Protocol for Infant Massage in Home Settings: An e-Delphi Approach for Consensus Guidance Integrating Traditional Wisdom with Modern Medicine.

Infant massage is a highly prevalent traditional practice in India and other parts of Asia. Clear guidance on safe and effective uses of infant massage is lacking especially in the contemporary times when the traditional knowledge is on the verge of extinction and preparations may differ from in the past. This paper presents a consensus guidance in the form of a standardized protocol for routine massage of infants in home settings. Furthermore, a feasible method to develop an integrative protocol involving traditional and modern medicine experts is described. A modified e-Delphi method was used to develop the protocol. A group of seventeen experts, including academicians and practitioners from disciplines as modern paediatrics, Ayurveda paediatrics, Physiotherapy and Naturopathy participated in three rounds of a Delphi study to evolve the consensus guidance. The present protocol for massage of infants born beyond 34 weeks of gestation and weighing above 1.8 kg is recommended for use by care givers. This provides guidance on the preparation for infant massage such as when to begin massaging the infant, checking fitness of the infant for massage, the appropriate time, environment, person and substance for infant massage and a detailed description of the procedure for infant massage. Paediatricians, obstetricians and other child care practitioners can use this protocol to guide care givers on how to peform infant massage.

Short term escalating administration of large amount of sneha does not increase blood lipids.

Vardhamana snehapana or shodhana sneha is classical Ayurvedic treatment in which escalating dose of sneha or ghee is administered for utkleshana (precipitation and dilution) of morbid doshas in body. Due to snehana and swedana, doshas get separated from dhatus, channelized towards koshtha, from where they can be easily and safely removed by appropriate cleansing therapy or shodhana like vamana (emesis) or virechana (purgation). Since this type of snehana requires administration of large amount of sneha or ghee there is fear that patients may experience increase in harmful lipids. The present study examined the effect of vardhamana snehapana on relevant physical and physiological parameters in normal individuals before and after samyak snehana and shodhana. Vardhamana snehapana was administered in healthy individuals according to agni and koshtha to achieve samyak snigdha lakshanas (symptoms of proper oleation).We assessed parameters of vardhamana snehapana in all individuals including samyak snigdha lakshanas, jeeryamana lakshanas, total quantity of sneha consumed. Effect of vardhamana snehapana on weight, abdominal circumference and lipid profile were measured before and after vardhamana snehapana. Statistical significance of results were quantitated by paired t test. After vardhamana snehapana, 16 out of 29 volunteers showed a significant weight loss of > 2 kg (p < 0.0001). The remaining 13 volunteers showed less but significant weight loss <2 kg (p < 0.0001). Notably, all 29 volunteers showed a significant reduction in abdominal circumference (p ≤ 0.0006) after vardhamana snehapana. Although vardhamana snehapana did not significantly alter levels of total cholesterol, HDL, and LDL, it did cause a significant reduction in triglycerides (p = 0.009) and VLDL (p = 0.005) in all 29 volunteers. Vardhamana snehapana is responsible for precipitation of doshas and does not cause brumhana (Nourishment of dhatus or body elements). Importantly, this treatment did not negatively affect health of any of the volunteers. Notably, Vardhamana snehapana caused different degrees of statistically significant reduction in body weight, abdominal circumference, and levels of specific lipids (triglycerides and VLDL) in these 29 volunteers. These encouraging results could be due to the composition and metabolism of the pure cow's ghee used for vardhamana snehapana treatment in this study.