The effect of infant massage on father-infant attachment - a randomized controlled clinical trial

Chapter One

Project title: The effect of infant massage on the amount of father-infant attachment - a randomized controlled clinical trial

Statement of the problem

Research on animal fetuses and infants has shown that abnormal sensory experiences (either excessive stimulation or deprivation of more than limit) can affect the development of the brain. Touch sensitivity starts from the 7th fetal week and from the mouth area and in the 15th week it develops to other parts of the face, palms and feet, trunk, arms, legs, tongue and mucous membranes. Touch is considered one of the most important methods of emotional exchange for parents and infants, and it is the first sensory system that develops and forms the basis of interactions between infants and parents [1] because the baby has a sense of touch in every part of the body from the beginning [2].

The importance of physical contact in human kind cannot be neglected [1] Touch helps reduce stress by calming the baby and increases the amount of sleep [3-5] and plays an important role in development A baby has a physical and emotional body, and massage is the best way to touch. Massage not only helps to create interest and attachment between mother and baby and improves the emotional bond between mother and baby and creates more confidence in terms of parenting skills [1, 5] but it is also very beneficial for relieving colic, strengthening the digestive system and muscle growth. The type, time and amount of touch should be in harmony with developmental variables such as the age and current conditions of the infant, capabilities, threshold of tensions and abilities of the baby [1]. The type of massage and the amount of pressure used in the process of massage have an effect on the baby's weight gain, sleep, anger, crying, and anxiety [8].

A person's desire to establish a close relationship with certain people and feel more secure in the presence of these people is called attachment, and it seems that the initial attachment pattern is related to how the child copes with the experiences of a few years later. Attachment is an emotional relationship between parents and their baby that starts before birth and increases with the feeling of fetal movements and increases after birth, and mother-to-baby skin contact [10] and kangaroo care immediately after birth increases the amount of mother-baby attachment [11]. It should be noted that the attachment process between mother and baby is a mutual process because the relationship between parent-infant attachment and subsequent parenting behaviors has been well proven[12].

Parental communication before pregnancy and birth forms the cornerstone of major emotional and physical adaptations associated with the birth of a child[13]. The father's attachment to the fetus is a mental feeling of love and affection towards the unborn child, not a method or an opinion about the child [14]. There is a lot of evidence that shows that emotional separation combined with physical separation from the parent can disrupt the natural process of parent-baby emotional bonding. When an infant is sick, it seems that physical separation combined with emotional separation from parents causes a feeling of inadequacy in parents, and it is necessary to encourage parents to meet and touch the infant as soon as possible, because touching is the first method of communication between parents and the infant [1]. Many people who have recently become parents show a desire to touch and touch their babies[15].

Part of the development of a normal baby depends on the exchange of a series of emotional reactions between the parent and him, which brings them closer psychologically and physiologically. This relationship is strengthened by the emotional support of the family [16]. The baby-parent relationship starts before the birth of the baby with the planning and certainty of pregnancy [16]. Fathers in the early stages after childbirth - who may be under a lot of stress - are not satisfied with the amount of facilities available to accelerate close interaction with their babies[17], while studies show that holding a training class on how to massage and bathe babies for 4 weeks causes babies to establish a good relationship with their father and show more eye contact, smile and verbal communication with their father and show less avoidance behavior compared to the control group[18].

New studies show that the initial father-infant interaction makes fathers as fascinated by children as mothers.The child's close relationship with the father can compensate for the consequences of not having a safe relationship with the mother, and fathers who take care of their children may feel more comfortable and successful with their parental role [1]. When parents find peace, their self-confidence increases and the benefits for both parents and babies are great [5], while fathers who participated in educational programs related to baby massage, their stress level decreased significantly [17] and those who participated in baby health programs, including the importance of breast milk, showed less anxiety than other groups [19].

Usually the process of dependence in Fathers cause behaviors such as visual contact with the baby, especially focusing on the beauty of the baby, tactile contact that often appears as a desire to hold and hug the baby, paying attention to the specific and independent characteristics of the baby with an emphasis on his similarities to the father, understanding the baby as a desirable perfection, developing a strong sense of orientation towards the baby, which leads to more attention to him and creates a deep sense of self-confidence and satisfaction [1]. However, both father and mother establish an emotional relationship with the fetus when they are waiting for the birth of the child [20]. The time to develop attachment to the baby is different for mothers compared to fathers. Although mothers show a rapid increase in the level of attachment in the fifth month of pregnancy and have a special feeling during pregnancy, but this feeling happens slowly and mostly in fathers after birth and while caring for the baby [12] Paying attention to the attachment of parents to the baby is very important in terms of the child's psycho-social development and the agreement between the couple [20] and studies on father-child emotional relationships have shown that the stages of this emotional bond are somewhat similar to the mother's. [1, 21].

The interaction of parents with the developing fetus is different. But the available evidence shows these differences to be contradictory. Some showed a higher level of mother's attachment, some showed a higher level of father's attachment, and some of them showed the same level of attachment between father and mother. It is very important to recognize the factors affecting the attachment of parents to the baby because they are involved in the health and growth and development of the baby[20].

One ??of the goals of the staff who are in contact with parents is to encourage the improvement of attachment or effective communication between parents and the baby[12]. Nurses may examine the factors involved in the level of parent-infant attachment during prenatal care [20] and nurses can have a positive effect on the attachment process [1]. Neonatal nurses should increasingly look for interventions such as massage to satisfy this need of parents [15] and to develop deeper relationships between parents and children, educate them and identify possible problems [1] and if the pregnant woman and her husband are not ready to have deep feelings for the baby, the nurse should introduce them to a counselor [20]. Because fathers who participate in the process of massaging their babies feel more pleasure and show more intimacy in interacting with the baby [22] and in this process it is necessary to recognize the importance of early contact between the father and the baby. Fathers should be encouraged to express their positive emotions [1]. In the first 48 hours after giving birth, fathers show less attachment-related emotions[21], especially if for some reason the father believes that these feelings should be hidden, if this point is not clear to them, the father may be misled in the contradiction between his previous beliefs and the deep feelings that he tends to reveal, and miss the best opportunities to interact with his child[1] and some factors involved in the attachment of the father to the baby, such as the relationship between the parents, the age of the father previous experiences of being a father, high-risk pregnancy, number of children, level of education, these factors cannot be changed[20].

In Scholz's study, the positive effects of the father's intervention in the process of bathing and massaging the baby have been pointed out [18], but the drawback of the study is that both the father and the mother were involved in the care and both cares (bathing and massaging the baby) were performed together, and practically the positive effects of each of the techniques alone have not been determined. is