsikul N. Effects of infant massage on behavioral pain responses, heart rate and oxygen saturation in newborn undergoing vein puncture. JFONUBUU. 2020;28(2):96-105. Available from: https://ojs.lib.buu.ac.th/index.php/nursing/article/view/6956 (in Thai).

Numanit R, Kamonthree K, Horaban J. Effectiveness of infant massage program on infant’s behavioral cues and maternal infant bornding attachment in early post-partum period. MJSBH. 2019;34(3):413-26. Available from: https://he02.tci-thaijo.org/index.php/MJSSBH/article/view/231591 (in Thai).

Boskabadi H, Rakhshanizadeh F, Zakerihamidi M. Evaluation of maternal risk factors in neonatal hyperbilirubinemia. Arch Iran Med. 2020;23(2):128-40. PMID: 32061076.

Creeden JF, Gordon DM, Stec DE, Hinds TD Jr. Bilirubin as a metabolic hormone: the physiological relevance of low levels. Am J Physiol Endocrinol Metab. 2021;320(2): e191-207. doi: 10.1152/ajpendo.00405.2020.

Kalakonda A, Jenkins BA, John S. Physiology bilirubin. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470290

Al Gameel AK, El-Sary AY, Mahmoud RA, Abd El-Hmid R. Prevalence and associated factors of neonatal hyperbilirubinemia among NICU cases in Abshway Central Hospital. Fayoum Univ Med J. 2023;11(1):19-27. doi: 10.21608/fumj.2023.278459.

Han HS, Park CM, Lee DS, Sinn DH, Gil E. Evaluating mortality and recovery of extreme hyperbilirubinemia in critically ill patients by phasing the peak bilirubin level: a retrospective cohort study. PLoS One. 2021;16(8):e0255 230. doi: 10.1371/journal.pone.0255230.

Ercelik ZE, Dogan P, Bal Yılmaz H. The effect of massage on growth in premature babies: a systematic review and meta-analysis. J Educ Res Nurs. 2022;19(2):191-7. doi:10.5152/jern.2022.13285.

Rashwan ZI, Abohadida RM, Khonji LM, Saleh SES. Bundling gentle body massage along with regular position change under phototherapy among full-term neonates with hyperbilirubinemia: is it effective? J Neonatal Nurs. 2023; 29(3):464-70. doi: 10.1016/j.jnn.2022.08.002.

Natashia D, Rahmania S, Yulianti DA, Laily D, Istinganah I, Humairah F. Effectiveness of massage therapy to reduce bilirubin levels in neonates with hyperbilirubinemia a systematic review and meta analysis. J Midwifery Nurs. 2024;6(1):345-55. doi:10.35335/jmn.v6i1.4800.

Korkmaz G, Esenay FI. Effects of massage therapy on indirect hyperbilirubinemia in newborns who receive phototherapy. J Obstet Gynecol Neonatal Nurs. 2020;49(1):91-100. doi: 10.1016/j.jogn.2019.11.004.

Johnson’s.® Johnsons-baby-learn-to-massage-baby [Internet]. 2021 [cited 2024 Mar 1]. Available from: https://www.johnsonsbaby.co.th/sites/jbaby_th/files/johnsons-baby-learn-to-massage-baby.pdf. (in Thai)

Prescott SL, Liberles SD. Internal senses of the vagus nerve. Neuron. 2022;110(4):579-99. doi:10.1016/j.neuron.2021.12.020.

Yurita N, Jumari J, Solihat A. Giving oral massage is effective in increasing the suction reflex stimulus of LBW babies. J Complement Nurs. 2022;1(3):78-83. doi:10.53801/jcn.v1i3.45.

Des Jarlais DC, Lyles C, Crepaz N; the TREND Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health. 2004;94(3):361-6. doi: 10.2105/ajph.94.3.361.

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(2):97-102. doi: 10.1620/tjem.223.97.

Gupta KK, Attri J, Singh A, Kaur H, Kaur G. Basic concepts for sample size calculation: critical step for any clinical trials! Saudi J Anaesth. 2016;10(3):328-31. doi:10.4103/1658-354X.174918.

Lee B, Piersante T, Calkins KL. Neonatal hyperbilirubinemia. Pediatr Ann. 2022;51(6):e219-27. doi:10.3928/19382359-20220407-02.

Abdellatif M, Vuong NL, Tawfik GM, Elfaituri MK, Mansour MIM, Zaki MMM, et al. Massage therapy for the treatment of neonatal jaundice: a systematic review and network meta-analysis. J Neonatal Nurs. 2020;26(1):17-24. doi: 10.1016/j.jnn.2019.09.002.

Elkandoz NA, Younis AA, Ads SE, Ads SE. Effects of applying Vimala massage on neonates with exaggerated physiological jaundice on their clinical outcomes. Tanta Sci Nurs J. 2024;32(1):13-30. doi: 10.21608/TSNJ.2024.348101.

Doğan E, Kaya HD, Günaydin S. The effect of massage on the bilirubin level in term infants receiving phototherapy. Explore (NY). 2023;19(2):209-13. doi: 10.1016/j.explore.2022.05.001.

Gallagher S, Petrou T. Breastfeeding protocol: signs of effective breastfeeding [Internet]. 2019 Apr [cited 2024 Mar 1]. Available from: https://breastfeedingresourcesontario.ca/sites/default/files/pdf/BFI_Signs_of_Effective_BF_web_final.pdf

Dehghani K, Nouroozi E, Mandegari Z, Salmani N, Shakiba M. Comparison of the effectiveness of bath and massage in bilirubin levels in neonates. Iran J Neonatol. 2019;10(3): 45-50. doi:10.22038/ijn.2019.33607.1484.

Prachukthum S, Tanprasertkul C, Intarakhao S. Does weight loss predict hyperbilirubinemia requiring readmission for phototherapy in term infants? Sci Tech Asia. 2020;25(3): 11-8. doi:10.14456/scitechasia.2020.30.

Pulmamidi RK, Yendamuri RM. Prospective study to determine weight loss as predictor for neonatal hyperbilirubinemia in term neonates. Panacea J Med Sci. 2021;11(1):120-4. doi: 10.18231/j.pjms.2021.026.

Rakhecha G, Parihar RR, Dhania B. Breastmilk jaundice: a nurse perspective. Int J Contemp Pediatr. 2022;9(11): 1127-31. doi:10.18203/2349-3291.ijcp20222780.

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Published

2024-06-27

How to Cite

1.
Intanai N, Daramas T, Patoomwan A. Effects of Mothers’ Infant Massage on Bilirubin Levels and Re-hospitalization for Hyperbilirubinemia: A Quasi-experimental Study. PRIJNR [Internet]. 2024 Jun. 27 [cited 2024 Nov. 13];28(3):676-88. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/268257