resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
January, 2012, Vol. 12, Issue 01
Nurturing Touch in the NICU
By Tina Allen, LMT, CPMMT, CPMT, CIMT
When a baby is born prematurely, parents and caregivers of babies in the Neonatal Intensive Care Unit (NICU) may face some serious challenges. One of the main challenges is likely providing appropriate tactile stimulation.This can be difficult given the number of doctors rounds, medical equipment and requirements for medical interventions. Not only are there the physical limitations, but also consider the emotional component of seeing your baby covered in medical tubes, much smaller in size than you imagined, and the insecurity of not knowing what would be appropriate or might cause harm. When baby does become stable enough for touch, what can a parent or caregiver do to provide comfort to their child? One of the best approaches can be infant massage.
Touch therapy research has demonstrated that nurturing touch for an infant is critical in establishing the foundation of their psychological well-being. When it comes to babies born prematurely, this can become even more important. Evidence has shown that massage therapy provided for neonates:
These recent research findings show there are significant benefits to infant massage that out weigh over-stimulation. Even a simple intervention of massaging a baby's leg prior to a heel stick might decrease pain responses. A nurse I trained at the Sutton's Children's Hospital used this very technique. With the parent's permission, she provided a gentle massage to a neonates lower extremities prior to rounds for blood draw. When the healthcare provider "poked" baby's heels and began to take the sample, he commented about how quickly it worked, and the need to only "poke" once. The nurse shared with me, how she smiled and let the healthcare provider in on her secret. A little massage goes a long way! Now, the healthcare provider plans to massage each baby's legs before administering a heel stick. Not only did it make his job easier, the baby cried less. Sounds like a win-win for all involved. Properly applied techniques produce increased benefits and should be used safely to ensure effectiveness.
Due to the baby's immaturity at birth, it is not appropriate to immediately begin providing massage therapy, but rather to implement nurturing techniques employed by parents and healthcare providers. Once the infant is stable enough, skin-to-skin contact should be utilized to provide appropriate stimulation and encourage bonding between parent and child. This skin-to-skin contact might be in the form of placing the baby securely on the parent's chest as is done with the technique of Kangaroo Care. Kangaroo Care can be a very simple, but powerful intervention providing the infant with stability in regulating heart rate, respiration and body temperature.
There are specific guidelines and protocols to follow prior to introducing infant massage in the neonatal intensive care unit. In addition to providing regular attentive care such as cuddling, holding and comforting, massage should be introduced slowly and with extra care. The baby must meet minimal weight and neurological requirements prior to introducing infant massage. However, as the baby shows stability in response to Kangaroo Care, nurturing touch and containment holds are the next steps to safely progress towards the introduction of infant massage therapy.
Containment holds are performed while always being mindful of the baby's states, cues and all verbal and non-verbal communication. Caregivers are encouraged to watch the baby closely for physiological cues (color changes, tremors, startles), motor state (tone, reflexes), behavioral state (alertness) and skin state (response to stimulation) responses. Whenever the baby exhibits any stress cues or overstimulation cues, it is time for the baby to have a break from tactile stimulation.
The best way to perform containment holds is to first ask the caregiver to relax and then proceed slowly. It is always optional for parents and caregivers to provide nurturing touch, as opposed to outside healthcare providers. This is due to the fact that the caregivers need to feel competent caring for their baby, as well as to encourage bonding to take place between parent and child.
The caregiver should always ask the baby's permission prior to beginning, by speaking gently, warming their hands and asking if it is okay to continue. Throughout the hands-on session, caregivers must watch baby's cues and follow their lead. Mindful of any medical apparatus, hands placed in two safe locations on baby's body. Common places to begin include head and feet, both arms/shoulders, and back/abdomen.
First, caregivers consider each baby's individual touch history and medical intervention history, and caution is used in areas where we believe the baby may have experienced discomfort. Especially on the heels, time must be taken before ever touching the heels. Due to the repetitive heel sticks these infants receive, touching this area might not immediately be well received.
It is imperative that any and all monitors are watched for changes, and that direct placement over medical apparatus is avoided. No lubricant is used on the hands while performing containment holds, as doing so may cause hands to slip, increase possibilities of infection or possible dislodgement of medical lines.
Parents are reminded to always watch baby's cues and make eye contact. Due to an infant's compact sensory receptors and their developmental immaturity, a little touch goes a long way. It can be very easy to cause over stimulation. This is never our goal. Sometimes, just placing your hands on two areas, then pausing and starting again another time, is the best route to safely introduce nurturing touch and containment holds without overstimulation.
Safety and precaution is always the best way to introduce touch in the NICU. Due to their baby's compromised health, many families with babies in the NICU have some delays in bonding. Delays in the bonding process might occur for a variety of reasons, and nurturing touch, along with infant massage, can be very beneficial in contributing to establishing the bond between parent and child.
Nurturing touch and massage contain all of the elements necessary to begin the process of bonding, introduce appropriate tactile stimulation and encourage healthy development. When provided safely, infant massage might be just the nurturing intervention an infant needs to cope with medical interventions and encourage optimum development.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
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