Within the confines of the Neonatal Intensive Care Unit (NICU) at Lucile Packard Children’s Hospital Stanford, a room filled with state-of-the-art medical equipment helps safeguard newborn infants.
Its equipment is lifesaving, but the personal touch provided by a group of volunteers called cuddlers makes this particular NICU something very special.
Supervised by developmental and behavioral pediatrics specialist Lori Bowlby, R.N., the Baby Cuddler Program at the Stanford, California, hospital comprises mostly older adults sharing the common purpose of providing babies comfort in the critical early stages of life.
When the program began in 1990, there were seven volunteers. There are now more than 130 volunteers who give over 10,000 hours of service a year.
“When we started the program there was a cocaine epidemic, and babies needed a calming touch as their tiny bodies went through the detox process,” said Bowlby. “Cuddlers provided that special touch, and it helped free nurses to assist other babies.”
To properly develop, babies require positive touch as they may experience distress from separation anxiety and pain, she said.
“Greater than 80 percent of a [NICU] baby’s touch is negative,” said Bowlby. “Our goal is to change that.”
Studies show babies go into a deeper sleep when held, Bowlby said. One study, “The Effects of Kangaroo Care on the Sleep and Wake States of Preterm Infants,” published in the Journal of Nursing Research in December 2016, found that babies placed on their mothers’ chests spent even more time in deep sleep compared with babies who were held in their mothers’ arms.
Cuddlers do just that—cuddle, rather than practice infant massage—and may be found caring for babies not only in the NICU, but also in the cardiac care, surgical and pediatric intensive care units. They spend at least 45 minutes, or one sleep cycle, with their assigned baby, sometimes longer.
Why Touch Helps
Experts say the ideal touch is that of a parent, so a team of developmental specialists, nurses, respiratory therapists and physicians help parents and caretakers learn proper baby-care techniques. This includes a skin-to-skin method while in the isolette, when appropriate, or massage.
“Bonding between baby and parent is essential to brain and emotional development,” said Bowlby.
Tiffany Field, Ph.D., director of the Touch Research Institute in the Department of Pediatrics at the University of Miami School of Medicine, in Miami, Florida, said among the many psychological benefits of massage is reducing stress hormones, especially cortisol, to decrease depression and anxiety.
“Moving the skin in a massage method increases serotonin, which is the body’s natural antidepressant,” said Field. “Physical effects include a reduction of pain sensation, and an overall enhanced immune function, which contributes to a greater sense of wellbeing.”
Husband-and-wife volunteers Pat Rice and Claire Fitzgerald have cuddled babies for more than 16 years. In an article, “Cuddling Comfort,” published on the hospital’s website, Rice said, “This hospital has become an integral part of our lives and continues to enrich us every time we volunteer and spend time in that culture of caring.”
Progressing to Infant Massage
As babies grow, infant massage provides a natural next step to continue this bond and its benefits. Posted on one of the hospital’s website links was an article titled “The Power of Touch.”
“‘Infant massage is always about bonding, loving and respect,’” said Maureen McCaffrey, a certified infant massage instructor at Lucille Packard Children’s Hospital, who was quoted in the article. “‘We ask a parent’s permission and then listen for the baby’s cues to see if they’re engaging or disengaging. Babies communicate with us from the moment they’re born through body language, sound and behavior.’”
The article noted that McCaffrey sets up a nurturing environment that’s an easy, safe and relaxing example to parents. “‘They will begin to feel the benefits just by setting up a quiet space where massage takes place,’” she said.
Parents are taught a variety of infant massage techniques, each tailored to the unique needs of babies and families. The developmental specialists in the NICU are certified in infant massage.
Bowlby recalled two special occasions:
“One of my assigned babies had been a patient for three months, and she received therapeutic massage four days a week,” Bowlby said. “When I approached her bedside to say hello, she would stretch her foot out for me to massage her leg. Just the sound of my voice stopped her crying and increased oxygen saturations.
“She was able to sleep quietly, and before discharge, her mother was trained in child massage,” Bowlby continued. “It was special for me to see, because at first the mother couldn’t touch her fragile newborn, but over time she became more attached to her baby and became capable of taking charge of her care at home.”
Another special moment occurred between a father and his baby who was born 11 weeks premature and weighed less than one pound, she added.
“[The father] stood at a distance and watched as the medical team cared for her,” said Bowlby. “When she was stable and in the nursery, we taught him the technique of gentle containment—how to hold a baby at the head and feet to give it comfort and security.
“When he spoke to his baby, she opened her eyes and looked in his direction,” said Bowlby. “That first interaction was incredibly special and heartwarming.”
The Language of Touch
Applicants to the Baby Cuddler Program must complete an online volunteer course prior to meeting the director of volunteers at the hospital. During the visit, the applicant learns about hospital-wide volunteer options—but the Cuddlers Program remains among the most popular, as evidenced by its waiting list.
Potential volunteers are interviewed, and if chosen, undergo a screening and a background check. “There are two mandatory three-hour training sessions, followed by shadowing a trained cuddler on various units,” said Bowlby.
“We teach them how to read the readiness of an infant for different kinds of touch—from gentle containment in an isolette to holding techniques during its sleep cycle, and gentle massage,” she added.
“They also become familiar with the equipment attached to the babies, and the correct way to hold them,” Bowlby said.
Massage therapists educated in the benefits and special needs of fragile infants are also welcome to apply. Basic infant massage training is held during the Cuddler training course to make them aware of the various certification classes they can participate in.
From the first cuddle, babies and parents can benefit enormously from learning the language of touch. It is a strong start toward a lifetime of affection and good health.
This article originally appeared in Massage Magazine & was written by Larry Schwingel.
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