Pediatric and infant massage looks different than adult massage but in both cases massage is never forced and permission is always asked before performing massage.

http://massagetoday.com/mpacms/mt/article.php?id=15051

http://www.liddlekidz.com/infant-massage-permission.html

Asking permission before touch teaches kids healthy boundaries and positive touch and makes them feel safe and empowered. The one-on-one sessions last thirty minutes while the infant massage classes last an hour and a half. The first pediatric fascial balancing session lasts an hour and the subsequent sessions lasts 30 minutes.

 

Pediatric fascial balancing (also known as pediatric manual therapy or pediatric cranial work) “uses gentle touch and movement techniques to release tension patterns in the cranium, skeletal system, organs and other soft tissue (muscles/tendons).” (http://www.craftedtouch.com/laurens-practice-1.html).  I will be providing the massage and clothing will remain on as the massage can be performed over clothes. Each session will be held once a week every 2-3 weeks depending on the needs of the child. For issues related to nursing or constipation each session will be scheduled a week apart until the issue resolves. Typically I will see the child for 3-4 sessions. The final session is usually a shorter check-in.  I’m certified to work with newborns-3 years. During the session the infant may be on a table, held by a parent/caregiver, or held by me depending on the child’s cues and what work needs to be done. After a session an infant will usually react in one of two ways: "in the case of significant release/treatment (strong or central), infants often sleep long and hard that evening (sometimes up to 10, 12, or 14 hours). Usually these children wake up with a noticeable change in their symptoms. Others, who receive more moderate treatment during a session, often show little immediate change; rather parents notice generalized improvement 4-5 days later." (Christman, 2014, 5) Pediatric fascial balancing differs from the infant massage instruction in that the massage is more medically oriented, uses more advanced techniques, and is not meant to be a daily treatment while the infant massage instruction is more relaxation/general wellness oriented and uses simple strokes and techniques that the parents/caregivers can use every day. 

 

With infant massage (3 weeks-1 year) it will be the parent/caregiver who gives the massage. It is recommended that clothing be removed to facilitate skin-to-skin contact (which promotes bonding/attachment) but with very young infants leaving the child partially clothed may be warranted to keep the child comfortable. Massage can also be done over clothes if the infant shows a lot of tactile defensiveness around skin-to-skin contact.

 

Infants under 8 weeks can only see 8-12 inches in front of them and before 8 months infants don’t have object permanence (the awareness that things out of sight still exist). These two facts mean that when you’re out of sight and physically distant you have literally disappeared, which is scary for young infants. Therefore I recommended keeping young infants physically close to you such as in your lap while doing the massage. 

 

It is recommended to try and schedule the massage when your baby is most relaxed and/or most often in the quiet alert state, which is when the infant is most receptive to massage. If the infant is not receptive to touch the parent/caregiver can practice on a doll. 

 

As infants learn to crawl and become more active it can be hard to do massage. Work with their cues and try to find quiet moments in the day when they are more slowed down and see if they’re open to massage. Many children come to love massage and may even request it.

 

When learning to massage your infant or child one of the first steps parents/caregivers must take is to be open to the child’s cues. Every infant/child has their own yes/no cues. Learning these cues can reduce crying in infancy and promote verbal/non verbal communication as well as attachment. Some common cueing is breathing patterns (breathing from the stomach versus from the chest), movement of limbs (smooth versus jerky), facial expression (smiling versus grimacing), trying to move toward or away from the caretaker/stimuli, and muscle tension (are they relaxed or can you feel/see that their body is tensed up). In regards to infants some common signs that a baby is stressed or overwhelmed (taken from Levine, 2010, 314) are: squirming and twisting away, startle reflex, facial gestures of disgust, protesting through loud vocalizations, averting eye gaze, kicking or pushing movements, involuntary jerking, arching spine or tensing muscles, dazed expression and "checking out" by excessive sleepiness.

 

Learning your child’s cues means seeing the child for who they are, what they need, and what they are telling you through non-verbal communication. Then, as you provide a soothing or gentle touch, the parent/caregiver is not only teaching the child what healthy touch looks like, they are communicating to the child that: “I hear you,” “You are safe,” “I am here for you now.” These messages communicated by the primary caregiver are vital for a sense of emotional healing and growth. (Allen 106T)

 

With pediatric massage (1 year-18 years) I will provide the massage but I will also teach the parent/caregiver so that eventually the parent/caregiver can take over. The child will likely not take off their clothes (and in the rare case they do I follow conservative draping protocols) as the massage can be done over clothing or compression suits.

 

I will need to establish trust with the child before I can perform massage. This trust building may take a few sessions, especially if the child is suffering from trauma or is on the neurodiverse spectrum. The older the child is the faster trust can be built barring trauma or neurodiversity (both of which can impact development and trust). Since pediatrics covers a broad range of development some of the following advice may apply more to young children.

 

Pediatric massage may look like playing: this is normal. Through play I am able to build trust and introduce touch. When needed I may use toys or storytelling. If a child is on the neurodiverse spectrum I may need to help calm and organize their nervous system through play before touch can be introduced. The session will likely occur on the floor, as being up on a table can feel threatening and scary to a child especially if they have had a lot of medical interventions.   The child will never sit in my lap but may sit in the parents/caregivers lap if that is where they feel most comfortable and receptive to touch. The parent/caregiver is required to be present in the room.  I will follow the child’s cues and always respect "no."  If the child is not receptive to touch or is wary I will demonstrate the massage strokes on a doll/toy or on the parent/caregiver if they are comfortable receiving touch.  

 

Children suffering from trauma or who are on the neurodiverse spectrum may take longer to build trust and may need to see the massage performed on a doll/toy or on their parent/caregiver (if they are willing) before feeling comfortable receiving massage. Massage is never forced on the child.

 

I encourage parents/caregivers to bring their own oil and to do a skin patch test if they are using oil their child has not been previously exposed to. It is recommended that unscented, natural, cold pressed, organic, fruit or vegetable oil such as sunflower, grape seed, almond, olive, sesame, or coconut be used as these are safer than mineral oil which is a carcinogen and does not easily absorb into the skin.  Some things to keep in mind is that 60% of what goes on the skin is absorbed, children have more fragile and more porous skin, and younger children tend to put everything in their mouths, so it would be ideal if the oil is edible (mineral oil is non-edible). With infants the lack of scent promotes bonding and can provide relief from a sensory overwhelming world. It is recommended that the caregiver put the lotion on their hands and warming it rather than placing the oil directly on the child. Some things to consider when picking oil are any allergies or sensory issues, the fact that almond is a fruit not a nut and coconut has antibacterial and antifungal properties.  

 

It is recommended to try and arrange for food and other needs to be addressed before the massage.

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Ballard

Seattle, WA  98107

axjmd2@gmail.com

 

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