Neonatal massage and neurobehavioral development: sensory integration, neurochemical modulation and promotion of affective bonding

Neonatal massage is a therapeutic practice that supports newborn development. It has been widely studied in recent decades for its effects on the infant’s physical, emotional and neurobehavioral well-being. This technique is based on tactile, vestibular and proprioceptive stimulations that interact with the newborn’s nervous, endocrine and immune systems, promoting the regulation of vital functions, the modulation of behavioral responses and the strengthening of the emotional bond with the mother, with the parents, and with the caregiver.

Physiological and biochemical mechanisms

Neonatal massage stimulates mechanosensitive cutaneous receptors (Merkel, Ruffini, Pacinian and free nerve endings), activating myelinated and unmyelinated afferent fibers (Aβ, Aδ and C). Tactile information is transmitted to the dorsal horn of the spinal cord and to the brainstem nuclei, simultaneously modulating parasympathetic activity through the vagus nerve. Vagal activation is associated with:

• Reduction of heart rate and blood pressure
• Improved heart rate variability (HRV)
• Increased intestinal motility and improved digestion

From a neurochemical perspective, neonatal massage induces the release of oxytocin, both in the newborn and in the caregiver, which promotes emotional bonding, stress modulation, and the regulation of heart rate and respiration. An increase in beta-endorphins is also observed, with analgesic and anxiolytic effects, as well as an increase in serotonin and dopamine levels, which contribute to improved mood, muscle tone and alertness.

Tactile perception and well-being

The newborn’s skin, extremely sensitive and rich in tactile receptors, is the main organ through which the massage–infant interaction occurs. Tactile stimulation provides:

• Physiological relaxation: reduction of muscle tension and neuroendocrine stress
• Behavioral regulation: decreased crying and increased quiet alertness
• Sensory development: promotion of body mapping and postural awareness

The newborn perceives manual contact as a form of nonverbal communication that conveys safety, warmth and continuity with the intrauterine environment. Pressure, speed and rhythm of touch modulate the activation of C-tactile receptors, associated with sensations of pleasure and comfort.

Effects on the caregiver and bonding

Neonatal massage has a direct impact on caregiver well-being. Tactile contact with the newborn stimulates the release of maternal and paternal oxytocin, promoting:

• Reduction of cortisol levels and psychophysiological stress
• Increased motivation for caregiving and enhanced parental competence
• Facilitation of bonding, strengthening a secure emotional attachment

The massage–infant interaction thus represents a bidirectional model of early communication, in which the newborn responds with behavioral, motor and physiological signals, and the caregiver adjusts the intensity, rhythm and duration of the contact based on the infant’s responses.

Neurobehavioral effects

Neurophysiological studies show that neonatal massage:

• Modulates limbic system activity, reducing anxiety and stress
• Promotes myelination of nerve fibers and cortico–limbic connectivity
• Improves sleep patterns and the quality of alertness
• Supports secure attachment, increasing the newborn’s ability to self-regulate and interact

Effects on vital functions

Neonatal massage promotes stabilization of vital functions:

• Heart rate: average reduction of 5–10 bpm during and after massage
• Respiratory rate: reduction of tachypnea peaks and better respiratory coordination
• Body temperature: improved thermoregulation, especially in premature infants
• Weight gain: increased growth in low-birth-weight infants, likely mediated by improved intestinal absorption and reduced metabolic stress

Neonatal massage is a multisensory practice with significant neurochemical, behavioral and physiological effects for both the newborn and the caregiver. Tactile stimulation, combined with vagal modulation and the release of oxytocin and beta-endorphins, supports mother–infant bonding, relaxation, regulation of vital functions and neurobehavioral development. Regular, safe and individualized practice based on gestational age and clinical conditions represents a powerful tool to promote health, well-being and early interaction.