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Frühgeborenenmassage: taktile Körperstimulation in der Neonatalmedizin

Effekte auf Wachstum, Gesundheit und Immunsystem

Preterm infant massage

Effects of tactile stimulation on wellbeing, growth, and the immune system

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Zusammenfassung

Besonders bei Frühgeborenen können geeignete Berührungs- und Bewegungsinterventionen den Reifungs- und Entwicklungsprozess außerordentlich positiv beeinflussen. Obwohl die Skin-to-Skin-Methode grundsätzlich auch mit intubierten Frühgeborenen in kritischem Zustand durchgeführt werden kann und Untersuchungen deren positive Effekte belegen, ist die Hürde zur tatsächlichen Durchführung aus Angst vor Komplikationen häufig zu hoch. Mit wesentlich geringerem Aufwand lassen sich bei Frühgeborenen mit extrem geringem Gewicht und/oder Komplikationen bereits systematische taktile Körperstimulationen im Inkubator durchführen. Die belegten Effekte gehen weit über die Förderung der psychosozialen Bindung hinaus. Der vorliegende Übersichtsartikel legt die Befunde zu regelmäßiger systematischer taktiler Körperstimulation dar, die anhand randomisierter kontrollierter Studien gezeigt wurden. Zentrale Effekte umfassen schnelleren Gewichtszuwachs, Verkürzung des Krankenhausaufenthalts, gesteigerte Knochenmineralisation sowie positive Auswirkungen auf die kognitive und psychomotorische Entwicklung. Zudem schliefen behandelte Frühgeborene besser, beruhigen sich schneller nach schmerzhaften Prozeduren und erkrankten seltener an Spätsepsis. Um die zugrunde liegenden Mechanismen verstehen zu können, sind weitere Studien erforderlich. Aktuell werden eine durch Frühgeborenenmassage angeregte Zunahme der Vagusaktivität, Senkung des Kortisolspiegels sowie positive Effekte auf Immunsystem und Verdauung angenommen. In der Mehrzahl der existierenden Studien wurde die Behandlung 3‑mal täglich für 15 min an 5 bis 10 aufeinanderfolgenden Tagen durchgeführt.

Abstract

Particularly in premature infants, suitable touch and movement interventions can have a highly positive impact on maturation and developmental processes. Although studies have revealed positive effects of skin-to-skin care on intubated preterm infants in critical condition, the fear of complications often renders the hurdle to actually implementing the method too high. Significantly easier to perform on premature infants with an extremely low birth weight and/or complications is systemic tactile body stimulation inside the incubator, and the proven effects are not just confined to promoting psychological bonding. The current review presents findings on repeated systematic tactile stimulation from randomized controlled trials. Central effects include more rapid weight gain, reduced hospital stay, improved bone remineralization, as well as positive effects on cognitive and psychomotor development. Additionally, treated preterm infants slept better, calmed down faster after painful procedures and showed a lower incidence of late-onset sepsis. Further studies are needed to elucidate the underlying mechanisms. It is currently assumed that preterm infant massage stimulates vagal activity, reduces cortisol levels, and has positive effects on the immune and digestive systems. In the majority of existing studies, the treatment was performed three times a day for 15 min, on 5–10 consecutive days.

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Authors and Affiliations

  1. Medizinische Fakultät, Paul-Flechsig-Institut für Hirnforschung, Haptik-Forschungslabor, Universität Leipzig, Liebigstraße 19 Haus C, 04103, Leipzig, Deutschland

    S. M. Mueller & M. Grunwald

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Correspondence to S. M. Mueller.

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S.M. Mueller und M. Grunwald geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Mueller, S.M., Grunwald, M. Frühgeborenenmassage: taktile Körperstimulation in der Neonatalmedizin. Manuelle Medizin 57, 260–265 (2019). https://doi.org/10.1007/s00337-019-0546-2

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