Effects of Body Massage on Response to Phototherapy in Neonatal Hyperbilirubinemia: A Randomized Clinical Trial

Background: Massage therapy has been commonly practiced as a traditional complementary therapy in neonates. This study was designed to evaluate the effects of massage on decreasing bilirubin levels in infants undergoing phototherapy. Materials and Methods A total of 60 term icteric infants without known risk factors who were admitted to the neonatal intensive care unit of Ghaem Hospital, Mashhad, Iran from 2016 to 2018 were involved in this preliminary clinical trial. The infant participants were randomly divided into the massage + phototherapy (intervention group, n=30) who received massage therapy (with field technique) thrice daily (every 8 hours) for 30 minutes each, and phototherapy alone (control group, n=30) who received phototherapy and routine care. Serum bilirubin samples were obtained at different time points in both groups. Results: The mean feeding time in the intervention and control groups were 22.5 and 21.4 min, respectively. The mean birth weights in the intervention and control groups were 3052 and 3187 gr, respectively. No significant differences were found between the two groups in age, sex, Apgar score, maternal profile, and previous history of jaundice (P>0.05). Rates of bilirubin loss were 0.81±0.19 mg/dl/h and 0.59±0.18 mg/dl/h in the intervention and control groups, respectively (P=0.043), in the first 8 hours of admission which dropped to 0.46±0.16 and 0.37±0.22, respectively (P=0.958), in the first 30 hours of admission. Conclusion Based on the results, massage is suggested as a complementary method for phototherapy, especially in the first eight hours of treatment during toxic high bilirubin levels and at the peak risk of kernicterus.