Introduction

The aim of this project is to outline a course of five weekly workshops in Shiatsu baby massage for parents and practitioners. It is not meant to be a definitive guide, and so doesn't cover all the relevant meridians and points and only deals with a few conditions affecting babies.

My way into baby massage was through my experiences as a mother, an auntie of six children in Brazil, and a Shiatsu therapist. I am the youngest of four children so I did do a lot of looking after my nephews and nieces when I was a young teenager growing up in Brazil. This kind of surrogate parenting is quite common practice there, and together with looking after the babies and children of neighbours, helps to create a strong sense of community. What I didn't know then was how useful this informal training would come to be later in my life. Being around babies and toddlers, feeding, changing their nappies and playing with them gave me confidence in handling children. Then, when my own daughter was born at home, one of my midwives showed me some basic massage strokes. That led me to research into the subject. I practised massage with my daughter daily and I could see how much that was helping both of us. Her confidence and expressiveness continued to blossom every day. This so inspired me that within six months I started to run massage workshops for other babies. However, I found that my Shiatsu training enabled me to work in a more holistic way. For example, I massaged the mothers as well as the babies, focused on teaching breathing techniques and comfortable position for mothers. I also learned some fundamental things with these workshops: that you have to be extremely flexible and responsive, and that there is a limit on the number of mothers and babies you can work with at one time without compromising the quality of the workshops.

During studying for the Diploma in Holistic Care in Pregnancy, Birth and Babyhood, though working with mothers, I have learned a lot more about how to apply Shiatsu techniques to baby massage. One that is very simple yet fundamental is the act of observation. Observing how babies move, breath and communicate. Listening all the time for their response and permission to touch. The effect of pregnancy and labour on babies. The course inspired me a lot in relation to letting parents discover their babies needs and wants. Paying attention to breathing and reactions, a lot of listening and observations. During the course I became much closer and comfortable with babies using more of a Shiatsu approach rather than just a straight forward massage.

Why Massage Babies?: The Importance of Touch

Touch, I would argue, is vital to the development of a child, especially if the child was not breast-fed or was born by caesarian (or both). Our bodies and organs need stimulation so they can work and develop properly. (Montague, A., pp. 48, 49 (1986)) One of the consequences of being born naturally is that we are squeezed by contractions in the birth canal during labour, so you could say that the contractions a baby experiences in the womb and down the birth canal are a kind of primal massage.

We are the only animal (mammals), together with the marsupials that are not fully developed at birth. Respiratory, digestive, circulatory, and immunological systems are not fully developed at birth. We cannot walk or even eat without assistance as we do not start developing teeth until 6 or 8 months. However, unlike our relatives the marsupials, who maintain close contact with their young as they carry them in pouches, where they continue to gestate until sufficiently mature, many babies just see their mothers or fathers only for few hours a day while most of the time they are looked after by strangers. Then there are also babies that spend most of their time in their cots alone. SIDS more commonly known as cot death is becoming increasingly common in Western countries. Michel Odent while on a visit in China, where mothers sleep with their babies for at least one year, observed that nobody seemed to understand the meaning of the issue of cot death. "We will never be able to evaluate fully the harmful effects of separating mother and baby at night."(Odent, M., p159 (2002)). That kind of distance between parents and babies carry on for many years when then sometimes is a bit too late to establish this very important contact. This lack of loving touch in the first years of a persons life has been shown to profoundly affect their subsequent development, resulting in adults who not only feel uncomfortable when being touched by others but also feel unable to respond to touch. When I say loving touch I mean a touch that is unhurried and that is enjoyed by both the giver and receiver. A touch that is not looking for appraisal and instant gratification but is all ears to what the receiver needs, learning with your baby as you go. The main intention is LOVE.

The immediate and long term benefits

In my experience, and based on the anecdotal evidence of other parents, very soon after a young child is massaged and touched in a loving environment, will develop from one month to the other without hindrance. It might have a cold here and there but generally it will thrive with a strong immune system. For example, the eyes of a child that is massaged are expressive, present, and aware. In Chinese medicine, the "Shen is the awareness that shines out of our eyes when we are truly awake." "Each parent contributes to the creation of the offspring Shen, yet the Shen is also continuously and materially nourished after birth" (Kaptchuk, Ted J., (1997)). Massage will stimulate all the organs in the babies body promoting harmony amongst the functioning of the organs. Another important point is that the mother by massaging their infant will develop a strong bond with her baby.

Where there is a lack of loving touch with a baby or child the physical and emotional development of that child will be impaired. If given freely the child will become confident self-assured and to have an inner strength and resolve which will make them more prepared to cope with life and less prone to anxiety and fearfulness. Likewise a child that has been taught to appreciate positive touch is unlikely to later be someone who would engage in negative touch which is so much a problem today.

Shiatsu Baby Massage Workshops

I would recommend that the baby is a month old when starting a baby massage workshop.

In the developing world especially in big cities with the increasing demand made on women to get back to normal life straight after giving birth, mothers should be given incentive to stay at home spending time with baby and rest during the first few weeks following birth. Shiatsu is highly recommended for mother and baby as soon as they feel it could help relieving any stresses however, a home visit would be more advisable in the first few weeks after birth than a massage group. These first weeks are special and important for mother and baby it shouldn't be disturbed. The other reason is that in the first few weeks mother is trying to get to grips with breast-feeding, nappy changing, recovering from the birth, etc. Remembering everything that a mother and baby need in order to go out can be stressful and unnecessarily distracting. New born babies will gain from being touched very gently by their mums or just being held skin-to-skin contact. Hara holding is a good way to calm and nurture baby, and can be done when mother is lying down next to baby.

Before Starting a Class

This is a session to be done one-to-one or for a group of maximum 4 people, lasting one hour of 5 consecutive sessions. That's what works for me, I find very hard to run a class of more than four people and keep the focus and clarity needed. The reason for 5 sessions is that after each session parents are given some homework as you will read below. Within 5 weeks they'll slowly find out all sorts of things about their babies which will be reported during the sessions. Also babies will change a lot from week to week and it is important to notice these changes. Babies of all ages are welcomed, however when they start to crawl, the massage will have to change and adapt as they no longer stay still for long. It is good to have different ages as parents from younger ones will find out different techniques and movements that they can use when their baby is older.

Material you will need

It takes a long time to master motherhood so quite often first time mothers (and those are more likely to attend to a baby massage workshop than second or third time mothers) are very tense and forgetful as they are trying hard to learn a job they weren't trained for. Usually they will forget to bring towels, oil etc., so why not provide those things and make sure workshop run smoothly.

1 Small flexible baby doll preferably made of wool or cotton. I find that plastic dolls are too hard and inflexible specially when demonstrating how to work joints and pressing points around the head. You might need to use it when babies are sleeping, don't want to be massaged, sick, etc.

2 Futon or thin mattress, big enough for parent, baby, and teacher. A bigger space creates confidence in parent as they won't have to worry about baby rolling onto harder surface. Also everyone will be more comfortable.

3 Thick large plastic sheet or mat, large thick towel to go on top, few more towels in case you need to change, 2 thin muslin cloths and nappies. The reason for a large plastic mat or sheet is that when baby boys pee usually is like a fountain and it can go everywhere around where baby is lying. A towel for baby to lie on. Muslins are used for when baby throws up the milk or food. Nappies-mums do forget to bring them on a regular basis.

4 Oil. Here, there are several options. I really like to work with cold pressed calendula oil, but is not cheap so I tend to use that if baby's skin is very dry or if baby has ecxma or cradle cup. However, normally I use Almond oil or extra virgin organic olive oil. If the baby has an allergy then the parents will provide the appropriate oil or cream recommended usually by their GP.

5 Heater. There are many choices. It is paramount that the room is warm enough (you will start sweating slightly during class).

OBSERVATIONS BEFORE SESSION
Listening and observing baby with mother. The sound of the mothers voices how they express themselves how they hold their babies, and how they respond to them. The relationship between mother and baby is essential in order to raise a picture of what is going on. Also I would recommend mother to have a shiatsu before I start the baby shiatsu workshops especially if she never had a treatment before. Like in the 5 phases where the relationship between the phases resembles the relationship of mother and child. The phases influence each other like a mother can influence a child. Many times a mother needs to be treated and child will improve his mood and recover from a condition.

IMPORTANT THINGS TO REMIND PARENTS
Warm your hands before touching babies. Do not massage a baby if has been vaccinated within 48 hours and after that only if baby is well. Do not massage baby if he has a temperature or is ill or crying continuously without an obvious reason (just hold him). Young babies should be stroked very gently.
Do not use force, be gentle. Make sure baby is being massaged in a warm room. Wear comfortable clothes.

Session One

I usually start by asking the parents to put oil on their babies bodies and massage them. As this is being done I key in a part of the mother's body I feel is most kyo, or other times they lead me by telling me where it hurts . Sometimes just by touching or holding the area that is most kyo, the whole body relaxes. As I am doing it I also include the baby by observing him as I treat the parent. Many times mothers are very tense around shoulder and shoulder blades and they need constant deep pressure around these areas. As well as points being pressed like GB 21 which will help lactation as well as release tension from shoulders.­ Rotate joints very slowly using your breathing. If baby cries I ask mother to pick up the baby and find a better position while I carry on working on her. Maybe baby is hungry which in this case you can carry on treating mother as baby feeds. If baby needs to burp, you can hint to mother to carry him in an upright position, or if there is something else then this is a good time to find out by asking mother to touch baby. If baby cries mother won't relax so it is very important to deal with a crying baby first.

HOMEWORK - Spend some time each day to observing your baby naked lying on its back. As you do that you can sing or talk to your baby. Also the eye contact between mother and baby during massage can help bonding between baby and mother.

OBSERVATIONS (these should be reminded in every single session) - The use of voice during massage is very important and can be very soothing. The infant is getting to know you better and registering these sounds which if carried on will enable the baby to attempt to make his own sounds and eventually talk. Some parents hardly ever talk directly to their babies. The conversations or sounds between mother and baby should start taking place in the womb.

In all sessions mothers should be addressed by being massaged even if briefly. Also parents should have the opportunity to experiment in advance with the massage technique move, stroke, rotation or kneading before teacher corrects or add to that. Even when explaining meridians and points before you show their locations, parents should have the opportunity to guess where they are, hints could be given. It is wise to allow parents to learn by themselves to soothe their infants otherwise they might feel intimidated by the wrong idea that only experts can do it. By allowing their input into the classes their learning will be more effective as they will learn from within themselves. Also they will trust more themselves when handling their babies. The right position, moving from the Hara and focus on breathing should always be reminded. When showing a movement that requires holding or kneading is good to show the amount of pressure in the mother's body, so they can understand in their skins the amount of pressure required.

Session Two

Ask the mother to massage her baby as she usually does, and demonstrate what she has learned from the first session homework. Be generous with the amount of oil a mother uses as that will help hands to slide and feel the shape of babies body. If you feel mother is insecure about touching her baby, show her just simple stroking movements. Have mother stroking baby from head to feet lying on its back, minding not to get oil around baby's eyes, it can blur his vision.

Praise mother's work without being over the top, just look for good things about mother's massage and you will find them. Making your own breathing heard helps them to remember in focusing in their breath again. Here you can start introducing the stroking clockwise around baby's belly and the use of ST 25 which is excellent to soothe diarrhoea and constipation as well as other belly complaints. I find useful to explain what is Kyo and Jitsu at this stage in very simple terms, hot and cold, and hard and soft.

Often the question of massaging or avoiding completely the genitals area have been raised. That is very particular decision of each individual parent however the total avoidance of touching these areas which is surrounded by ignorance and fear should be more discussed and challenged. In many countries and tribes around the world parents seem to have a more relaxing and healthy view on the subject: "Frederick Leboyer has published a detailed photographic account of this traditional Indian art of baby massage. This is most illuminating, for there is not a nook or cranny of the baby's body that is not lovingly massaged by the mother's hand." "Among the Arapesh (tribe from New Guinea) society........... The mother during breast-feeding blows into the baby's ears, or tickles its ears, or playfully slaps its genitals." (Montagu,A., p.322,348 (1986))

If parent want to massage baby addressing genitals I would then advise to use gentle strokes while massaging the whole body.

HOMEWORK - First ask parent to observe baby; where does it like or don't like to be touched; Does it change breathing when touched some areas; What kind of movements it makes with its body; maybe here they could start writing a diary about how they and baby feel. Ask parent to massage baby at home starting with the whole body stroke then moving to explore legs. If during this exercise they feel their hands want to go somewhere else and do a different stroke as long as the movement is gentle and slow (and it will be if they are focusing on their breathing) and they are confident about it, there is no problem. Parents should practice everyday even if is only 10 min, so in the next session with the practitioner they can report on their experiences.

OBSERVATIONS - By now parents should be feeling much more confident than when they started. And because they have been working for a week with their babies they have started to develop a special bond with them. Before the next session starts you can ask parents about homework, keeping it short. Have them telling about their discoveries. The demonstrations of what new movements they found can be done during the session. Sometimes baby will be asleep so you can treat parent for longer. It is very important to be malleable as working with babies and parents.

Session Three

As the session unfolds you ask them to show how they would work with legs. Good time to explain about joints and rotations. I show stroking and holding of legs and explain about meridians briefly. The main thing to know about the meridian for mothers in this session is that each meridian is connected to an organ and that they are everywhere in the body. By palpating or palming a meridian an equivalent organ is stimulated and the energy can be changed by pressing, holding or stroking a meridian.

Here is introduced the Spleen and Kidney meridians. I picked those two Spleen and Kidney as I think they play an important part on the baby's development and the time is short to show them all. Spleen because it transform food in Qi and Blood. It is traditionally referred as the "foundation of postnatal existence." In addition to that the Spleen rules the muscles, flesh and the four limbs. The movement of the body and being upright depends on the power of the Spleen. Diet of course too plays a fundamental part in the process of a baby's development which in this case maternal milk is the best. The Kidneys store the Jing and rule development and maturation, they are called the root of life. The entire body and all the organs of the body need Jing in order to thrive. The Kidneys rules the bones and produce the marrow which plays a fundamental part on a baby's development. Points that can support Spleen and Kidneys are shown like ST36 tonifies Ki and Blood, good for stomach ST40 for phlegm in the chest CV12 tonifies the stomach, KID1, tonifies Yin and calms the Shen, KID3 tonifies kidneys, Ki and essence and tonifies the Yin and Yang of the whole body, BL23 stimulates all functions of the Kidneys.

The use of the palm of hand as well as finger should be emphasised. Because of insecurity some parents have a tendency to hold baby's body by using just fingers and not the whole hand. Then I show them the hand shake exercise; Basically I hold a mother's hand as we pretend we have been introduced for the first time. Then amongst various hand shakes I use only my fingers to hold their hands and ask them their impression of it. A hand shake where only fingers are used to hold the other person's hand is weak and it doesn't inspire confidence or warmth. One parent said that "a hand shake where fingers only were used didn't have heart". The same applies to when you touch your baby, the way you touch your baby can make a lot of difference on how he responds to you. The way you hold your baby and child will give him confidence or not. After working with legs you could move on to feet which can be very relaxing, by holding KID 1 you can send baby to sleep or make him very calm. Also show working with holding toes and rotating ankles and toes. The thing with points is that you have to try different points for different babies. Also babies are quicker in responding to them which is very helpful.

HOMEWORK - You can ask for parents practice what they have learned in the last classes or focus maybe in working an area they have difficulty with. The homework should focus on each parent\baby and their needs.
For example; a mother that finds difficult to focus on her breathing would benefit to practice breathing exercises or meditation. That can be just sitting on a chair and meditating 5 min. morning and afternoon. Alternatively mother could massage baby with simple strokes but focusing in counting her breaths or just hold baby for 5-10 min while she counts how many times she was aware of her breathing.

OBSERVATIONS - You'll be surprised and so too the parents about the variety of learning that will emerge out of this homework. During the sessions parents might not feel confident with one or other movement so homework will also give them the opportunity to practice them in the comfort of their own surroundings.

Session Four

Here you can show parents the CV meridian and briefly explain that this meridian is very important for baby's development. They can thumb CV gently using thumbs or side of hand or fingers. Let them have a go first. Show LU1, as babies are prone to be mucousy, this point can be good for clearing phlegm from chest amongst other things. Strokes on chest spreading into the inside of arms and hands can be very calming. When you get to the hands sometimes either they don't want to open their hands or they get hold of your fingers tightly. Ideally you don't want to force the opening so you can work the shoulder joint very gently with really slowly rotations while you hold the hand at the same time. Many times they just let go of their hold and relax or open their hands, then you can massage their hands and fingers. You can try doing the above movement using the parents arms and shoulder joints first so they can understand how it feels and have a go on their babies.

Stretch arms above head this is good to stimulate GB and to make baby aware of movements he can make. Rotate all the arms joints and hands be very gentle with fingers joints. Side stretches, baby lying down on his back bend his knees and bring both legs together to one side of the body then the other side. It is good for relieving tension in the back and stimulating all meridians in the back as well.

Using pads of fingers you can massage scalp moving it slightly. Babies that are born by ventouse, forceps or had a difficult or long delivery can be sensitive with work done on their heads. If they cry continuously try working off the body then later you can just hold the head, find a part they like most to start off with. Ears are wonderful areas of the body to receive massage. Ear acupuncture is famous for having an extremely calming effect on the whole body. Explore the inside the ears with your thumbs and first fingers hold and bend them. Babies tend to be very quiet while you massage their ears. Point SI19 benefits the ears.

HOMEWORK - Ask them to massage babies in various places using various positions. You can massage baby on your lap on a table on top of a big folded duvet. Lying belly down across your thighs when sitting on a chair. Lying down with your baby. Try massage your baby anywhere with clothes on. Add to that massaging the back which is very good for the whole body.

OBSERVATIONS - The sitting in a chair can give ideas about when they are in public places like buses trains aeroplanes or waiting rooms etc. Working with babies on prone position helps baby to develop neck muscles and strengthens the spine. It is important to tell parents that as they are encouraged by the medical profession not to let their babies lying on their belly for fear of cot death.

Session Five

Review the homework. Usually they will have many positions so you only have to add ideas and points that can be worked in those positions. For example having mother sitting in a chair with baby lying belly down across mother's lap. Here you can show working GV in the same way you showed CV plus stroking and kneading the back of legs. Baby sitting with his back against mother's belly and mum kneading legs arms shoulders and ears, GB 21, ST25.

Holding baby upside-down - Do not use oil, hold baby by the ankles use your whole hand fingers and palm of you hand. Parents are usually a bit apprehensive about this one. But they feel very confident once they do it. Parents tend to tense up shoulders and arms and look down when they are holding their babies. Make sure you have a very soft surface underneath baby and also make sure that baby hasn't eaten recently. When you finish, no longer than 30 sec., put baby down gently following the curvature of spine. In older babies you have to follow the movement baby is doing with his head, if they are lifting their heads forward then you put them down on their bellies otherwise you follow the curvature of the spine gently vertebrae by vertebrae on their backs. Good for creating confidence in both mother and baby. Good for development of neck and spine and circulation in head. Dancing slowly with baby holding him in different positions as you do so using soothing music if you wish.

RECOMMENDATIONS - Encourage the parents to keep massaging their babies. As their baby grows and develops they will find themselves trying different movements. It is good to read books of baby massage as they can increase one's repertoire. To have one-to-one shiatsu baby massage class is highly recommended as a follow up.

 

Conclusion

My background in working with my family's and friend's children, shiatsu training, and the Diploma course have all contributed and lead me into working with baby massage.

In many ways life only begins and makes sense after we are touched, to be touched with love is to be nourished. Without enough touch babies all over the world, in orphanages, hospitals, rich or poor die. They also become ill, insecure, and unsure of who they are as they grow up. The benefits of massage are immense and can be seen straightway. The long term benefits are numerous among them, confidence, self-esteem, strong immune system etc. For working mothers baby massage can be the only incentive for them to spend a relaxed time with their babies.

In order to develop a rapport with a baby a mother needs to spend time and observe her child therefore a workshop of 5 weeks will enable parents to see how quick their baby's and their needs change from week to week. Also by having to keep a diary of their massage practice they will pay attention to what they are doing, how they feel and baby's responses. Mother have to be addressed as well as baby, their moods influence each other, they are an unity. What I wrote is pretty much a plan for a baby massage workshop in progress. It should be adapted to the needs of the participants and evolve from their input and curiosity. To be fully present and mindful is a very important part of the Shiatsu path for me. Also to be open and allow people to join the journey and discover from within how resourceful we all can be. I hope that my insights on Baby Shiatsu Massage can assist people in working with babies and parents.

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