Interview with Susan Swiat

Infant Massage in Action
Early Intervention CEIM Profile

Teaching parents to massage their babies is a very useful practice in early intervention work. Pediatric Physical Therapist Susan Swiat, and Speech Pathologist Gwen Borsenberger took an Infant Massage Parent Educator Certification training from Trainer Jody Wright in Ridgewood NJ in October of 2006 and brought it back to their agencies, Ages and Stages Therapeutics, in Middletown, NY and St. Luke’s/Cornwall Hospital in Newburgh, NY.

Susan and Gwen, both early intervention providers, submitted a proposal to the local early intervention officials and were approved to offer infant massage training to every family in Orange County, NY that qualifies for EI services automatically through New York State guidelines. Automatic qualifiers are those children who are born with about 30 specific developmental disabilities that carry a high probability of developmental delay such as low birth weight, Down syndrome, spinal bifida, etc. What this means for families is that as soon as they are approved for early intervention services, they can immediately begin getting visits from a CEIM (Certified Educator of Infant Massage) who can teach them infant massage while they are being assessed for other services. According to Susan, “Since we instituted this program last March, I personally have successfully integrated infant massage training into the early intervention program for over 60 families in Orange County, NY, and presented numerous workshops and conferences on the topic to other professionals in my county.”

Ages and Stages is one agency that offers early intervention services in Orange and Ulster counties in New York. They serve about 500 families each year. Early Intervention services are funded by federal funding for Birth to Three, which is, in turn, administered by New York State and local county governments. The infant massage program is billed the same hourly amount as Birth to Three Family Training and intervention services.

Teaching infant massage is treated like other early interventions – with home visits by a qualified professional. The county model requires that the CEIM (Certified Educators of Infant Massage) on their staff are also approved providers of other services for the agency (such as P.T., O.T., speech or special instruction). Six sessions are allowed over a six month period but can be taught in a shorter time frame if the medical status of the child or the family needs support it. The CEIM professional brings a doll and works side by side with the parent. Susan says, “We have to do a lot of modifications with the strokes and positioning. Many of the babies who are born significantly prematurely are very disorganized and cannot tolerate touch or typical positions. We teach parents to read their baby’s cues, and when to stop or take a break. We spend a lot of time on infant cues. I use my knowledge of physical therapy to develop appropriate positioning for the baby - to help them organize themselves and to be comfortable. But I am teaching as a CEIM, not as a P.T., when I am teaching the families infant massage.”

Some of the goals for the use of infant massage for children in the early intervention program include:

• looking at and teaching the parents supportive positioning,
• appropriate timing of daily care with a special emphasis on reading, interpreting and responding to their baby’s cues;
• support of nervous system development and the ability to self regulate
• aid in digestive issues like reflux and colic.

Some of the babies have been in the NICU for months. This hospitalization has not been conducive to supporting the creation of a strong bond between the parent and baby. The parents are grappling with acceptance of their child’s special needs and their own feelings. Some of the babies Ages and Stages work with may go in and out of the hospital, and are very susceptible to respiratory infections. As a result the therapists must be flexible with their scheduling, adjusting it to meet the family’s needs. A team of therapists work with the family at the same time – and they all report back and forth to each other on successes and challenges and how their work supports the family’s and child’s specific needs.

I asked Susan to tell me a few stories from her infant massage work at Ages and Stages.

One family Susan taught infant massage to had a baby that suffered from lack of oxygen at birth. He has many difficulties including tight muscle tone, and the need to be fed through a gastrointestinal tube. He has a nurse who helps care for him. He had a long hospitalization requiring many medical procedures and was extremely sensitive and aversive to touch as a result. Susan taught both the parents and the nurse to massage the baby. Afterwards the mother told her, “When I massaged him, it was the first time I felt that we could just relax and have a special time together.”

Ages and Stages teaches community classes, with a mix of special needs and typically-developing children. A couple of moms with babies with Down Syndrome came to the class. All the moms bonded, as they have a tendency to do in an infant massage class. Soon they were talking about where they go to get photos taken, where their favorite place is to shop for their baby, etc. One of the moms told Susan, “This is the first time I have felt like a real mom,” - chatting about the same things other parents talk about and not being so concerned with doctor’s appointments and therapy schedules.

Another baby with Down Syndrome had undergone open heart surgery. After learning infant massage when her baby was three months of age, this mother confided in her instructor that she had not been able to look at and touch the scar on her baby’s chest. Through the massage she was able to accept, look at and massage the scar, thus accepting her child how he really was.

Now, after a year of offering infant massage to all the families at Ages and Stages, Susan has found that it is the perfect compliment to their Family Training program.

If you would like to contact Susan for more information: Susan Swiat P.T., CEIM, Ages & Stages Therapeutic Services, 2277 Goshen Turnpike, Middletown, NY 10914. 845-692-4391.