Baby Massage

baby-massage

What is the best oil for baby massage?  This ought to be a simple question.  But first of all, should we be massaging babies at all in the first place?

It doesn’t sound like it should be a problem.  People like cuddling babies and babies seem to like being cuddled.  Massaging is just an extension of that after all.  But not everything that seems obvious turns out to be true.  Has anyone reviewed the evidence?

In fact they have.  The Cochrane Review looked at 14 papers on the subject of massage and the progress of premature babies, and found that they did indeed do better when they were massaged. So that looks promising.  But the same organisation did a similar review of the literature on healthy babies.  This review – from last April so very up to date – did not find any evidence of benefits.  This could be because the effect was too small to pick up, or the studies were too small to pick up an effect.  But equally, it might be that a healthy baby simply is already okay and massaging them doesn’t add to their well being.

Still I imagine the babies enjoy the process even if it is not doing them much, if any, good.  But again, that is an assumption.  We can’t ask the recipients because they aren’t old enough to talk yet.  But it can’t do them any harm.

Or maybe it can.

Although there is nothing stopping you doing a massage with bare hands, it can involve applying an oil.  There are plenty of massage oils out there including ones designed specifically for babies.  Is it okay to put natural oils on a baby’s skin?  Again the answer would seem to be an obvious yes.  But an intriguing paper published earlier this year presents evidence that olive oil can have a detrimental on the barrier function of the skin.  Sunflower oil on the other hand was okay.

It has to be said that this paper is a bit of an outlier in the field, and there is a long history of use of olive oil on the skin during which nobody else has noticed this effect.  It takes more than one paper to overthrow a consensus.   The authors nonetheless specifically point out that the use of olive oil on infants might lead to dermatitis in later life.

I must say this had me scratching my head a bit.  Olive oil and sunflower oil are chemically different, but not that different.  What is it in the olive oil that could be causing the problem?  Especially when another paper indicates that olive oil and lanolin together are beneficial for infant skin?

The best explanation I can come up with is that it isn’t anything to do with the chemistry of the oils in question.  In the study that showed a harmful effect the oils were applied in a controlled amount.  Six drops were applied to the subjects by the scientists so both treatments were used in controlled amounts.   The oil would spread across the surface of the skin.  Maybe the slightly thicker olive oil didn’t spread as far the sunflower oil.  This might mean that the olive oil had a stronger effect in blocking moisture loss from the skin’s surface.

The loss of water across the skin is usually a bad thing, and particularly as you get older you find that your skin’s barrier function is usually something that needs a bit of help.  But biology is never straight forward, and the loss of water does have a beneficial effect as well.  It is one of the ways we maintain our body temperature.  I wonder if the olive oil was causing local overheating of a part of the skin, which was what was causing the problem.  One of the symptoms quoted in the paper was skin reddening – which is one of the features of skin when it gets too hot.

Maybe this sounds a bit far fetched, but remember that swimmers in cold seas will cover their skins in grease as a protection against the cold.  Oils on the skin can definitely have an impact on body temperature.

Which brings me back to applying oils to babies.   Like adults, babies have to regulate their temperature.  The issue is a bigger one for them because they have a much bigger relative surface area than an adult and less ability to control things by how many clothes they are wear or moving to a more comfortable spot.  So I think we need to take care when we apply what by adult standards is a very modest amount of oil to their skin.  This is particularly the case when a large proportion of their skin is being treated.

Now most of this baby massaging is going to be carried out by the baby’s mum.  Mums are generally very sensitive to the effects of what they are doing on their children and would probably instinctively stop if they noticed that what they were doing was causing their offspring any distress.  But nonetheless it might be something to be aware of.

So to answer my original question, the best oil for a baby massage might be no oil at all.

References

http://summaries.cochrane.org/CD000390/massage-for-promoting-growth-and-development-of-premature-and-low-birth-weight-infants

Pediatr Dermatol. 2013 Jan-Feb;30(1):42-50. Effect of olive and sunflower seed oil on the adult skin barrier: implications for neonatal skin care.
Danby SG, AlEnezi T, Sultan A, Lavender T, Chittock J, Brown K, Cork MJ.

Pediatr Dermatol. 2008 Mar-Apr;25(2):174-8. The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants: a randomized controlled trial. Kiechl-Kohlendorfer U, Berger C, Inzinger R.

2 thoughts on “Baby Massage

  1. Heather

    Hi Colin, I remember a dermatologist once mentioning this at an SCS lecture – it’s to do with the double bond in the oleic acid, if I remember correctly, which disrupts the structure of the stratum corneum lipids if it becomes incorporated (essentially because its structure isn’t linear but ‘bumpy’), which allows more water to leave (TEWL). I had a quick look for papers & found this one (among many others) http://onlinelibrary.wiley.com/doi/10.1111/exd.12296/epdf

  2. Colin Post author

    Thanks Heather, wow that is quite a paper! I’d be more convinced if they’d also looked at skin penetration enhancement. I get the theory about the lipid barrier and the data they present is impressive. But if olive oil is that disruptive you should be able to use it to get drugs across the skin. Perhaps you can of course. It didn’t work when I tried it, but maybe it does if you get the conditions just right.

Leave a Reply