This is the second submission of a proposed study designed to investigate possible mechanisms leading to enhanced weight gain in premature infants who receive massage. Multiple investigations demonstrated that preterm neonates who received massage therapy for five to ten days exhibited 28 to 47 percent greater daily weight gain. Findings were consistent in showing that preterms receiving massage do not consume more formula or calories than control infants. The proposed research will examine possible underlying mechanisms for this enhanced weight gain following massage therapy. The model that will be tested is that moderate pressure massage therapy enhances vagal activity, which in turn promotes gastric motility and the release of hormones that enhance the metabolism of digestion. Medically-stable preterm neonates (N=120) residing in the progressive or intermediate care nurseries will be matched on gestational age, birthweight, NICU days, mother's SES, and entry weight and then assigned to one of three groups: Massage Therapy (n=40), Sham Massage (n=40), or Control (n=40). Massage therapy and Sham Massage will be provided for 15 minutes, three times per day, for five days. Massage Therapy will use moderate pressure and Sham Massage will use light pressure. Group comparisons will focus on physiologic (vagal tone and gastric motility), biochemical (serum insulin, IGF-I, oxytocin, and cortisol) and behavioral (performance on the Brazelton Neonatal Behavior Assessment Scale) variables. At the end of the 5-day period, the massaged infants are expected to show: 1) higher vagal tone during massage and higher vagal tone across the study; 2) higher concentrations of serum insulin, IGF-I, and oxytocin, and lower cortisol; 3) greater gastric motility values, and 4) superior performance on the Brazelton. Regression analyses will be conducted to determine the percentage of variance in weight gain and Brazelton performance that is accounted for by the physiologic and biochemical variables.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Research Project (R01)
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Special Emphasis Panel (ZRG1-RPHB-2 (01))
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Klein, Marguerite A
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University of Miami School of Medicine
Schools of Medicine
United States
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Field, Tiffany (2014) Massage therapy research review. Complement Ther Clin Pract 20:224-9
Diego, Miguel A; Field, Tiffany; Hernandez-Reif, Maria (2014) Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms. Early Hum Dev 90:137-40
Hernandez-Reif, Maria; Maluga, Mark; Field, Tiffany (2012) Maternal depression and infant birth measures relate to how neonates respond to music. Infant Behav Dev 35:655-61
Field, Tiffany (2012) Prenatal exercise research. Infant Behav Dev 35:397-407
Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria et al. (2012) Yoga and massage therapy reduce prenatal depression and prematurity. J Bodyw Mov Ther 16:204-9
Field, Tiffany (2012) Exercise research on children and adolescents. Complement Ther Clin Pract 18:54-9
Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria (2011) Potential underlying mechanisms for greater weight gain in massaged preterm infants. Infant Behav Dev 34:383-9
Field, Tiffany (2011) Prenatal depression effects on early development: a review. Infant Behav Dev 34:1-14
Field, Tiffany (2011) Tai Chi research review. Complement Ther Clin Pract 17:141-6
Field, Tiffany (2011) Yoga clinical research review. Complement Ther Clin Pract 17:1-8

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