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The Role of Cue-Based Infant Massage in Postnatal Depression

Even under the best of circumstances, crying, sleep difficulties and simply working out how to care for a new baby can cause distress and confusion for many new parents. For Louise, after the birth of her second child Ryan, these challenges became overwhelming through the fog of postnatal depression.

While seeking treatment and support from her GP, Louise was referred to the First Touch Program. Louise credits the program, which centres on building parent-baby relationships using cue-based baby massage, as being one of the crucial parts of her recovery. And she’s not the only one: a growing body of research and evaluation studies suggest that, under certain conditions, cue-based infant massage has the potential to have a long-term impact on the health and well-being of babies, as well as their parents.

As well as potentially delivering long-term benefits for families affected by postnatal depression, cue-based baby massage is likely to benefit other families too. With evidence suggesting a link between baby massage and improvements in infant settling and sleep and even healthy brain development, it’s no wonder that many parents, medical staff and organisations are jumping on the baby massage bandwagon.

“I had a very complicated birth with my second baby. I didn’t experience those same overwhelming feelings of love I had with my first,” Louise recalls. “I thought: ‘Oh well, fair enough, I’ve just been through a traumatic experience’. I then developed problems with breastfeeding and was just feeling really down and found myself crying a lot. I felt like I was just going through the motions. I thought that maybe it’s the baby blues. But by six weeks I realised I wasn’t getting any better and I thought I might actually be getting worse.”

The courage to talk to her GP led Louise to a range of supports, including the First Touch baby massage program.

Rather than focusing on the depression and all the problems she was facing, the First Touch Program worked on supporting the bond between Louise and Ryan. “When I had depression, I’d get in the car to go and get a loaf of bread and I’d be alone, and I’d plan it all out. I’d drive to Sydney and just stay there. I was ready to leave my husband and kids. I just needed to get out. And that feeling happened quite a lot. I didn’t have that connection with Ryan. He was just a baby, I loved him but I wasn’t in love with him like I was with Dean. So I struggled with that because I didn’t want to feel like that at all. I’m not normally a depressed person.

Louise says, “Doing baby massage in the First Touch Program became our ‘us time’. When we walked in, there was music playing and the lights were dimmed. We went through different parts like massaging the legs, doing the arms, and Ryan absolutely loved it. It was just amazing. You don’t normally spend that time just being with your baby like that. It was just beautiful, it was unreal. It calmed him. I don’t know whether he sensed my feelings before, but there was a definite change between us.”

The First Touch Program doesn’t claim to treat any particular type of problem, but focuses on supporting early relationships and interactions between parents and babies. According to beyondblue, this is a crucial element of postnatal mental health, and particularly recovery from postnatal depression. For this reason the First Touch Program has value for parents who are well, and also for parents who are struggling.

But research suggests it is parents who feel the struggle who have the most to gain from attending a high-quality infant massage program. Supports and programs like First Touch, which can enhance parent-baby relationships, and help to calm and soothe babies in the first 12 months of development, can help change the course of mental health development.

However, while Louise’s story suggests the potential benefits of infant massage, parents should exercise caution when sourcing baby massage information, advises Alice Campbell, CEO of Baby in Mind, the infant mental health promotion charity that runs that First Touch Program.

“Good research about baby massage is conducted using set protocols and guidelines. There are many baby massage programs available in Australia – and, while they all claim to benefit families, unfortunately the vast majority of infant massage information bears no resemblance to the cue-based programs used in the research. Therefore, we don’t really know the benefits, or risks, of many baby massage programs or DVDs that are out there.

“And there is also some interesting research which suggests that who you learn baby massage from, can have a big impact on the outcomes you and your baby experience. That’s why it’s important to shop around for your baby massage information” says Ms. Campbell.

The available research identifies a number of features of a high quality baby massage program.

Most importantly, parents should look for a trained facilitator who is properly registered with a reputable association specialising in cue-based infant massage. According to Ms. Campbell, a reputable association will have things like a Code of Conduct for its infant massage instructors, a formal complaints system for parents, and requirements for its instructors to have completed high-quality (nationally accredited) training specifically in cue-based infant massage education.

When these things are in place, baby massage can help empower parents to find their own, unique way to provide a loving, healthy and secure start in life for their baby through touch, voice, movement and many other interactions crucial to early development. As Louise says, “I think all Mums and Dads should do it. It was just amazing.”


Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H. & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129 (2), 195-215.

beyondblue. (2009). Postnatal depression: Evidence relating to infant cognitive and emotional development. Melbourne: beyondblue.

Guzetta, A., et al. (2009). Massage accelerates brain development and the maturation of visual function. Journal of Neuroscience, 28 (10), 6042-6051.

O’Higgins, M., St. James Roberts, I. & Glover, V. (2008). Postnatal depression and mother and infant outcomes after infant massage. Journal of Affective Disorders, 109, 1-2, 189-192.

Onzawa,K., Glover, V., Adams, D., Modi, N. & Kumar, R. (2001). Infant massage improves mother-infant interaction for mothers with postnatal depression. Journal of Affective Disorders, 63, 201-207.

The Australian Association for Infant Mental Health & The Australian Research Alliance for Children and Youth. (2013). Joint Communiqué: Halving Rates of Mental Illness in Australia: Starting at Birth. Canberra: AAIMHI.

Underdown, A. & Barlow, J. (2011). Interventions to support early relationships: mechanisms identified within infant massage programs. Community Practitioner, 84 (4), 21-26.

Underdown, A., Barlow, J. & Stewart-Brown, S. (2010). Tactile stimulation in physically healthy infants: results of a systematic review. Journal of Reproductive and Infant Psychology, 28 (1), 11-29.

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