Influence of Massage Intervention on Salivary Cortisol Level in Preterm Infants

Document Type: Original Article


1 Department of Child Health, Faculty of Medicine, Airlangga University

2 Department of Child Health, Faculty of Child Health, Airlangga University


Introduction: Stress in preterm infants is associated with morbidity and mortality. Preterm infants needing special care are at risk of experiencing stress because of separation from the mother, ambient noises, lighting intensity, and medical procedures. Massage is believed to reduce stress through touch stimulation. Cortisol is one of the indicators of the stress response.
Objective: To identify the effects of touch stimulation in the form of massage on salivary cortisol in preterm infants
Methods: A post-test only design study was conducted. There were 19 preterm infants receiving massage and standard therapy and 20 preterm infants as a control group receiving only standard therapy. Massage was given to the infants three times daily for 15 minutes. Salivary cortisol was measured after 10 days of intervention.
Results: The average salivary cortisol concentration of the control group was higher (0.53 ± 0.73 µg/dL) than in the intervention group (0.05 ± 0.32 μg/dL). There was a significant difference between groups (p=0.001). Based on pre-test and post-test results, there was a significant decrease in salivary cortisol levels in the massage group compared to the control group (p=0.03 versus p=0.53). There were no observable side effects during the intervention.
Conclusion: Based on a decrease in salivary cortisol levels, this study suggests that touch stimulation given as a massage may improve preterm infant stress.