The Effect of Massage on Serum Bilirubin Levels in Term Neonates

INTERVENTION: control group will administer routine ward care. Intervention 1: intervention groups: tactile and kinesthetic stimulation will carry out by the mother under the supervision of the researcher in 15‐minute sessions in 3 consecutive hours, daily for 4 days. Each session consisted of 3 standardized phases of 5 minutes each, in which the infants were keep in a prone position in the 1st and 3rd phase. The neonates will gently stroke with the soft, smooth surfaces of all the fingers of both hands. The tactile stimulation procedure included 12 strokes at a rate of approximately 5 seconds per stroking motion over each region of the neonate in the following sequence: • From the top of the head down the sides of the face to the neck, and vice versa • From the back of the neck to both ends of the shoulders, and vice versa • From the thighs down to the ankles, and vice versa • From the shoulders down the arms to the wrist, and vice versa In the middle phase, the neonate will make to lie in a supine position for kinesthetic stimulation that included 5 segments of 1 minute each which consist of 6 passive flexion/extension movements, each lasting 10sec. The stimulation will do on each arm, then each leg and lastly both legs together. The neonate will then return to a prone position to repeat the tactile stimulation phase. Massage intervention will carry out alongside phototherapy (without interruption) in the sample group at a fix hour between 7am and 7pm every day. Initially, phototherapy lamps will check and adjust at a height of 30cm above the neonates who weill keep in the cots with eyes close and reproductory organs will protect. After every 2 hours of therapy a rest period of 30min. will give in which the neonates will allow to breast feed with eyes open. Bilirubin will measure at 6a.m. everydaycontrol group: without intervention. Intervention 2: control group will administer routine ward care. intervention groups: tactile and kinesthetic stimulation will carry out by the mother under the supervision of the researcher in 15‐minute sessions in 3 consecutive hours, daily for 4 days. Each session consisted of 3 standardized phases of 5 minutes each, in which the infants were keep in a prone position in the 1st and 3rd phase. The neonates will gently stroke with the soft, smooth surfaces of all the fingers of both hands. The tactile stimulation procedure included 12 strokes at a rate of approximately 5 seconds per stroking motion over each region of the neonate in the following sequence: • From the top of the head down the sides of the face to the neck, and vice versa • From the back of the neck to both ends of the shoulders, and vice versa • From the thighs down to the ankles, and vice versa • From the shoulders down the arms to the wrist, and vice versa In the middle phase, the neonate will make to lie in a supine position for kinesthetic stimulation that included 5 segments of Treatment ‐ Other CONDITION: Hyperbilirubinemia. ; Neonatal jaundice, unspecified Neonatal jaundice, unspecified PRIMARY OUTCOME: Level of Serum Bilirubin. Timepoint: Daily. Method of measurement: Blood test. SECONDARY OUTCOME: Jaundice. Timepoint: End study. Method of measurement: Clinical Sign. INCLUSION CRITERIA: INCLUSION CRITERIA: term neonates born after 37‐42 weeks of pregnancy; weighing between 2500gm and 4000gm; having a bilirubin level of 13–24mg/dl; All the children were breast fed; were not under any medication and showed no contra‐indications to massage. Exclusion criteria: having jaundice on the 1st day of birth; hyper bilirubinemia caused by hemolysis; diseases or infections occurring in the course of the study; blood transfusion carried out in the infant; the occurrence of bronze children's syndrome during phototherapy; diarrhea during phototherapy; and lastly the desire of the parents to be omitted from the study.