Megan Brooks

September 18, 2014

Preterm babies benefit from a type of soothing, rhythmic touch known as the M Technique, according to a pilot randomized controlled trial.

The researchers observed positive effects on weight as well as on physiologic and behavioral measures in babies who received the technique during a 5-week period relative to a matched control group.

"Babies in neonatal intensive care are a vulnerable population, and they encounter a lot of negatives during their stay," Joan Smith, PhD, RN, NNP-BC, from the Division of Nursing and Newborn Intensive Care at St. Louis Children's Hospital, Missouri, told Medscape Medical News. "I wanted to see if we could help with some type of positive effect. Indeed, we had very positive immediate responses with the M Technique."

Dr. Smith discussed her research at the National Association of Neonatal Nurses 30th Annual Educational Conference in Phoenix, Arizona.

The M Technique is composed of structured, stroking movements, done in a set sequence at a set pressure and speed. It has been shown to be useful in many patient populations, including critically ill patients and hospice patients. The M stands for manual ― a structured, manual method of touch ― which distinguishes it from massage.

In a prior feasibility study, Dr. Smith and her team showed that the M Technique was safe to perform in preterm babies in the neonatal intensive care unit (NICU). And after just 1 session, they observed improved physiologic and behavioral effects in the babies.

In the latest study, the researchers investigated the cumulative effects of the M Technique in the NICU.

They enrolled 20 very preterm infants of less than 30 weeks' gestation with average birth weights of less than 1000 grams and randomly allocated 10 to receive the M Technique and 10 to receive no such treatment, to serve as a control group.

Each infant received standard NICU care or standard NICU care plus a 7-minute M Technique session 6 times per week for 5 weeks (30 applications total).

Physiologic parameters of heart rate, respiration, oxygen saturation, and behavioral states all improved both from baseline to during and post intervention, said Dr. Smith. There were also positive effects on growth velocity in the babies who received the M Technique.

There were no differences in neurobehavioral outcomes using the NICU Network Neurobehavioral Scale (NNNS), "but we personally believe that is because we did the test on the earlier end of the study," she added.

Stress Reliever

"In addition to clinical outcomes, the people working on our team also felt the responses were very positive. Some of our therapists are starting to incorporate as part of their touch therapy," said Dr. Smith.

"It's very easy to learn," she said. "We learned the technique over 4 days. The biggest thing you have to know is the appropriate pressure to apply."

As part of their training in the M Technique, the researchers performed it on each other. "It was so relaxing, almost all of us fell asleep," said Mary Raney, MSN, RN, NNP-BC, a developmental care expert at St. Louis Children's Hospital who participated in the study.

"We experienced firsthand how it can be a stress releaser. When I was performing it, I felt like it calmed me down, because it is very rhythmic and I could feel the person relax," she said.

"It does require you to have a strong developmental background to be good at reading cues from the baby and be able to identify what pressure that infant likes," she explained. "You can tell very quickly how the baby responds, and if someone interrupts you, you can feel how the baby tenses."

The beauty of the technique "is that it is easy to learn and it is something we can teach parents to do," Raney said.

"Parents are very receptive to it — especially after they see how their baby relaxes," Sandy Conner, BS, PT, neonatal physical therapist, who also participated in the study, told Medscape Medical News.

National Association of Neonatal Nurses (NANN) 30th Annual Educational Conference: Abstract 802b. Presented September 13, 2014.

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