Cue-based Baby Massage is the central, defining element of the First Touch Program.  This provides the purpose and focus for parents attending the program and offers the perfect setting to support parents to gain confidence in interacting and communicating with their infant.

The Importance of Cue-Based Infant Massage

There are dozens of different approaches and styles for teaching infant massage to parents, with each varying in its effectiveness and safety.

Our organisation, Baby in Mind, specialises in a type of infant massage known as cue-based infant massage.  This is believed to be the approach most likely to lead to good outcomes for parents and babies (Underdown & Barlow, 2011).

Unlike the remedial or therapeutic massage for adults that most people are familar with, cue-based infant massage has nothing do with treating or fixing any particular problem. Cue-based infant massage is not a “day spa” treatment for babies.

What is Cue-Based Infant Massage?

Babies depend on interactions of touch, voice, movement, eye contact and facial expressions with others, to gain information and learn about their social world.

Babies, in turn, respond to this communication back to their parent through different vocalisations, facial expressions and other cues…to which the parent responds back again.

This conversation or “dance” between parents and babies is something that child development experts call serve-and-return.

Our First Touch Program uses cue-based infant massage to build on this serve-and-return interaction between parents and babies.

How does cue-based infant massage benefit babies?

On the surface, the Baby in Mind First Touch Program offers a friendly, relaxed and fun activity for parents to do with babies. However, the simple, non-threatening activities in the First Touch Program provide a gateway to meet some significant child development needs.

Researchers have known for quite some time that adequate amounts of healthy touch in infancy and early childhood are crucial for the physical and social development of babies (Ardiel & Rankin, 2010; Stack in Bremmer & Fogel, 2001). Babies who do not receive adequate amounts of healthy touch can develop a medical condition known as failure-to-thrive. In the worst case scenarios (as we see in some overseas orphanages) lack of healthy, interactive touch can result in developmental delays, brain damage or even death.

The exact reasons for the importance of touch have, however, not been understood until more recently as researchers have begun to discover that the serve-and-return interactions (voice, movement, and eye-contact and particularly healthy touch) are the mechanisms that enable a baby to regulate (maintain) their emotional arousal and essential bodily functions (like heart rate) (Schore, 2001).

This regulation is fundamental to early mental health and physical development because – when babies are well-regulated, the toxic stress hormones that stunt brain development are kept at bay (Schore, 2001; American Academy of Pediatrics, 2011). This provides the best possible chance for babies to establish the brain foundations needed for later mental health, cognitive and social development (Harvard University Centre on the Developing Child, 2014; Shonkoff, et al., 2011).

The serve-and-return interactions which our cue-based infant massage program builds, are believed to be one of the crucial keys underpinning all future brain development.

Is cue-based infant massage good for parents too?

Serve-and-return might be a “natural” process but (just like breastfeeding) does not always come easily to everyone. Most of us can relate to the feeling of frustration, confusion or overwhelm most of us have at one time or another, from trying to decipher and understand what a new baby is “saying” with their cries, settling difficulties and other behaviours.

Therefore, in the First Touch baby massage program, the instructor supports parents to build their own understanding of their individual baby’s cues, body language, vocalisations and other signals they use to “talk”. A Baby in Mind educator doesn’t just give a photocopied list of a few tired or hunger signs: every baby is very different so we believe that giving out a few “one-size-fits-all” descriptions of infant signs are not enough (and can even be counter productive if a parent is having additional difficulties interpreting their baby’s signals).

In addition, babies communicate a whole lot more than just tiredness or hunger through their body language. For this reason, the First Touch Program is less about how to “do” baby massage. Instead, the educators supports parents to notice and understand their baby’s cues, and then to adapt and modify their touch, voice, movement and eye-contact in response to their baby’s needs.

This is where the most parents find the immediate value of taking the cue-based First Touch program: having individualised, high quality support to help understand and explore their baby’s own unique (and often complex) cues and signals, and to explore what they might mean.

Are there other benefits?

Quite a lot is now known and understood about the long-term benefits of programs supporting parents’ understanding of infant cues. For example, studies with pre-term babies have found that just a few hours of cue-based education for parents during infancy improves cognitive and social outcomes at age five (Norhov, et al, 2011).

Other reviews find one of the best ways to reduce (or even eliminate) some of the earliest risks for later developmental and mental health issues is to provide programs which support parent sensitivity to their baby’s cues (Bakermans-Kranenburg, van IJzendoorn & Juffer, 2005) with effects on even brain development observed (Milgrom, et al., 2010).

The First Touch baby massage program is considered the “gold standard” by medical researchers (Underdown & Barlow, 2011). The program runs over 5 sessions (usually once a week), each session lasting for about 1 – 1.5 hours. The program is taught in a friendly and relaxed environment, usually with between 4 – 5 other families. All parents and babies are welcome in the First Touch Program.

Each of the activities in the First Touch baby massage program are designed to build a parent’s confidence in engaging sensitively and authentically with their newborn through, for example:

• having a “conversation” with their baby using healthy touch;
• using and adapt different massage strokes and routines for their baby, including the use of techniques for sensitive or very unsettled babies (what used to be referred to as “colic”);
• using other types of healthy/ respectful touch (particularly important for sensitive or medically fragile babies, or babies who don’t respond well to massage/ moving strokes);
• incorporating more eye-contact, facial expressions and voice into parent-baby interactions; and
• ways to use movements to help communicate with baby…

as well as opportunities for parents to meet and get to know other parents in a friendly and non-judgmental environment.

In each of the five sessions the Baby in Mind educator gently guides parents through a series of different activities incorporating baby massage, healthy touch, voice, eye contact and many other interactions. Rather than just getting parents to copy the mechanics of each activity, the facilitator works with parents to highlight and help identify what an individual baby might be “saying” through their body language, cues and other interactions.

The educator then offers ideas for how a parent might be able to adapt and modify the massage or other interactions you are using to suit each baby’s individual reactions…and the parent’s own personal preferences and styles.

Parents sometimes worry that they may not be able to attend a baby massage class because their baby is squirmy or very unsettled. We reassure all parents that all babies are welcome in the First Touch Program. The purpose of the program is not to “force” a baby to have a massage during the sessions, but to give parents the skills and knowledge they can use at home and throughout your baby’s development.

Each First Touch Program is run at the pace of the individual babies in the group – when a baby needs to sleep, eat or rest during the session, this is accommodated. The baby massage program is structured with the needs and realities of babies in mind: with small group sizes and ample time, parents and babies receive the individualised, supportive environment they need to get to know each other.

A properly trained infant massage instructor will never interfere in the relationship between a parent and baby. For example, our educators do not massage other people’s babies…but instead demonstrate different ideas and techniques on a doll, for a parent to use and adapt with their own baby.

Our educators know a lot about infant massage generally, but we firmly believe that parents are the experts about their own babies. In our program we don’t issue rules or instructions like “you must never massage your baby after a bath” – because we are not the experts in the nuanced and subtle preferences of each baby. Instead we teach the highest quality cue-based infant massage program which aims to empower parents to understand their baby’s unique and individual needs. The job of an Baby in Mind Educator is simply to support parents in their job of coming to know and understand your own little baby.

We implement a range of measures to ensure our educators offer the highest possible standard of cue-based infant massage education to families.

High-Quality, Nationally Accredited Training

In Australia, Baby in Mind are the only infant massage educators who have completed a nationally (government) accredited curriculum which meets the the national competency standards for Delivering Infant Massage Education to Families.

Program guidelines and standards

Baby in Mind educators deliver the First Touch program in accordance with a specific set of guidelines and standards.

These guidelines cover standards for things like group sizes, oils, safe environments and, of course, infant massage itself. When a baby massage program is delivered as The First Touch Program, it must comply with these standards.

Our standards are developed by a team of experienced educators with diverse backgrounds ranging from senior medical doctors (Pediatricians, Neonatologists, Psychiatrists), nurses, midwives, occupational therapists and social workers, as well as people representing the perspectives of parents. The guidelines are formally reviewed, by an independent expert panel, every two years, to ensure they reflect the latest research and community expectations.

Professionalism and Code of Conduct

Infant Massage Instructors who are registered with Baby in Mind are all required to comply with the Australian Code of Conduct for Certified Infant Massage Instructors. This Code of Conduct describes the standards that the community expects from our members and are the standards to which our members hold themselves to. The Code of Conduct also provides parents with a clear framework for making a complaint, if they feel the service they received was unsatisfactory.

Through our membership process our educators must keep their skills up-to-date through a mandatory Continuing Professional Development program. In order to be member of Baby in Mind, educators must confirm they do not hold any criminal convictions or findings from other proceedings that would make it inappropriate for them to be working in a role supporting parents and babies.

Safety and Research

In 2006 a Cochrane Review of all available research found there was no evidence of physical injury or harm associated with baby massage (Underdown, Barlow, Chung & Stewart-Brown, 2006). Subsequent studies have found there may be some mental health risks for families who already have some difficulties, when they learn infant massage from a person who has not completed any infant massage training (even if they hold other health qualifications – such as nursing); or when they learn a style of infant massage that is not a high-quality cue-based program (Underdown & Barlow, 2011). This is why we highly recommend parents learn infant massage with a Baby in Mind accredited educator…who are the only infant massage instructors in Australia to have completed government accredited cue-based infant training.