The Effect of Massage on Salivary Secretory Iga Level in Preterm Infants

Aim: Secretory Immunoglobulin A (sIgA) is one of the most important components of the immune system and has a prominent role in preventing infections that are transmitted through the gastrointestinal tract and respiratory mucosa. The primary objective of this study was to evaluate the effect of massage on the salivary sIgA level in pre-term infants and the secondary objective was to assess the effect of massage on neonatal weight gain. Materials and Methods: This study was performed on 150 preterm infants weighing between 1,500 gm and 2,000 gm who were hospitalized in 3 main medical centers of Khorramabad city, Iran between March 2018 and March 2019. The 3 major selected centers were Asalian, Shahid Madani and Shahid Rahimi Hospitals. All infants were randomly allocated to either the intervention (n=75) or the control (n=75) group. Due to our criteria, 18 patients were excluded from this study. In total, 132 infants were included in this study. The initial samples of sIgA were obtained from the saliva of the neonates in both groups on the second day after birth and when acute symptoms of respiratory distress syndrome had resolved. The second samples were collected on the 14th day after birth. During this period, neonates of the intervention group were massaged properly using the Field technique for 15 minutes, three times a day by a trained Neonatal Intensive Care Unit nurse for 12 consecutive days. It should be noted that due to the effect of breast milk on the neonates' sIgA levels, we selected all subjects from those who were not fed with breast milk for some reason, but were fed with formula instead. Results: According to our findings, a significant difference was observed between the mean weight of the infants between the second and 14th days after birth in both the intervention and control groups (p<0.001). However, in comparison, there was no significant difference between the mean weight changes of the infants in both groups (p=0.845). Moreover, there was a significant difference between the mean sIgA level changes between the second and 14th days after birth in both groups (p<0.001), but these changes were more significant in the intervention group compared to the control group (p<0.001). Conclusion: These results showed that massage therapy in neonates can increase the level of sIgA which plays an important part in the infant's immune system. However, this had no positive effect on the weight gain process. It is recommended that massage therapy be used as a safe auxiliary therapeutic procedure for preterm infants and that mothers can learn and perform this technique as a simple way to boost the immune system of their infants.