The Lowering of Bilirubin Levels in Full-Term Newborns by the Effect of Combined Massage Therapy and Phototherapy Practice

Abstract

Objective Various therapeutic treatments have been prescribed for decreasing the bilirubin level. Massage therapy is one of the neonate treatments for jaundice. The aim of this study is to investigate the effects of combined massage therapy and phototherapy on neonatal jaundice.

Study Design This study was performed at Shahid Madani Hospital in the city of Khorramabad in 2016, where 83 healthy full-term infants were enrolled. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups. The control group (n = 43) received phototherapy, whereas infants in the intervention group (n = 40) received 4 days of massage and phototherapy. The serum bilirubin level, frequency of stooling and amount of urination, duration of hospitalization, and feeding frequency were analyzed using SPSS by descriptive and analytical statistics (mixed regression models).

Results Baseline levels of bilirubin were similar between the two groups (p > 0.05). The bilirubin level was measured as 13.4 ± 0.7 mg/dL in the intervention group on day 1. It stood at 14.4 ± 1.5 mg/dL in the control group, which was not statistically significantly different. However, the mean bilirubin level was decreased on day 4 of hospitalization to 7.4 ± 0.56 mg/dL and 9.0 ± 2.3 mg/dL, showing a significant difference decrease in the intervention and control group (p < 0.05), respectively.

Conclusion Intervention had a significant role in decreasing the bilirubin level, amount of urination, and duration of hospitalization of full-term infants suffering from hyperbilirubinemia.

Keywords

hyperbilirubinemia - infant - jaundice - bilirubin - massage

Authors' Contributions

S. A., A. M., and P. B. planned the study, wrote the protocol, collected the data, and drafted the manuscript and accepted the final draft. M. G. N. and M. M. planned and designed the study, collected the data, analyzed the data, critically revised the draft, and, finally approved the manuscript.

Note

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

This study was approved by the Research Ethics Board of the Lorestan University of Medical Sciences (IRCT2015113025287N2). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Publication History

Received: 26 April 2018

Accepted: 07 March 2019

Article published online:
18 April 2019

• References

• 1 Alex M, Gallant DP. Toward understanding the connections between infant jaundice and infant feeding. J Pediatr Nurs 2008; 23 (06) 429-438
• 2 American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114 (01) 297-316
• 3 Basiri-Moghadam M, Basiri-Moghadam K, Kianmehr M, Jani S. The effect of massage on neonatal jaundice in stable preterm newborn infants: a randomized controlled trial. J Pak Med Assoc 2015; 65 (06) 602-606
• 4 Bhutani VK, Johnson-Hamerman L. The clinical syndrome of bilirubin-induced neurologic dysfunction. Semin Fetal Neonatal Med 2015; 20 (01) 6-13
• 5 Chen J, Sadakata M, Ishida M, Sekizuka N, Sayama M. Baby massage ameliorates neonatal jaundice in full-term newborn infants. Tohoku J Exp Med 2011; 223 (02) 97-102
• 6 Dalili H, Sheikhi S, Shariat M, Haghnazarian E. Effects of baby massage on neonatal jaundice in healthy Iranian infants: a pilot study. Infant Behav Dev 2016; 42: 22-26
• 7 Field T, Diego M, Hernandez-Reif M. Moderate pressure is essential for massage therapy effects. Int J Neurosci 2010; 120 (05) 381-385
• 8 Faraji-Goodarzi M, Taee N, Mohammadi-Kamalvand M. Comparison of the effect of cold drink and dexamethasone, and their combined effect on children with croup. Drug Res (Stuttg) 2018; 68 (04) 185-188
• 9 Underdown A, Barlow J, Chung V, Stewart-Brown S. Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database Syst Rev 2006; (04) CD005038
• 10 Semmekrot BA, de Vries MC, Gerrits GPJM, van Wieringen PM. Optimal breastfeeding to prevent hyperbilirubinaemia in healthy, term newborns [in Dutch]. Ned Tijdschr Geneeskd 2004; 148 (41) 2016-2019
• 11 Lin C-H, Yang H-C, Cheng C-S, Yen CE. Effects of infant massage on jaundiced neonates undergoing phototherapy. Ital J Pediatr 2015; 41: 94
• 12 Boskabadi H, Alfi N. Effect of massage on response rate of a neonate with hyperbilirubinemia to phototherapy. Iranian J Pediatr 2013; 23 (1 suppl): 52
• 13 Eghbalian F, Rafienezhad H, Farmal J. The lowering of bilirubin levels in patients with neonatal jaundice using massage therapy: a randomized, double-blind clinical trial. Infant Behav Dev 2017; 49: 31-36
• 14 Seyyedrasooli A, Valizadeh L, Hosseini MB, Asgari Jafarabadi M, Mohammadzad M. Effect of Vimala massage on physiological jaundice in infants: a randomized controlled trial. J Caring Sci 2014; 3 (03) 165-173
• 15 Karbandi S, Lotfi M, Boskabadi H, Esmaily H. The effects of field massage technique on bilirubin level and the number of defecations in preterm infants. Evid Based Care J 2016; 5(4): 7-16