The effect of massage on salivary secretory IgA level in preterm infants

INTRODUCTION: Secretory IgA in one of the important components of the immune system and has prominent role in preventing infections that are transmitted through the gastrointestinal tract and respiratory mucosa. The primary objective of this study was to evaluate the effect of massage on salivary secretory IgA (sIgA) level in preterm infants and the secondary objective was to assess the effect of massage on neonatal weight gain.
METHODS: This study was performed on 150 preterm infants weighing between 1500 g and 2000 g which have been hospitalized in 3 main medical centers of Khorramabad city, Iran from March 2018 to March 2019. The 3 major selected centers were; Asalian, Shahid Madani and Shahid Rahimi Hospitals. All infants were randomly allocated to intervention (n=75) and control (n=75) groups. Due to our criteria, 18 patients were excluded from the study. In total, 132 infants were included in this study. The initial samples of sIgA were obtained from saliva of neonates in both groups on the second day after birth and when the acute symptoms of RDS had resolved. The second samples were collected on the 14th day of birth. During this period, neonates of intervention group were massaged properly using Field technique for 15 minutes, three times a day by a trained NICU nurse for 12 consecutive days. It should be noted that due to the effect of breast milk on the neonates sIgA level, we selected all subjects from those who were deprived of breast milk for some reason and were fed with Formula
RESULTS: According to our findings, a significant difference was observed between the mean weight of the infants between the second and 14th days after birth in both intervention and control groups (P<0.001). However, in comparison, there was no significant difference between the mean weight changes of the infants in both groups (P=0.845). Moreover, there was a significant difference was found between the mean sIgA level changes between the second and 14th days after birth in both groups (P<0.001), but these changes were more significant in the intervention group compared to the control group (P<0.001).
DISCUSSION AND CONCLUSION: The results showed that the massage therapy in neonates can increase the level of sIgA as an important part of the infant's immune system. Although it had no positive effect on the weight gain process. It is recommended that the massage therapy can be used as a safe auxiliary therapeutic procedure for preterm infants and mothers can learn and perform this technique as a simple way to boost the immune system of their infants.