Ivanna Cardenas gave birth to quadruplets nine weeks before her due date.
Doctors said Baby D wasn’t getting enough nutrients and wouldn’t survive the pregnancy. The largest of the four infants weighed 2 pounds; the smallest, 1 pound, 3 ounces.
“We didn’t think the smallest one was going to make it. We called a pastor in. We were praying and crying, praying and crying,” said Cardenas, 27.
Two months later, the quadruplets remain in incubators in the neonatal intensive care unit at Holtz Children’s Hospital at the University of Miami/Jackson Memorial Medical Center, where they are massaged on a regular basis. Using arm holes in the incubators, doctors, massage therapists, mom and dad all take turns massaging the premature babies, stimulating their growth and development.
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Tiffany Field, a psychologist and professor at UM’s Miller School of Medicine, started the neonatal touch research program at the University of Miami/Jackson Memorial Medical Center in 1982. She initially began with a light massage, more like a tickling, which the babies didn’t seem to like, she said. She then observed how lab rats licked their pups, which stimulated pressure receptors under their skin and which, in turn, stimulated their growth and development.
She and her research team recently received the Golden Goose Award, a national award that honors federally funded research projects that may not have seemed practical at the time, but have resulted in major economic and societal benefits.
Field started the touch therapy program a decade before the medical community accepted massage as a treatment for incubated babies. Today, neonatal touch therapy is used in about 40 percent of neonatal intensive care units nationwide and results in a savings of about $10,000 per infant — $4.7 billion annually nationwide — by shortening hospital stays by nearly a week for premature babies.
More importantly, the massage helps the premature baby to develop.
“Pressure to the skin stimulates brain activity, slows down heart rate, lowers blood pressure, allows for a deeper sleep, makes the babies less irritable and ultimately helps mental development and physical growth,” said Field, professor of pediatrics, psychology and psychiatry and director of the Touch Research Institute at the University of Miami’s Mailman Center for Child Development.
Field developed an interest in preemies through personal experience. She gave birth to her daughter a month early in 1976, when she was a graduate student studying developmental psychology at the University of Massachusetts at Amherst.
She was studying the effectiveness of nipple sucking at the time and had found that infants given pacifiers gained more weight, went off tube feeding earlier, did better on newborn behavior and neurological tests and were discharged sooner than infants who did not use a pacifier.
“I argued that if we could accomplish that by stimulating the inside of the mouth, we could do more by stimulating the entire body,” Field said. “My daughter became my guinea pig.”
She massaged her daughter daily. She found that a light massage on her daughter’s back and neck and gentle movement of her arms and legs had a calming effect while strokes on the face, belly and feet had a stimulating effect. She used the power of touch to reduce her daughter’s anxiety and encourage her to drink more formula.
“Now she’s 38, taller and smarter than me,” Field said.
She received a seed grant from Johnson & Johnson to start the research program at UM.
Field and research collaborators Cynthia Kuhn, Gary Evoniuk and the late Dr. Saul Schanberg were already massaging premature infants at UM when they discovered rats licking their pups stimulated a growth hormone similar to one found in humans. They began applying more pressure and moved the skin as they massaged, resulting in the preemies gaining more weight and growing faster.
Studies have shown that touch therapy increases weight gain on average, by 47 percent, compared with babies left alone in their incubators. Studies also have found that massage boosts development of circulatory, muscular and neurological systems, and increases communication and intimacy between baby and parent.
Field and her team of licensed massage therapists have taught Cardenas and father David Gutierrez, 30, to perform touch therapy on their babies.
With sanitized hands poking through the arm holes in the incubators, the parents use gentle, firm and slow touch to massage the babies on different parts of their bodies.
“You think infants are too delicate, but they are actually really resilient and acclimate to the touch,” said Gladys Gonzalez, a licensed massage therapist on Field’s team. “It creates a sense of calm and bonding between the baby and mother.”
Even after babies are discharged, Field recommends massaging children for 15 minutes three times a day until they’re old enough to say they don’t want it anymore.
“Touch therapy shouldn’t be used for premature infants exclusively, but for all children with different conditions,” Field said.
She has treated more than a hundred babies and recently received a $75,000 grant from Johnson & Johnson to teach mothers how to perform touch therapy on their own babies.
As for Cardenas and Guiterrez, the parents hope to bring Francesca, Julian, Sebastian and Baby D – now Gabriel – home by mid-November.