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Baby Massage Course for Instructors

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 What we will learn…
Day 1
 Professionalism, ethics and the role of the instructor
 Origins of baby massage
 Anatomy and physiology of the infant
 Infant sensory awareness
 Benefits of positive touch and research studies relating to baby massage
 Setting up your class, oils and creating the right environment for baby
massage
 Baby massage routine

Day 2
 Teaching techniques for successful learning
 Presentation skills and how to face challenging situations
 Baby massage assessment
 Marketing and setting up a business
 Accreditation
 Course
(face to face)

 Written
assignments

 Case studies
Accreditation
Necessary resources for your classes
Recommended reading
The Blossom & Berry Philosophy
Our classes provide:
• Time for baby
• Relief for colic and support unsettled babies
• Enhance parent/baby communication
• Opportunities for parents to meet the early developmental needs of babies through
touch, movement, sight and sound
• Opportunities to enhance the bonding process between carer and baby
• Time for parent and baby to spend together

Classes also aim to:

• Encourage instinctive parenting
• Build confidence
• Enhance a sense of community amongst parents
• Help parents be inspired by baby and understand baby more
• Present an opportunity for time out from a hectic world and domestic/life pressures
• Allow parents to feel “normal” and share experiences
• Teach parents a new skill for life
• Empower parents and help them grow in self belief
• Provide an opportunity to talk about experiences.
 Professionalism and Ethics
We are you to respect the following principles as an instructor:

1. The importance and uniqueness of the parent/child

relationship must always be central to any activities in classes. It
must be respected at all times

2. During your classes parents should massage with their own baby.

3. You may find that a nanny or childminder may ask you to

teach him/her baby massage with the baby in their charge.
It is possible to do this but the nanny/child minder/third
person must have the written consent of the parent
and it would also be advisable to speak to the parent
yourself to make sure that they are aware of what will be
going on in the class.
Professionalism and Ethics
Confidentiality
Always a Pro!
Expert in baby massage
Professional limits

Do not diagnose, make referrals

with appropriate professionals
when applicable

Record keeping (oils, attendance…)

Legal aspects in order (employment, insurance)

Avoid controversial topics

Skills and Abilities
 Legal Aspects
 Working as freelance
 Limits of the accreditation (only to give classes
to parents and carers)
 Health & Safety
 Consumer legislation
 Professional insurance
 Data protection
 Working from your home
 Preparing for your class...

 Necessary equipment
 Find the right place to deliver the classes
 Decide dates and times
 Define price
 Marketing
 Bookings registration
 Setting up the room
 Materials for parents/carers
(oils and handouts)
 What is massage?
• Therapeutic practice in which muscles and other soft tissues of the body are manipulated with
the aim of improving health and wellbeing.
• Evident benefits in systems: muscular, circulatory, lymphatic, endocrine and nervous.

History of massage…
• China
Sui Dynasty 589-617 and Qing Dynasty (1644-1911)
Anmo – antique word that means pressure and friction
Tui Na – of more modern origin, it means press and stretch
Massage in China was commonly incorporated with methods of Acupuncture
• Japan – massage was developed through the interpretation of Chinese literature
• Egypt – usage of creams and oils (camel fat, almond oil, perfumed oils): as offering to their gods,
for embalming and as beauty products
• India – oils for cosmetic use, massage for military soldiers, Ayurvedic massage
• Greece – Aristotle stated that touch was the most fundamental of all senses. Hippocrates
(‘father of medicine’) described the benefits of massage
• Romans – Greek influence.The Emperor Galen wrote at least 16 books related to massage and
exercise, he recommended massage to all injured gladiators. Julius Caesar received massage to treat
his neuralgia (nerves condition).
 History of massage…
• 1517-1590 – Ambrose Pare (French doctor, one of the founders of modern surgery), began
using massage techniques to treat rigid joints and to treat wounds after operations.

•1776-1839 – Per Henrik Ling

(Swedish physiotherapist and teacher of medicine
and gymnastics) (Pehr)
He got inspiration from his trips to China.
Recognised the importance of having anatomy and
physiology knowledge before applying massage.

• 1839-1901 – Johann Georg Mezger (Dutch masseur) – applies French terminology to

name 5 basic massage techniques: effleurage (circular stroking movements), petrissage (kneading
the body), friction (deep pressure), tapotement (rapid and repeated striking of the body) and
vibration (trembling movements).

• 1894 (Bond St, London) – The Chartered Society of Physiotherapy

• The term 'Swedish massage’ is known in English, Dutch and Hungarian
speaking countries. In other places, including Sweden,
it is known as ‘classic massage’.
• Other types of massage: reflexology, lymphatic, aromatherapy, Ayurvedic
 Benefits of Massage
• Promotes healing
• Increases energy levels
• Reduces the recovery time after injury
• Decreases pain
• Encourages relaxation, improves mood and wellbeing in
general

• Autism
• Atopic dermatitis / eczema
• ADHD
• Bulimia
• Cystic fibrosis (lung congestion)
• Diabetes
• Arthritis
• Down Syndrome
 Baby Massage Origins
• The word ‘massage’ comes from the Arabic ‘to stroke’

Infant massage origins are difficult to trace

• India – from generation to generation
• USA – 1970s: Vimala McClure, 2000s: Tina Allen
• UK – IAIM, Blossom & Berry…
• Russia – parents learn baby massage in hospitals
• Morocco – henna, butter, mint or some aromatic mixed of
marjoram (a type of oregano) is used to massage babies

• Nepal – babies are massaged twice per day, using mustard

seed oil and breast milk
• Nigeria – babies from Borno are welcomed to this world
with a massage from the people who visit them after birth
Colombia – ‘Kangaroo Care’ for premature babies
 Anatomy and
physiology of the
infant
 Circulatory System

The circulatory system if formed by the cardiovascular system that carries blood and
lymphatic system that carries lymph.

The cardiovascular system consists of the heart, blood and blood

vessels. The heart pumps oxygenated blood around the body via
arteries, and pumps deoxygenated blood carrying carbon dioxide
via the veins.

There are two types of circulation:

• Pulmonary / minor / central – which transports blood to and from the lungs
• Systemic / mayor / general – which transports blood to and from the body

Functions:
 To carry oxygen and nutrients to all body cells
 Drain waste products to be eliminated by the kidneys via urine or by the lungs when air
full of carbon dioxide is exhaled
 Intervenes in the defence mechanism of the body against diseases
 Regulates body temperature
 Cardiovascular System

In the womb, the blood circulates through the placenta.

Cardiovascular System

When the baby is

born, the blood
starts to circulate
through his/her
own heart.
 Cardiovascular System

The right ventricule of the newborn is thicker

than the left one, as the baby adapts to
pulmonar breathing, it slims down. At four
weeks, both ventricles (right and left) weight
the same.

The weight of the baby’s heart doubles in the first year of life, and it grows six
times from its original size by the time the child is 9 years old. The growth
rhythm decreases 20% from 3 to 15 years of age.
 Cardiovascular System

• Vitamin K intervenes in blood clotting and its synthesised by a gut

bacteria flora. Newborns don't have this flora, besides, they have a low
number of red blood cells. That is why babies get a Vitamin K injection
when they are born, to prevent hemorrhagic syndrome. The colostrums in
breast milk has got high vitamin K content.
• Iron is very important to prevent infant anaemia (babies that are
breastfed obtain 50% of the recommended dose, bottle fed babies only
10%). A child needs approximately 8mg of iron per day, half than an adult.

Massage helps boosting circulation,

removing waste products from the
body and transporting fresh oxygen
and nutrients to all body tissues.

Precaution: massage firmly towards the heart, more gently away from the heart. It is best
to obtain medical consent before massaging babies or children with circulatory problems,
and if consent is granted, avoid movements away from the heart.
 Lymphatic System

Consists of:
• Vessels – structures that transport the lymph.
• Lymph – formed by the drainage of excess liquid
from the blood vessels to the interstitial space. This
excess is picked up by the lymphatic capillaries and
ends in the left subclavian vein.
• Nodes – small swellings in the lymphatic system
where lymph is filtered and lymphocytes are formed so
they help the body recognise and fight infections.

The lymphatic organs:

• The spleen – located in the upper-left part of the abdomen. Its main function is to filter the
blood. It removes old or damaged red blood cells. The spleen also detects viruses and bacteria
and triggers the release of lymphocytes.
•The thymus - located in the thoracic cavity, just under the neck. It’s made up of two lobes
of lymphoid tissue. Each lobe has a medulla surrounded by a cortex. The cortex is where
immature lymphocytes first go to become T cells, but their maturation finishes in the medulla.
Lymphatic System

When the lymph doesn't

flow correctly, that area
of the body can suffer
from inflammation due to
accumulation of
interstitial fluid, this is
known as edema.

As well as this fluid, the

body can accumulate
toxins and waste
products which can cause
pain, swelling and other
issues.
Lymphatic and Immune Systems

These two systems share

several organs and
physiological functions.

The B lymphocytes serve as the military

intelligence system of the body, they identify
the target and send the defence to attack it.
The T lymphocytes act like soldiers, destroying
the invaders identified.
T cells mature in the thymus, unlike B cells
that stay in the bone marrow.
Lymphatic and Immune Systems

• Babies are born with passive immunity (the antibodies that the
mother transferred via the placenta are reinforced through
breastfeeding)
• Those antibodies disappear between 6 and 12 months
• As the immune system of the baby develops, the baby is able to
produce his own lymphocytes
• The development of the immune system takes years and this is
why babies and children are more likely to catch infections and
diseases
• Immunisations help to build immunity as well as being exposed to
bacteria

Layers of defence of the body:

1. Skin
2. Inflammation and white cells = immune response
Babies have an immature immune response, therefore are more vulnerable to invasions
because they have a weaker inflammatory response
3. Acquisition of immunity
Exposure to infections and other viruses (colds, chicken pox)
Immunisations
Lymphatic and Immune Systems

In the lymphatic circulation there is no driving/boosting organ, like in the

blood circulation, where the heart acts like a pump. Movement of the lymph
is therefore slower, pushed by the pulsation of nearby arteries, muscular
and body movements.

Massage can help increase the lymphatic flow of the body, helping processing
and expelling toxins and waste products.

Precaution: In time of illness (particularly when there

is fever), the lymphatic system will be working very
hard to purify the body from unwanted toxins. The
lymphatic glands will be very sensitive. To avoid pain
and discomfort in case pressure is applied on the
glands, is better to avoid massage until the baby is fully
recovered.
 Muscular System

In what muscles does baby massage focus?

On the skeletal muscles, which allow voluntary and conscious movements such as
crawling and walking. In tummy massage, we work in smooth muscles.
 Muscular System
The main function of the muscular system is to allow the movement of the
body. We have more than 650 muscles which are connected to the skeletal
system through the tendons.

Does anybody know which are the most developed muscles in a baby?

Babies tend to have the muscles around the chest very

developed, to ease the respiratory vital function.

Massage increases the blood supply in the muscles, bringing oxygenated blood
and nutrients and taking away waste products, reducing muscles fatigue and
warming up the muscles.
Regular massage helps muscles become firmer and more flexible, more
malleable and elastic. Massage is very helpful in cases of hypotonia and
hypertonia.

Precaution: Massage firmly in areas with more musculature (like the thighs), be more gentle in
less fleshy areas (such as the chest). Apply moderate pressure when massaging so that the
strokes are not ticklish, pressure to get into the second layer of the skin to aid relaxation.
 Skeleton System

Consists of:
• Bones
• Joints
• The bones remain together
thanks to strong fibre tissue
called ligaments

The bones’ functions are:

• To provide structure, shape and support to the body
• To protect vital organs
• It is where the red and white blood cells are produced
• They store calcium, which is then freed up into the blood stream and it is of vital
importance for the muscles to be able to contract
Skeleton
System
 Skeleton System

Why are babies’ bones softer?

The bones of babies and children are relatively soft because the skeleton consists
predominantly of cartilage, which becomes harder through a process called ossification (with
doses of Vitamin D and calcium).
Skeleton System

How many bones do

babies have?

Approximately, babies have got

300 bones when they are born,
compared to 206 when they are
adults. This is because a lot of
bones fuse over time.
 Skeleton System
The spinal cord of a baby measures 15-18 cms
It is curved and goes into various stages of development:
 Skeleton System
• During pregnancy, 300 mg of calcium go to the foetus everyday via the placenta
• Calcium daily needs:
500 mg – 1 to 3 year olds
800 mg – 4 to 8 year olds
800-1300 mg – 9 to 18 year olds
• The levels of calcium in the blood need Vitamin D to be absorbed in the gut, to maintain
circulation of calcium throughout the body and for bones to have the necessary minerals to
remain strong. Sunlight is therefore necessary and healthy.

All these changes bring

physiological, psychological
and social implications.
 Skeleton System

Massage helps facilitating mobility in the joints, enhances flexibility

and muscle strength as well as increasing circulation to the bones
favouring growth (through the production of growth hormone -
somatotropin).

Precautions:
• Do not apply pressure on the skull or head during
massage
• Avoid putting excess pressure on the joints as they are
very malleable, movements should glide on the skin and
joints
• Be very careful when massaging arms and legs, do not
stretch them abruptly, work with baby’s natural flexibility,
do not force any movement
• Do not apply direct pressure on the spine when
massaging the back
 Skin
The skin is the largest organ of the body. When
the embryo is developing in the womb, the skin Functions:
is one of the first organs to form and is made • Protective barrier against infections
of the same embryonic tissue as the brain. • Temperature regulator
• Controls fat storage
• Regulates liquid waste and allows
the exit of electrolytes and water
(sweat)

A newborn is more likely to get

infections, irritation of the skin and
loss of water. A baby produces less
secretion via the sebaceous glands.
Vernix caseosa

The newborn has to develop a skin

The weight of the skin in a newborn is
barrier relatively impermeable to be
13% of his total weight, compared to
only 3% in the adult’s able to adapt to the outside world.
Skin

The stratum corneum prevents

the entry of most foreign substances as
well as the loss of fluid from the body
 Skin

Babies are very sensitive to touch because of the high concentration of nerve
endings in the dermis layer of the skin. Depending on the pressure used in
massage, the effect of touch can have a stimulating or relaxing effect on the body.

Massage can help improving the

condition of the skin, removing dead
cells and stimulating sebaceous glands.
It can also help maintaining the skin
healthy and resistant to infections.

One third of the toxins of the body goes out through the skin. It is
important that skin pores are not blocked to help eliminate waste
products. A vegetable based oil helps lubricating the skin, providing
nutrients and absorbing more easily.
 Skin

The skin is known as ‘the third lung’ or ‘third kidney’ in Chinese culture,
which illustrates its role of eliminating waste products from the body

Precautions:
• Massage can help skin suffering from
eczema, only in areas where the skin is not
opened, severely irritated or weeping. If this is
the case, then eczema is a contraindication.
• Avoid mineral and essential oils for baby
massage.
• The emollients (like the ones used for
eczema) should not be applied in the
direction of hair growth and therefore are
not appropriate for massage as pores can be
blocked.
• The baby’s skin is very thin, the epidermis is
weakly linked with the dermis, even friction
can cause bruises.
Reproductive System

Baby massage doesn’t have a significant impact in

this body system due to the fact that sexual
organs do not develop until puberty.
 Urinary System
The role of the urinary system is to filter
the blood and excrete any waste products
in the form of urine.

The kidneys:
• Filter the blood to remove urea,
uric acid and creatinine
• Balance the body’s fluids (sweat
and urine)
• Regulate mineral electrolytes
(sodium and potassium)
• Release hormones to help with The total water content of an infant’s body is
the production of Vitamin D and red vulnerable to loss because they ingest and excrete
cells a relatively greater water volume each day. A baby
• Helps control blood pressure and may exchange half of his extra-cellular fluid daily,
volume whereas the adult may only exchange 1/6; so
• Controls the pH of the blood at proportionally the baby has less reserve of body
7.4, so that enzymes can work fluid at any one time. This is also due to their
metabolic rate, infants expend 100kcal/kg of body
adequately (neutral to alkaline)
weight, whereas adults 40 kcal/kg.
 Urinary System

Massage helps increasing the

production of urine and
therefore, helps removing
waste products from the body.

Precautions:
• The kidneys are protected by the ribs and muscles covered with a layer of fat, however,
they are delicate and one has to be careful not applying a lot of pressure when massaging
the back.
• When massaging the lower abdomen, do not put excess pressure on the bladder as this
will be uncomfortable for baby.
• During class, it is recommendable to have spare baby wipes at hand, so that parents feel
that it is safe and it is allowed to take baby’s nappy off during the massage.
 Respiratory System

The respiratory system’s is

to provide oxygen for the
cells and tissues of the body
and expel carbon dioxide

In the womb, the baby’s lungs are filled with fluid. When the baby is born, this
fluid is dispersed. The contractions of the uterus and the passage of the baby
through the birth canal helps to clear the lungs of mucus and fluid.

Children breath quicker than adults. The normal respiratory rate changes
from 30 to 60 breaths per minute when the baby is born, to a rate of 12 to
20 breaths per minute at 18 years old.
 Respiratory System

Age Rate Too high

As the baby grows, the
Newborn 30-50 Over 60 airways enlarge, resistance
1 year 26-40 Over 50 reduces and respiration rate
2 years 20-30 decreases.
4 years 20-26 Over 40
6 years 18-24
10 years 15-22
12 years 14-21
16 years 11-14

Source: Adapted from Wallis et al. (2005) in

MacGregor 2008.

Note: Rates may be higher by 10% if the

child is awake, anxious or restless.
Respiratory System

The pulmonary alveoli are

the terminal ends of the
respiratory tree where gas
exchange occurs. A baby has
20-70 millions alveoli in each
lung at birth, in adulthood this
increases to 300-400 million

Until 4 weeks after birth, babies only

breathe through their nose, so the risk of
lack of air increases if baby has a cold,
vomits or is laid on his tummy.
 Respiratory System

Massage helps with the

circulation of oxygen and carbon
dioxide in the body.The chest
massage and movements on the
thorax’s joints, can help improve
the condition, strength and
function of the lungs, increasing
the flow of blood in this area. Precautions:
• The movements on the chest should start
from the lower ribs upwards, avoiding the
abdominal area.
Relaxation during the baby • Do not put pressure on the neck to avoid
massage class encourages blocking the pharynx and larynx and to
deeper breathing, avoid obstructing the flow of air.
supporting the oxygenation • When teaching the back massage, move
of the body’s cells the head of the demonstration doll to one
side, to model a position where the nose is
not blocked with the floor.
 Nervous System
3 main functions:
• Sensitive – reacts to internal and external stimulus
• Integrative – analyse the information received and makes decisions on what behaviour to follow
• Motor – responds to stimulus initiating muscular contractions or glands
Central Nervous System
Peripheral Nervous System
 Nervous System

Massage helps baby and parent relax, and when they

are relaxed, the blood vessels expand increasing the
blood flow and oxygen and nutrient levels into the
body tissues. All muscles maintain certain tension or
contraction of their fibres to help us, for example, to
keep a straight posture, it is necessary at times to
consciously relaxed the tensed muscles, to facilitate
rest and recovery.

Massage has a heart-warming and

relaxing effect and therefore, helps
activating the parasympathetic response
of the nervous system.
 Nervous System
At birth a baby’s nervous system is immature. The connections between the body
and the brain have not yet fully developed. The result is that newborn babies
exhibit reflex reactions to stimulus.

Grasp
Grasp Galant

Stepping
Moro Rooting
Suck
 Nervous System
More reflexes…

Forward
Creeping parachute

Atonic neck

Dive Crawling
 Nervous System
What is myelination?

Myelination
enables messages
to be
transmitted
more effectively,
and at greater
speed, along
nerve cells. This
helps overall
body-brain
communication.
 Nervous System

Neuron growth and connections over time

Nervous System

The brain represents between

10 and 12% of the newborn’s
weight, and it increases to 20-
25% at the age of one.

The most active areas in the

baby’s brain are the motor
sensory cortex, thalamus,
brainstem and the cerebellum.

The cerebral cortex is not yet

fully developed so babies are
not able to think in a complex
way. This area of the brain
keeps developing as myelination
occurs thorough time.
 Nervous System
Studies have shown that when babies and children are
deprived from sensory experiences, or when the nervous
system doesn't receive enough information, due to lack of Through touch,
tactile stimulation or lack of social interaction, the infinite messages can
development of the brain can be significantly affected and be transmitted to the
this may result in behavioural problems, social and brain from the outside
emotional issues during adulthood. world.

The sensory
stimulation during
massage accelerates
the myelination
process.

Until 12 years old,

touch continues being
the predominant sense
to integrate external
information.
3 years old child
 Nervous System

Infant massage develops

respectful relationships,
through trust and emphatic
communication, which
benefits the part of the brain
that concerns with emotions
and moral sense.

Precautions:
• Once babies are undressed, if the parent or carer constantly removes his/her hands
from baby or separates, the baby can get unsettled or upset, because of the sudden
assault of the peripheral nervous system (sense of danger or uncertainty). It is important
to keep contact and closeness at all times.
• During the face massage, remember not to cover the eyes or the ears, so that baby can
see and listen at all times and doesn’t feel invaded.
• Apply moderate pressure, if the massage is too light, then this will cause a ticklish
sensation, which can alter the baby’s peripheral’s nervous system.
Endocrine System

The endocrine system is

responsible for the
production and release
of hormones which
enable slow and long
lasting changes. It helps
to maintain homeostasis
or “balance” in the body.
It works closely with the
nervous system to
control this process.
Endocrine
System
 Endocrine System

The endocrine system works alongside the primal brain (sub cortical brain) and the immune
system (hypothalamus and pituitary gland). Michel Odent (1986) calls ‘primal health’ to the
equilibrium levels achieved by these systems at the end of the first year of life.

Oxytocin: ‘the love hormone’

Awakens maternal and loving behaviour,
and the need of touch, tenderness,
confidence in the other and serenity.
Contributes to the reduction of cortisol
(stress hormone) in the body.

Stressful moments that last for long periods of

time, increase the levels of cortisol in the body
and can cause: reduction of the hippocampus, cells
death in the frontal cortex, deficient immunity,
damage to short memory and distortion of
normal heart rate levels.
 Endocrine System

Massage contributes to the release of

oxytocin, in both, parent and baby,
producing a calm effect.

It also promotes the release of

prolactin (essential for breastfeeding)
and serotonin (associated with
feelings of happiness and wellbeing)

Precautions:
• When teaching parents and carers, it is very important to reiterate that massage should
only be carried out when the baby allows it, it must not be forced.
• Mention the importance of ‘listening’ and responding to the baby’s non verbal cues. This
allows mum/dad to help regulate the baby’s emotions and to reduce the incidents of high
cortisol levels.
• Avoid the usage of essential oils as these can cause instability in the endocrine system.
 Digestive System

The role of the digestive system is to break down food

into simple molecules which can be used by the body.
The smaller molecules can be absorbed into the
bloodstream from the gut and can be transported
around the body to where they are needed for
metabolism.

The baby’s digestive system is immature at birth and a

baby will be fed on milk until its digestive system is
mature enough to cope with solid foods. In some cases
the digestive tract may not be fully toned at birth
which can lead to babies suffering from wind because
the muscles in the bowel are not strong enough to
expel wind effectively.

At birth babies pass their first stool which is called

meconium. It is a green/black substance containing
waste and bile pigments and fatty acids.
 Digestive System

What size is the stomach of a baby?

The baby will ingest

the same amount
of air than milk
when feeding, that
is why it is so
important to help
them burp after
each feed.

Stomach capacity in ml
Newborn 1 week 2-3 1 month 3 1 year 2 years 10 years 16 years Adult
weeks months
10-20 30-90 75-100 90-150 150-200 210-360 500 750-900 1,500 2,000 –
3,000

Source MacGregor 2008.

 Digestive System

How many calories does a baby need?

Age Average daily

calories need
0 – 5 months 650
5 – 12 months 850
1 – 3 years 1,300
4 – 6 years 1,800
7 – 10 years 2,000
Source: www.keepkidshealthy.com en MacGregor 2008.
 Digestive System
What is the neonatal jaundice?

This condition is common in 15% of

healthy breastfed babies, caused by
the immaturity of the hepatic
function, it becomes worse with
dehydration

If the bilirubin gets to the intestines,

it will cause faeces to be dark green

Most of the times this condition

doesn't harm long term and
improves without treatment within
1-2 weeks

The bilirubin is a yellow substance that the body

produces when it replaces the old red cells. The Precaution: it is a
liver helps breaking down this substance so that it contraindication for baby
can be eliminated via the faeces. massage.
 Digestive System
Massage is effective at stimulating the colon thus
aiding digestion and excretion of waste products.
Peristalsis (the movement of food through the bowel)
can be increased by massage over the abdomen.
Massing the liver also stimulates cell activity and helps
increase baby’s metabolism and the expulsion of
waste products. Massage on the abdomen can be
particularly useful for babies with colic.

Precautions:
• When massaging the tummy, movements are always
clockwise and downwards, below the ribs. This is
because peristalsis occurs in this direction.
• One must be careful not putting pressure directly on
the belly button.
• The massage movements must be done below the
diaphragm, so that they assist peristalsis correctly.
 Baby’s Sensory World
Sight Hearing
From third
trimester gestation
onwards, the
foetus becomes
aware of external
sounds , the
mother’s voice will
become very
Newborn ---------------------- Six Months familiar.

Taste Smell
Taste manifests from
7-8 weeks gestation Parental/maternal smells
and matures at 14 provide baby with very
weeks. important sensations
about her environment
Babies prefer sweet and provides security.
flavours as breastmilk This is essential to
is sweet. strengthen the bond
between parent and baby.
 Baby’s Sensory World

Touch
The sense of touch is the first one to
develop, from only 3 weeks gestation.

From 12 weeks, the whole body (except

the upper part of the head) is sensitive
to touch.

The baby receives constant massage

inside the womb, whilst her mother
moves.

Babies explore their world through touch. They use touch to comfort
themselves and seek being comforted through touch too.
Importance of skin to skin contact and
tactile stimulation

“Born into a confusing world, with simple primitive needs, all

babies crave and respond to human touch. Scientists call this
‘skin hunger’. Babies are designed to be physically appealing: a
baby’s soft skin compels us to stroke, kiss and protect him.
When a baby gives vent to an anguished wail he is often
literally crying out to be held”

- Deborah Jackson, ‘Mother and Child’ (2001)

 Importance of skin to skin contact and
tactile stimulation
Physiological
Reduces stress hormones such as cortisol
 Positively alters the immune system
 Helps weight gain in premature infants
 Increases white blood cell count
 Relieves wind, colic, constipation
 Relieves respiratory disorders and sinus congestion
 Increases circulation
 Improves the elimination of waste through lymphatic drainage and by supporting the venous
circulatory system
 Improves the condition of the skin

Psychological
Alleviates depression and anxiety by releasing “feel good hormones”
 Reduces pain by releasing endorphins (the body’s natural pain killing hormones)

Touch is often an underrated sense however it is quite amazing that stimulation of

the skin can have such a profound effect on all of the systems of the body.
 Babies’ Development

As a baby massage instructor, it is necessary to know

about infant development. This will help you create
the right environment for your classes and know
what babies do in each of their developmental
milestones.

All babies develop at a different pace. It is

important to make sure parents and carers
don’t lose confidence or feel disappointed if
their baby doesn’t do certain thing at certain
time. Generally, babies reach their optimum
development under the appropriate care, it
doesn’t matter if they take longer than others.
If parents have more serious worries, the
suggestion would be to consult a paediatrician
or a health professional. And later on, when you learn how
to walk and run, we can chase cats!
Benefits of Baby Massage
 Baby Massage and the Importance of Bonding

“A baby is a question mark and his mother the answer he

seeks. Sensitive to every encounter, the newborn
experiences life through the soft filter of mother’s
embrace, her milk, her lullabies.”
- Deborah Jackson, ‘Mother and Child’ (2001)

“According to attachment theory our first relationship with our

carers acts as a lifelong template, moulding and shaping our capacity
to enter into, and maintain, successful subsequent relationships with
family, friends and partners. It is believed that these early and
powerful experiences with the people who first looked after us will
shape our long‐term emotional wellbeing.”

- Juliet Neil-Hall, ‘Attachment: Supporting young children’s emotional

wellbeing’ (2015)

As baby massage instructors, we can encourage parents and carers to

continue communicating with their babies through positive touch, helping
them creating loving bonds that will last for a lifetime.
 Attachment Theory – Background

The psychologist John Bowlby was the pioneer of the

attachment theory, describing it as “lasting psychological
connectedness between human beings” (1969).

He proposed that attachment can be understood within an

evolutionary context in that the caregiver provides safety and
security for the infant. Attachment is adaptive as it enhances the
infant’s chance of survival. Bowlby suggested that the attachment
figure acted as a secure base for exploring the world. The
attachment relationship acts as a prototype for all future social
relationships so disrupting it can have severe consequences.

Characteristics of an ‘attachment’:
• Safe Haven: If the child feels threatened, he can return to his care giver for reassurance
and comfort.
• Secure Base: The caregiver provides a secure base for the child to explore the world.
• Proximity Maintenance: The child stays near the caregiver, to provide safety and
security.
• Separation Distress: If separation occurs from the caregiver, the child will become
upset.
 Attachment Theory – Background

Following on from Bowlby’s work, psychologist Mary

Ainsworth conducted a groundbreaking study ‘Strange
Situation’ which examined attachment and child
behaviour in more detail.

In the study, researchers observed how children between

the ages of 12 and 18 months responded when they
were briefly left alone by their mothers and then
reunited.

From the research Ainsworth identified three main styles of attachment:

• Secure attachment – the healthiest form of attachment where the child is
concerned about their care giver.
• Ambivalent – insecure attachment-here the children were distressed at their
mother leaving but they then did not react when they returned.
• Avoidant – insecure attachment- here the children did not seem to mind if
the mother was there or not.
 Attachment Theory – Background

Which is the fourth attachment style?

• Disorganized – insecure attachment where children had a lack of clear

attachment behaviour and a mix of avoidant and ambivalent behaviours.

(Mary Main & Judith Solomon 1986)

From these initial research studies into

attachment, a number of other studies
have been done which indicate that these
attachment styles are valid and that the
styles continue into later life and can have
an impact on social/emotional behaviours
and relationship successes.

Video: The Secret Life of the Brain

Video: InBrief – The Science of Neglect
 Baby Massage and the Importance of Bonding

Baby massage can help encourage the

formation of a strong healthy attachment
through its many benefits. The effects of
responding to an infant’s emotional/social
needs through gentle and responsive
parenting can have lasting positive impact.

Baby massage classes should look at

supporting and encouraging parents
and carers in their new role. The
element of discussion during classes
could help facilitate communication
about the main challenges of
parenting and could help boosting
confidence and self-esteem.
 What is attachment?

Video…
What is Attachment?
from Attachment Parenting International
 Baby Massage and the Importance of Bonding

Baby massage helps to encourage instinctive parenting rather than a

particularly parenting style. Parents should do what feels comfortable to them
and remember that their baby relies on them to meet their basic needs –
touch, warmth, security, food – as well as emotional needs.

It is important to emphasis that there is no right or wrong way to parent. All

babies and parents are different and all will have a different experience. By
parents trusting their instincts, they can be relieved from the pressure of trying
to act or behave in a certain way and embrace the experiences during the first
years of life of their children which are so crucial for their development.
 Upbringing in different cultures

“When a baby is
born – his parents
are too” - Osho.

Becoming a parent is a
wonderful experience, but
it is also full of challenges
and requires to adapt to
lots of changes.

Video: 4 babies, 4 countries, 1 year

 Common parenting challenges

• Tiredness and lack of energy

• Lack of structure in the day (and night!)
• Lack of confidence in parenting ability and confusion resulting from conflicting
advice
• Changing hormone levels affecting emotional states.
• Adjusting to the role of carer with less time for existing responsibilities and
interests
• Concerns over baby’s health/weight/sleeping/feeding patterns
• Bonding issues
Confidence in Parenting

• You are the best parent for your

baby

• You are getting to know a new

person in your life

• You have been through an

incredible physical and emotion
experience

• You are learning on the job

(with not much sleep!)

• No amount of preparation can

ever prepare you for how it feels
to be responsible for your baby
and take on the role of parent

• There is no such thing as the

“perfect parent” and it is
important to accept and embrace
your own unique parenting style
and celebrate all your talents and
abilities.
Relaxation
Research that Supports Baby Massage

The Touch
Research Institute Electronic book
University of Miami
website

Tiffany Field

What About the Children

website - research

Research studies in Blossom

& Berry’s website
 Summaries of Relevant Studies

Harlow and Zimmermann (1958)

"The Development of Affectional J.L. Fuller (1967)
Responses in Infant Monkeys" "Experiential
Deprivation and
Later Behaviour"

Hammett, F. S. (1922)
"The effect of
thyroparathyroidectomy
on reproduction
albino rats"
 Summaries of Relevant Studies
R. Hansen and G. Ulrey (1988)
“Motorically Impaired Infants:
Impact of a Massage Procedure of
Caregiver-Infant Interactions"

University of Warwick (2006)

"Massage Intervention for
promoting mental and physical
health in infants under six months"
Field T. & Hernandez-Reif M.
(2001) "Sleep problems in infants
decrease following massage
Tiffany Field, Scanfidi F., Abrams therapy, Early Child development"
S. and Richardson S. (1996)
"Massage therapy for infants of
depressed mothers Infant
Behaviour and Development"

Dr.Vivanne Glover (2008)

"Report: Massage and
Field T. et al.(1986, 1990, 1998,
mother baby interaction
2005, 2008). Research that
with depressed mothers"
supports the weight increase
after positive touch interaction
 Contraindications of Baby Massage

A contraindication is a reason or circumstance which

means that a massage should not occur.

Contraindications can be ‘general’ prohibiting any

massage or ‘local’ where massage can occur but not
in the specific area.

Make sure none of these conditions are present when a baby is due to have a
massage. Always ask the group if the babies are happy and healthy before you
begin each class to make sure nothing has changed since the last time you met.

And before you start a new group, always make sure parents and carers
complete a health questionnaire.
 General Contraindications

 Acute infections
 Fever
 Sickness
 Diarrhea
 Undiagnosed lumps and bumps
Massage
 Contagious disease
 Serious skin complaints
 Inflammation
 Recent haemorrhage
 Jaundice
 Meningitis
 Childhood Leukimia
 Brittle Bones
 Local Contraindications

 Recent immunisations (wait 48 – 72 hours)

 Skin disorders or localized eczema
 Cuts and bruises
 Unhealed or swallen navel
 Open sores
 Conditions requiring
GP / medical consent

• Congenital heart condition (most commonly seen as aortic valve

septum, atrial septal defect, pulmonary valve stenosis, ventricular
septal defect, transposition of the great vessel)
• Recent operations or surgery
• Dislocation of the hip
• Spastic conditions where there is an increase
in muscle tone
• Dysfunctions of the nervous system
• Epilepsy – where massage can take place,
make sessions brief and observe the
baby closely
• Asthma – during an acute attack.
 Baby Massages Contraindications

A parent may also feel that there are other times when it is
inappropriate to massage their baby. Each parent knows their own
baby’s mood and behaviour. Parents should always listen to their
instincts when deciding if a massage is appropriate.

There are areas which should not be massaged:

• Front of neck and throat
• Eye area
• Back of neck and directly on spine
• Under the arm (only soft gliding, no pressure)
• Front of elbow and back of the knee
• Directly on navel
• Groin area
• The skull
• Directly on the bones (no pressure on bones)
 Practical elements when
teaching baby massage
• Entry requirements of families in
your class

To join a class it is recommendable that a

baby is 6-8 weeks

For premature babies, keep sessions short

• Resources (mats, towels, cushions)

Families should bring their own blanket or

towel, to maintain hygiene and for baby to
feel comfy. They could also bring a cushion.

Adapt positions if parent/carer has back

problems or other physical limitations.
 Practical elements when
teaching baby massage

• Health questionnaire and booking form

• Patch test (oil)

• Necessary equipment for your classes

• Health & Safety

• Hygiene
□ Mats clean
□ Each family to bring their own blanket or towel
□ Floor dry and clean
□ Remove jewellery
□ Clean hands and short nails if possible
□ Ventilated venue with the right room temperature
□ Have handy: cleaning wipes, hand cleaner gel, anti-bacterial spray and cleaning cloth
Creating the right environment
 Creating the right environment

• Temperature
• Lighting
• Space
• Noise
• Music
• Items that families
should bring
Oils

An organic vegetable based oil is the type of oil

recommended for baby massage

• Sunflower
• Fractioned Coconut Oil
• Grape Seed Oil
(low in oleic acid, high in linoleic acid)

 100% natural
 Nourish the baby’s skin
 No harm if they end up in baby’s mouth
 Not irritable if they end up in baby’s eyes
 Unlikely to cause an allergic reaction
 Easily to absorb by the skin
 They don't block the skin’s pores
 Safe to use in dry skins
 Oils

 NO SMELL – carrier oils – mummy’s smell!

 ORGANIC – the difference in price is not

huge, and when it comes to babies, the best is to
choose what is most natural.

 COLD PRESSED – these oils come from the

seed without thermal or chemical treatments, so
they are in their natural state, reducing the risk of
an allergic reaction.

 EDIBLE – safe if it ends up in baby’s mouth.

Oils

Precautions:

 Always carry out an patch test in a small area of the body

(like the writs) in both, parent and baby, before applying
the oil all over the body. Wait for at least 10 minutes and
search for any secondary effects or reactions.

 Avoid oils from nuts, such as almonds or peanuts, to

minimise the risk of any allergic reaction . The same applies
to oils from wheat germ, to avoid gluten allergic reactions.

 It is not recommendable to give baby massage using

essential oils, especially when babies are less than 6
months, unless it is specified by a qualifies aroma-therapist
or if the product clearly states that it is safe to use on
baby’s skin.
 When to massage?

 Quiet – Sleep
 Active – Sleep (R.E.M.)
 Drowsy
 Active – Alert
 Crying

 Quiet – Alert
THE BEST TIME TO MASSAGE
Baby’s face is relaxed, bright open eyes,
observant, relaxed limbs

By observing the baby as he/she goes through these behavioural stages,

a parent can identify when is the most appropriate time to massage.
Being aware of the stages in baby’s day is also useful for planning
activities and keeping in rhythm with a baby’s natural routine.
It is useful to share this information on behavioural stages with parents
when talking about when is the best time to massage baby.
When to massage?
Signals that indicate that baby is relaxed during
massage
Frequent eye contact
Relaxed limbs (arms and legs)
Hands to mouth or hands at mid line
Making noises, vocalising

Signals that baby is

experiencing stress during
massage or is It is a good idea to talk
uncomfortable through these signals and
Jittery limbs cues with parents as a
Crying discussion topic during the
Hiccups class so that they learn to
Sneezing interpret their babies needs
Lack of eye contact during massage and at other
Frowning times.
 Familiarising baby with touch

 Baby massage can be introduced slowly and following baby’s

pace so he feels secure and comfortable

 Courses for families should last at least 3 sessions, for one to

one classes, and minimum 4 sessions for groups

 It is perfectly acceptable if massage is suspended during the

class, or if massage is shorter for a baby

Two minutes massage on a receptive

baby has a much greater benefit than Techniques to help babies familiarise
ten minutes massage on a baby who has with touch:
tried to tell his parent that he has had
enough massage and the parent has not  Skin to skin contact
listened. Ultimately massaging a baby  Touch through clothes
who does not want a massage is likely to  Relaxed touch
agitate the baby and the parent.
Relaxation techniques for parents
Babies are in charge of the class!
 Different reaction to massage

Remember that each baby is unique

Oh dear! I
They react differently... have been
cloned!

Common reactions:
 Alert
 Sleepy
 Tired or unhappy
 Crying

Precautions:
 Parents/carers should clean their hands with a cleaning wipe or wash their hands before
and after the massage.
 Babies should remain wrapped up warm after the massage.
 It is recommendable to offer baby a drink after the massage as they can be thirsty.
 Allow the baby to sleep if he/she is tired.
 Avoid exposing baby to sunshine straight after the massage as the oil can make him more
susceptible to sun burns.
 Course for parents structure

• Lasts 3-6 sessions The core element of the

• One session per week, each session of 60-90 minutes
course is the massage
• Each week, the massage strokes of a new part of the body are
learned
routine and this should
• Classes are relaxed and informal not be changed as it is
• Generally, a discussion is included based on safe and
• Supportive approach and friendly atmosphere appropriate massage
• Babies are always in charge or the rhythm and activities strokes for babies.The
• The size of the group depends on the aims of the course, the rest of the course can be
venue... adapted to reflect your
personal style
Examples of ways of structuring the types of
services:
Basic course
Tummy Workshop or Special
Session for Colicky Babies
Dads Workshop (whilst mum rests)
The First Massage of the Newborn
Working with babies with colic or unsettled babies

What is colic?
When the baby is crying, it is not the parents’
fault, they are the ones who can best respond to
their baby’s needs. Even when the first attempts to
soothe the baby might not seem fruitful, gradually
they will start getting to know the baby better and
better. If they are experiencing a very challenging
time, the best thing to do is to seek help.

Infant massage represents

another tool that
parents/carers can use to ease
colic and calm babies.
 Coping with crying
Why do babies cry?

Physical Needs – Such as hunger, temperature,

shelter, sleep, fresh air, activity, overstimulation,
protection from injury or danger, colic.
 Emotional Needs – These include love, security,
the need for comfort and touch, loneliness, fear,
confusion, reassurance.
 Developmental Stages – Babies may cry more
when they are reaching developmental goals such as
teething, crawling, walking.

Attitudes
towards crying
 Parenting and Massage

It is very important to only give out information in your sessions which you are
qualified to teach. However, it may be tempting to give out generic advice on
baby care, always be professional and never diagnose conditions or give out
medical advice. If you suspect there is an underlying condition causing baby to
be unsettled or unwell always advice a parent/carer to seek medical advice.
Although there is no medical treatment for colic, it is worth mentioning about
a condition called silent reflux which can often have similar characteristics as
colic which can sometimes be treated with medicine.
Discussion time during classes

When is good to give

a massage
Coping with crying
Adjusting to
parenthood
Facing colic
How to adapt the
baby massage routine
with toddlers or older
children
Attachment and baby’s
emotional needs
 Post Natal Depression (PND)
It is not known for certain what causes PND, but it
seems likely that in some cases it is the sudden change
in hormones after the birth which may be the trigger.
Research has shown that there are a number of things
which may make some women more vulnerable to
developing PND. These include:

• A previous or family history of depression

• Lack of social support
• No one in whom the mother can confide
• A poor relationship with her own mother or partner
• Major life events in the 12 months before the birth
(for example, bereavement, moving house,
unemployment)
• Social circumstances (for example, poor housing,
financial worries)
• A traumatic birth experience (research has shown
that the way the mother feels about her birth
experience is more important than what actually
happened)
• Unrealistic expectations
 Post Natal Depression (PND)

Symptoms:
• Anxiety
• Panic attacks
• Tension and irritability
• Fatigue / exhaustion
• Lack of concentration / inability to make decisions
• Rejection of baby / partner
• Inappropriate / obsessive thoughts
• Loss of libido
• Physical symptoms (lack of sleep, lack of appetite, headaches)
 Post Natal Depression (PND)

The first and most important step

on the road to recovery is for both
the mother and her family to
accept that she is ill. The second
step is understanding that the more
help the mother receives and the
sooner she gets this help, the
quicker she will recover.
Treatment:
• Ant depressants
• Tranquilizers
• Lithium
• Psychotherapy or counselling
• Electroconvulsive therapy
• Hormone supplements
• Stress management or relaxation classes
• Alternative therapies
• Self-help (balanced diet, exercise, rest, support groups)
The Baby Massage Routine

Time to pratice
 Baby Massage Routine
Chest
Legs and feet 20. Draw a heart
1. Relaxed touch 21. Criss-cross
2. Indian draining
3. Winging Arms and hands
4. Sole stroking 22. Relaxed touch
5. Rolling toes 23. Pit stroke
6. Pressure under toes and arch 24. Indian draining
7. Walking thumbs 25. Wringing
8. Foot strokes 26. Finger rolling
9. Ankle circles 27. Wrist circles
10. Swedish draining 28. Swedish draining
11. Rolling 29. Rolling

Tummy Face
12. Stomach hold 30. Face strokes – forehead
13. Stomach stroking 31. Stroking eyebrows
14. Elevated stomach stroking 32. Breathe easy
15. Open tummy 33. Happy gums
16. Full circle 34. Relaxed jaw
17. Half circle Back
18. Full circle/ half circle 35. Back to bottom and all the way above the ankles
19. Walking fingers 36. Back paddling
37. Circles
38. Combing
Any questions?
 I don't know about you but...
I am ready for the weekend!

Thank you for listening

Tomorrow... (add here any instruction relevant for day 2 of training)