Peer-reviewed article
Effects of parent-administered massage-based multimodal interventions on health outcomes in preterm infants: a systematic review and meta-analysis
Yan Li, HuanHuan Zhang, Wenyao Ma, Beibei Zou, Wenbo Wu ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This systematic review and meta-analysis pooled 24 randomized controlled trials of parent-delivered massage-based care for preterm infants. Moderate-certainty evidence linked the interventions to more breastfeeding or human-milk feeding at discharge, a shorter time to full oral feeding and a shorter hospital stay. The effect on weight gain was uncertain because results varied widely, certainty was low, and the result was no longer significant after adjusting for small-study effects. Effects on length, head-circumference growth and motor development were not statistically significant. Many interventions combined massage with other developmental components, so the benefits cannot be credited to massage alone.
Key points
- Higher odds of breastfeeding or human-milk feeding at discharge (OR 5.42, 95% CI 2.44–11.94), moderate certainty.
- Shorter time to full oral feeding (MD −2.04 days) and shorter hospital stay (MD −4.68 days), moderate certainty.
- Weight-gain velocity was higher in the main analysis (MD 5.55 g/day), but certainty was low and I² was 97.87%. The trim-and-fill adjusted estimate was not significant (MD 3.45 g/day, 95% CI −1.67 to 8.56).
- Length growth, head-circumference growth and motor development showed no statistically significant effects.
- Parental psychological outcomes were generally favorable but supported only by low-certainty evidence.
Limitations
Many interventions were multimodal, so the independent effect of massage cannot be separated. Heterogeneity was substantial, and several outcomes had low or very low certainty. The abstract does not say which countries the trials were conducted in.
Abstract
Background Parent-administered massage-based interventions are increasingly used in family-centered care for preterm infants, but their effects across infant and parental outcomes remain uncertain. Objective To systematically evaluate the effects of parent-administered massage-based interventions on growth, feeding, hospitalization, neurodevelopmental, and parental psychological outcomes in preterm infants. Methods We conducted a PRISMA 2020-compliant systematic review and meta-analysis of randomized controlled trials. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to 26 May 2026. Eligible studies compared parent-administered massage alone or combined with tactile, kinesthetic, oral, or other developmental sensory components against routine care or non-massage controls. Random-effects models with restricted maximum-likelihood estimation were used. Parental psychological outcomes were synthesized narratively because of substantial heterogeneity. Risk of bias was assessed with RoB 2, and certainty of evidence with GRADE. Results Twenty-four randomized controlled trials were included. Moderate-certainty evidence indicated that massage-based interventions were associated with higher odds of breastfeeding or human-milk feeding at discharge (OR 5.42, 95% CI 2.44–11.94), shorter time to full oral feeding (MD −2.04 days, 95% CI −3.95 to −0.13), and shorter hospital length of stay (MD −4.68 days, 95% CI −7.79 to −1.57). Weight-gain velocity was greater in the primary meta-analysis (MD 5.55 g/day, 95% CI 1.71–9.38), but certainty was low, heterogeneity was very high (I 2 = 97.87%), significant small-study effects were detected, and the trim-and-fill adjusted estimate was attenuated and no longer statistically significant (MD 3.45 g/day, 95% CI −1.67 to 8.56). Parent-related psychological findings were generally favorable but were supported by low-certainty evidence. Effects on length growth, head-circumference growth, and motor development were not statistically significant; certainty for length and head-circumference growth was very low. Conclusion Moderate-certainty evidence suggests that parent-administered massage-based interventions may improve selected feeding outcomes and reduce hospital length of stay in preterm or low-birth-weight infants. The effect on weight-gain velocity remains uncertain because of very high heterogeneity, low certainty of evidence, and possible small-study effects. However, many interventions were multimodal and heterogeneity was substantial; therefore, the findings should be interpreted as effects of parent-delivered developmental-care interventions that include massage rather than massage alone, and the independent effect of massage requires confirmation. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261435482 , identifier CRD420261435482.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Parent-administered massage alone or combined with tactile, kinesthetic, oral or other developmental sensory components, compared with routine care or non-massage controls
- Population
- Preterm or low-birth-weight infants and their parents, across 24 randomized controlled trials
Key finding
Breastfeeding or human-milk feeding at discharge: OR 5.42 (95% CI 2.44–11.94), moderate certainty.
Li et al. · OpenAlex · 2 Oct 2026