Funded by a four-year $2,437,784 National Institute of Health (NIH) Research Project Grant (RO1), UArizona Nursing Associate Professor Aleeca Bell, PhD, RN, CNM, plans to launch a randomized clinical trial (RCT) aimed at investigating the effects of a multisensory infant massage on mother-infant synchrony – known as reciprocal behaviors that promote a mutually rewarding interaction. The massage has the potential to improve attachment between mother and baby as well as child development.
The intervention – which will be tested on mothers with early life adversity – has the potential to increase early mother-infant synchrony, and promote a better functioning oxytocin system. Oxytocin, a naturally occurring hormone released during childbirth that helps promote maternal bonding, is known to aid in developing positive social attachment, empathy, and mood. Mutually rewarding mother-infant synchrony has also been shown to positively affect infant attachment and healthy brain development in the baby.
“This multi-sensory infant massage is low-cost, easy to learn, and can be applied as soon as the baby’s born. The mother applies the infant massage, but any caretaker or clinician can easily teach it," ~ Aleeca Bell, PhD, RN, CNM
This intervention has been researched for 30 years in primarily pre-term infants in the NICU, but Dr. Bell’s study will focus on full-term healthy babies. “We want to promote positive mother-infant interaction, but there’s limited research to show us what works in a cost-effective way,” she says. “This multi-sensory infant massage is low-cost, easy to learn, and can be applied as soon as the baby’s born. The mother applies the infant massage, but any caretaker or clinician can easily teach it.”
The scientific literature demonstrates that higher oxytocin levels in blood and saliva are associated with better mother-infant synchrony, but a unique element of Dr. Bell’s study is that it looks in greater detail at the oxytocin pathway to determine epigenetic effects (i.e., how oxytocin is regulated). “In this RCT, we hypothesized that moms with a history of early life adversity will demonstrate lower mother-infant synchrony due in part to a dysregulated oxytocin system,” Dr. Bell says. “We theorize that our intervention will lead to greater mother-infant synchrony and a better functioning oxytocin system.”
During the three-month intervention, participating mothers will give the 15-minute infant massage daily, because three months is the earliest that mother-infant synchrony can be reliably measured. More than just a massage, the technique is geared toward teaching new moms how to engage with their infant. There will also be a control group who will come to all the study sessions to donate blood and answer questionnaires, but they will receive an educational intervention about safe infant care.
The moms and babies will be videotaped during their interactions, after which video coders will complete the painstaking process of micro-coding behaviors. “We use a highly rigorous method that only requires three minutes of video recorded behavior to measure frame-by-frame the mother’s and the baby’s gaze, affect, touch and speech,” Dr. Bell says. She points out that most researchers who study mother-infant interactions use a more subjective method where coders are trained to reliably examine segments of recordings to rate the quality of that interaction. “Another unique aspect of the study is that it’s a very objective, quantitative way to measure behavior,” she says.
Currently, Dr. Bell is hiring staff for the project, but she hopes to begin recruiting participants in January. Though the recruitment sites have yet to be determined, Dr. Bell has already set in place a raft of safety guidelines to make the process safer during the COVID-19 pandemic. Recruiting will be done over the phone versus in person and when participants do need to come to the College for study visits, masks and social distancing will be required. Appointment times will also be limited and staggered to avoid waiting room interactions as much as possible.
Once this study is completed, Dr. Bell hopes to enhance her research with further inquiries. One extension is to follow vulnerable mother-infant dyads for a longer period of time to ascertain broader biobehavioral health outcomes, and to determine epigenetic effects of the massage in the infant. Another goal is to enable clinicians to implement teaching the infant massage, testing at multiple sites, so that it can eventually become standard of care.
Dr. Bell, who practiced as a Certified Nurse Midwife for seven years prior to entering academia, has an unwavering commitment to improve the wellbeing of mothers and babies in the perinatal period. She seeks to promote a positive birth experience for women and encourage optimal mother-infant interaction. “The same passion I had as a clinician is what drives my research,” she says. “As a clinician I wanted to promote physiologic birth and to help moms and babies get off to a great start – to help them fall in love with each other. These are the same desires that drive my research questions.”