Premature infants are exposed to a stressful environment, high intensity noise, and bright light continuously. They are deprived of mechanosensory stimulation which they receive in utero [1], constant tactile stimulus of amniotic fluid, and are also exposed to various touch stimulus during routine care [2]. Massage therapy may help in facilitating weight-gain process. We studied the efficacy of tactile- kinesthetic stimulation on the weight of infants in a neonatal intensive care unit (NICU).

This study was conducted in a level III neonatal unit from May, 2019 to August, 2019, after ethical clearance from the institutional ethics committee. All infants born between 28 weeks to <37 weeks gestational age, and birthweight of 1000 g -2500 g and admitted in the NICU within the first 48 hours were enrolled. Additional inclusion criteria were: Apgar score >7 at 1 and 5 minute with no resuscitation required at birth, and medically stable with medical conditions primarily related to immaturity (such as elevated bilirubin, mild hypoglycemia and hypocalcemia). Those with genetic anomalies, congenital anomalies, any infections, and any evidence of intraventricular hemorrhage were excluded. Enrolled infants were randomized by using computer-generated random numbers to receive tactile-kinesthetic stimulation and routine hospital care (RHC) after 48 hours of their birth. Experimental group infants received two sessions of tactile-kinesthetic stimulation for 10 minutes each day, for ten consecutive days along with RHC, whereas the infants in the control group received only RHC.

The stimulation protocol was taken from field study in 1986 [4]. For the tactile stimulation, the infant was placed in a prone position. The researcher used the palms of the scrubbed and warmed hands on the infant’s body while the baby was in the incubator. The following five regions of the infant’s body were then gently stroked for five seconds, 12 times conse-cutively (totalling one minute). From the top of the neonate’s forehead down the side of the face to the neck and back to the forehead; from back of the neck across the shoulders and back to the neck; from the upper back down to the waist and back up; from the thighs down to the ankles and back to the thighs; and from the shoulders to the wrists and back to the shoulders. For the kinesthetic and proprioceptive stimulation, the infant was placed in supine position. This stimulation was given for five minutes with five one–minute intervals. It included six passive flexion and extension movements in the right and left arm, the right and left leg and the two legs together.

The weight of the babies from both the groups were measured daily by digital electronic weighing scale by the same nursing assistant who was blinded about the allocation of groups. The outcome of this study was the weight of infants in the two groups after 10 days of intervention.

A total of 46 preterm babies were enrolled and forty infants completed the study. Both the groups did not differ on the matched variables of gestational age, birthweight, weight on day one of the study, and 1 and 5 minute Apgar scores (Table I). The mean (SD) fluid and calorie intake in the infants of the two groups was also similar. The mean (SD) weight gain after 10 days was higher in the experimental group as compared to con-trol group [10.79 (0.62) g vs 4.03 (0.89) g; P<0.001] (Table I).