The Influence of Intant Massage to Weight Gains in Low Birth Weight Infant (LBW) : A Systematic Review

Growth and development is a significant phase that cannot be replicated, underscoring the need for meticulous attention, particularly for those born with low birth weight (LBW). LBW can be stimulated using infant massage. This research aimed to evaluate the impact of infant massage on weight gain among LBW infants. This is a systematic review using PICOS framework, investigating studies from 2018 to 2023 in databases including Cochrane, PubMed, ScienceDirect, and Scopus. The inclusion criteria involved full-text access and the keywords low birth weight, weight gain, and massage. The initial search yielded 1913 literature, which were screened based on publication year and type, resulting in 122 articles. After being examined, 119 articles were excluded due to duplication, using non-English language, involving non-LBW, different outcomes, and non-RCT, leaving three articles. The assessment of literature quality was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. The results of outcome measurements and group comparisons across the three studies exhibited congruence. In conclusion, the finding indicated that infants who underwent massage intervention exhibited weight gain, as did those who did not undergo such intervention. Furthermore, infants who received massage intervention experienced a more pronounced increase in weight compared to their counterparts who did not undergo massage intervention.

INTRODUCTION

Infants with low birth weight (LBW) are characterized as newborns whose birth weight is below 2,500 grams, irrespective of their gestational age. Low birth weight constitutes a significant contributor to heightened rates of mortality, morbidity, and disability among neonates, infants, and children, imparting lasting effects on their future well-being. Potential enduring consequences stemming from LBW encompass developmental disorders, visual impairments (retinopathy), hearing deficits, chronic lung conditions, elevated morbidity rates, heightened occurrence of congenital anomalies, and necessitate specialized medical interventions^1-71234567.

Infants with low birth weight (LBW) face an elevated susceptibility to morbidity, hindered growth, impaired cognitive development, reduced adult stature, and an amplified likelihood of developing chronic illnesses during their later years. The progression of growth and development in infants and toddlers is profoundly impacted by the satisfaction of their fundamental requirements. These primary needs are often referred to as the "triple A" – encompassing the imperative necessities for nourishment, emotional connection, and early cognitive stimulation^{1,8-111891011}. Parents have the opportunity to provide effective growth and development stimulation to their children right from infancy. Through positive interaction and appropriate activities, parents can offer beneficial stimulation that aids in unlocking their children's full potential and fostering optimal development^12,131213.

A form of stimulation that the community has embraced is infant massage. Massage holds a historical lineage as one of the oldest therapeutic practices globally. Serving as an artistic facet of healthcare and medicine, massage can alleviate stiff joints and establish a harmonious connection among the body's organs through tactile engagement. Through the application of massage techniques to circulatory muscle tissue, the potential for enhancing muscle condition and restoring proper muscle positioning arises. This, in turn, can contribute to the optimization of organ function within the body, allowing for improved overall bodily functionality^14-16141516.

Multiple research has demonstrated a notable impact of infant massage on the weight of infants aged 3 to 6 months, substantiated by statistical test outcomes^{17-2917181920212223242526272829}. Research by Majid also indicated that baby massage is linked to weight gain in infants³⁰³⁰. Nevertheless, these outcomes diverge from the observations made in the study conducted by Fauziyah³¹³¹. The study by Fauziyah, in contrast, reported no discernible impact of administering baby massage on fluctuations in infant weight. These divergent findings between the two studies prompted the current research, aimed at meticulously analyzing the influence of baby massage on body weight in infants with low birth weight (LBW).

MATERIALS AND METHODS

The electronic database was searched through four sites, the Cochrane, PubMed, Science Direct, and Scopus. Based on the keywords (Low Birth Weight OR Infant Low Birth Weight OR Neonates LBW) AND (Weight gain OR Increase Weight OR Weight gain) AND (Massage OR Infant Massage OR Developmental Care Massage) we obtained 1,913 records. These results were then screened using the year criteria and obtained 122 articles. We excluded 119 records as 7 of them were duplicated articles, 1 article not in English, 50 articles with subjects other than infant low birth weight, 47 articles discussing different outcomes, and 14 articles with research designs other than the Randomized Controlled Trial. Three full-text articles were finally obtained and analyzed in this systematic review.

RESULTS

Figure 1.PRISMA Flow Diagram

Table 1.JBI critical appraisal

Question	Reference
	Montaseri et al., (2020)3232	Liao et al., (2021)3333	Naseh et al., (2023)3434
Was the trial design appropriate, and any deviations from the standard RCT design (individual randomization, parallel groups)	Yes	Yes	Yes
Was appropriate statistical analysis used?	Yes	Yes	Yes
Were outcomes measured in a reliable way?	Yes	Yes	Yes
Were outcomes measured in the same way for treatment groups?	Yes	Yes	Yes
Was follow up complete and if not, were differences between groups in terms of their follow up adequately described and analyzed?	Yes	No	Yes
Was follow up complete and if not, were differences between groups in terms of their follow up adequately described and analyzed?	Yes	No	Yes
Were treatment groups treated identically other than the intervention of interest?	Yes	No	Yes
Were outcomes assessors blind to treatment assignment?	Yes	Yes	Yes
Were those delivering treatment blind to treatment assignment?	No	Yes	No
Were participants blind to treatment assignment?	No	Yes	No
Were treatment groups similar at the baseline?	Yes	Yes	No
Was allocation to treatment groups concealed?	Yes	Yes	Yes
Was true randomization used for assignment of participants to treatment groups	Yes	Yes	Yes
Score of Yes	13	10	10

We assessed the quality of the literature with the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. The three obtained articles have met the inclusion criteria, the research design was appropriate as they used Randomized Controlled Trials and there was a standard deviation from this RCT design. The statistical analysis had been carried out correctly, and also the results from the outcome and group comparisons of these three studies agreed. In the article by Montaseri et al.,(2020)³²³²there were 13 checklists of yes, in the article by Liao et al.,(2021)³³³³there were 10 checklists of yes, and the article by Naseh et al.,(2023)³⁴³⁴found 10 checklists of yes (Table 1).

No	Article	N	Group	Initial Weight		Final Weight