MASSAGING HIV-1-EXPOSED INFANTS

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Massage facilities weight gain, state organization, social responsitivity and cognitive performance and reduces stress behaviors in preterm newborn infants. Touch has also been positively associated with changes in brain structure and improved immune functioning. Failure-to-thrive, poor immune functioning, and developmental and cognitive deficits are significant problems for the HIV-exposed infant. These data suggest using massage with HIV-exposed infants will facilitate weight gain, improve developmental performance and enhance immune functioning. Eight HIV-exposed preterm newborns will be randomly assigned to treatment (massage) and control conditions at the time they are transferred to the intermediate care units and are medically stable. The massage procedure used in our previous studies will be used in this study: three 15-minute periods of massage daily for a 10 day period. Sleep/wake behaviors (including stress behaviors such as facial grimaces, clenched fists and yawning) will be recorded and heart rate will be monitored on the first and last days of the study period to assess sleep/wake organization, activity and stress levels. Urine and blood samples will be collected on those days to assay cortisol, growth hormone and catecholamine levels. Developmental performance will be assessed using the Brazelton Neonatal Behavior Assessment Scale-Kansas Supplements. The parent/infant dyad will be followed in the UM Special Immunology Clinic at 3 and 6 months corrected age. Sleep/wake behavior, stress behavior and immune functioning will be assessed at each clinic visit. Bayley Scales of Infant Development also will be administered at 6 months corrected age. It is expected that the HIV--exposed preterm infants who are massaged will gain more weight, show superior developmental performance, exhibit fewer stress behaviors and have improved immune functioning.