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The WA department of health and ageing defines post-natal depression as Depression that
comes on within 12 months of having a baby, usually during the first few weeks or months.
It can start slowly or suddenly, and can range from very mild and transient, to severe and
lingering. Post-natal depression is most common after a mothers first pregnancy and
thought to affect one in 7 mothers, and one in 10 fathers.

PND rarely develops because of one direct cause. Emotional or mental health problems are
usually the result of many factors that interact in different ways for different people.

Some common risk factors include:
  • Antenatal depression (depression during pregnancy)
  • Personal or family history of mental illness
  • Substance misuse
  • Relationship difficulties or being single
  • Lack of emotional or practical support
  • Stressful life events
  • Complications during pregnancy or delivery
  • Adolescent, older or first-time mothers
  • Recent cessation of medication
 
Postnatal depression affects a mother’s ability to cope with the care of her baby, and limits
her capacity to engage positively with the baby in social interactions (Murray & Cooper,
1996). Postnatal depression can be a long-lasting condition which affects both the mother
and her baby, that has adverse consequences for the mother–infant relationship, and the
infants cognitive and emotional development (Murray & Cooper, 1996; Poobalan et al,
2007). Given the transgenerational effects and high prevalence, it presents a significant
challenge and cost to the public health system.
Standard interventions usually include a combination of pharmacological, support groups,
psychotherapy and cognitive behavioural therapy. Improving a mother’s depression per se
has been found to have little impact on mother–infant interaction and most interventions
(with the exception of some forms of psychotherapy) tend to focus on the treatment and
outcomes for the mother only rather than outcomes for the child.
 
Some of the many benefits of infant massage include:
• Speeds the development, maturation and functioning of the digestive,
respiratory and circulatory systems
• Speeds myelination of the brain and nervous system
• Relaxation, reducing stress hormone levels and improving mood, improving
sleep, reduces crying
• Improved circulation and alertness, strengthening the immune system
• Special needs children, drug affected children, low birth weight/pre-term
babies
• Relief of discomfort
• Enhances cognitive and motor development
• Enhances attachment and bonding
 
Benefits for parents
• Reduced anxiety
• Fewer depressive symptoms
• Improved mood
• Decreased stress (measured by cortisol levels in saliva)
• Improved self esteem
• Improved interaction with their baby
(Bennet, Underdown and Barlow, 2013; IMIS training manual)
 
Massage should only be done by regular care givers and not by a stranger – IMIS Certified Infant
Massage Instructors
(CIMI) and Paediatric Massage Consultants (PMC) provide massage education
and instruction to the parent/caregiver. The massage methodology is based on a combination of
Indian massage, Swedish massage and reflexology. Qualified instructors provide the parents with the
techniques and approaches and how to tailor these to best suit them and their baby, it is not a one
size fits all approach.
 
Massage tuition for parents can be provided in a group environment, (usually with 6-15 parents,
so the instructor is able to watch the parents and babies and provide assistance), or as a one-on-one
instruction with one or multiple caregivers. Baby massage tuition for parents should run for 4
hours in total to cover all the necessary education. Tuition is usually offered as an hour/week for 4
weeks. One off introductory sessions are also made available for parents who just want a little help,
getting started with the basics of infant massage.
 
Contraindications for massage (Source – IMIS)
• Circumstances under which you would not recommend massage
• Post surgery
• Inflammation
• Bleeding/open wounds
• Gain medical clearance
• Thrombosis or embolism
• Cardiovascular conditions
• Avoid during massage
• Local bruising/cuts/abrasions/infected skin irritations/burns
• Undiagnosed lumps
• Unhealed navel
 
Massage is completed with oil – cold pressed, organic fruit nut or seed oil, position is
important for safety - newborns can be massaged on parent’s knees while seated on the
floor, or with baby lying on the floor, when they are older massage can be completed in the
seated position between parent’s knees. Before massage there must be a permission
sequence
– a learned cue that massage is about to begin and gives infants the opportunity to
use body language or vocalisations to communicate whether they are happy to be massaged.
 
Massage should be conducted during the ‘quiet alert’ period, can be done up to
twice a day but otherwise frequency is up to the parents and infant. Infant does not have to
receive the full massage sequence at one time and the massage should only go for as long as
the infant is happy to receive it.
 
Other safety considerations are not to massage around bath time if under 5 months due to
overstimulation and after 5 months,  massage should take place after a bath due to oil residue on
the skin posing a safety risk if massage is performed before bathing.
 
Evidence
Onozawa et al (2001) Infant massage improves mother-infant interaction for mothers with
postnatal depression.
 
This was a pilot study with 34 participants, and compared Edinburgh
postnatal depression scale (EPDS) and maternal/infant interaction before and after
participation in either an infant massage group or a support group. The study found a
statistically significant improvement in the maternal/infant interaction in the group that
participated in infant massage, EDPS fell in both groups. Limitations of this study are the low
sample size, high dropout rate. The same authors were published in Seminars of
Neonatology and reported the same results but presenting the mother–baby interaction
scores over time, showing that for mothers who attended the massage class a statistically
significant improvement was achieved (P<0.001) compared with the control group cited in this
study. The authors suggest that mechanisms by which this is achieved are not clear but may
include learning to understand their babies' cues and the release of oxytocin (Glover, V,
Onozawa, K and Hodgkinson, A. (2002). Benefits of infant massage for mothers with
postnatal depression.) Both of these studies have been referenced in critical/systematic
reviews of PND treatments. “Definite conclusions cannot be reached about the relative
effectiveness of most of the nonbiological treatment approaches due to the lack of well-
designed investigations.”
 
O’Higgins, St James Roberts and Glover published a study in 2008 with a similar design. 4
weeks postpartum, used the EPDS to identify mothers and again randomly assigned
participants to baby massage classes or a support group. Outcome measures were EPDS,
depression, anxiety and infant characteristics questionnaires and were filmed with their
infants before and after 6 interventions sessions and at one year. They also had 34 non-
depressed mothers who completed the study. More of the massage than support group
mothers showed a clinical reduction in EPDS scores between four weeks and outcome
(p < 0.05). At one year, massage-group mothers had non-depressed levels of sensitivity of
interaction with their babies, whereas the support group did not. There were no other
differences in either mother or child between the two intervention groups. Depressed
mothers did not achieve control depression or anxiety scores at one year. Limitations -
small sample size, no control group.
 
Lack of robust research – cochrane systematic review in 2013 titled Massage for promoting
mental and physical health in typically developing infants under the age of six months
found ’available evidence is of poor quality and many studies do not address the biological
plausibility of the outcomes being measured, or the mechanisms by which change might be
achieved’. Some future considerations – greater sample sizes, whether there are demonstrable
benefits for children, long term studies (and impact on children, parents and siblings).
 
In summary, infant massage is particularly suitable for mothers with PND as it focuses on
supporting early relationships and interactions between parents and babies, empowers the
parent and increases their confidence, teaches about communication and body language
and responding to baby appropriately and has many other health/wellness benefits for the
infant.
 
References

• Bennett C, Underdown A, Barlow J. (2013) Massage for promoting mental and
physical health in typically developing infants under the age of six months.
Cochrane Database of Systematic Reviews, Issue 4.

• Dennis, C. E. (2004). Treatment of Postpartum Depression, Part 2: A Critical Review
of Nonbiological Interventions. J Clin Psychiatry, 65, 1252-1265.

• Glover, V, Onozawa, K and Hodgkinson, A. (2002). Benefits of infant massage for
mothers with postnatal depression. Seminars of Neonatology, 7, 495-500

• McLoughlin, H. (2012). Infant Massage Training Manual and Student Handbook.
IMIS NSW Pty Ltd, Infant Massage Information Service.

• Murray, L. & Cooper, P. J. (1996) The impact of postpartum depression on child
development. International Review of Psychiatry, 8, 55 .

• O’Higgins, M., St James Roberts, I., Glover, V. (2008) Postnatal depression and
mother and infant outcomes after infant massage. Journal of Affective Disorders.
109, 189-92.

• Onozawa et al (2001). Infant massage improves mother-infant interaction for
mothers with postnatal depression. Journal of Affective Disorders, 63, 201-7.

• Poobalan et al. (2007). Effects of treating postnatal depression on mother–infant
interaction and child development: Systematic review. British Journal of Psychiatry,
191, 378-386

• WA Perinatal Mental Health Unit. (2012). Postnatal anxiety and depression.
Australian Government - Department of health and agein

Eligibility and Course Prerequisites

No prior training or qualifications are required for the Certified Infant Massage Instructor(CIMI) qualification.

Wanting the Paediatric Massage Consultant (PMC) qualification and wondering if you meet the prerequisite requirements?

If your qualifications fall under the categories of health, allied health, natural therapies or education, you are guaranteed to meet the prerequisite requirements for the paediatric level qualification.

Some examples of qualifications that meet the prerequisite requirements for the PMC qualification are included below (please note, this is not a full list). 

Examples of health qualifications approved for PMC:

Nurse, midwife, aboriginal health worker, community health worker, retired nurse, child & family practitioner, paediatric nurse, maternal/child health nurse, neonatal nurse, paediatrician, medical doctor.

Examples of allied health qualifications approved for PMC:

Chiropractor, doula, childbirth educator, lactation consultant/educator, science degrees, mental health professional, social worker, occupational therapist, physiotherapist, psychologist. 

Examples of natural therapy qualifications approved for PMC:

Massage therapist, yoga instructor, nutritionist, Chinese medicine, kinesiology, myotherapist, naturopath.

Examples of educator qualifications approved for PMC:

Early childhood educator, early childhood teacher, other educator (e.g. B. ED Studies, diploma in primary teaching)

PMC students receive both qualifications, the Certificate in Infant Massage Instruction and the Paediatric Massage Consultant qualification. To obtain the paediatric qualification you need to meet the prerequisite requirements, complete your baby massage training through the Infant Massage Information Service and successfully complete 4 competency tasks. In addition to working with parents, and teaching them how to massage their babies, PMCs can provide theory presentations to other professionals, educating them on the researched benefits of massage for infants and children and ensuring they are aware of services available to families in this field. 

Course Fees and Variations

Course fees are the same regardless of your method of study (face-to-face or online).

Fees for the Certificate in Infant Massage Instruction range from $1125 - $1650, depending on the enrolment package (inclusions) selected. Interest-free payment plans are available and these are personalised for each student. 

Fees for the Paediatric Massage Consultant qualification range from $1485 - $2010, depending on the enrolment package (inclusions) selected. Interest-free payment plans are available and these are personalised for each student. 

The course fee table outlining the enrolment packages (inclusions) can be accessed here: Fee Structure | Baby Massage

Please note, the table automatically displays the fees for the Certified Infant Massage Instructor qualification. To view the fees and inclusions for the Paediatric Massage Consultant (PMC) qualification, be sure to click on the 'Paediatric Massage Consultant' box. 

Face-to-Face Course Details

Face-to-face training dates and locations can be found on our course dates and locations page: Locations | Baby Massage

The face-to-face training is completed over 3 days and courses are always held on a Friday, Saturday & Sunday.

Career and Qualification Pathways

Infant Massage Information Service 3-day face-to-face courses have a mixture of both Certified Infant Massage Instructor (CIMI) and Paediatric Massage Consultant (PMC) students.

All students cover the same content/units of study.

The differences are:

- Our CIMI students are usually going into the industry as something new i.e. with no prior related background. There are no pre-requisite requirements they need to meet.

- CIMI students complete the 3-day course successfully and are then able to work with parents, teaching infant massage. All assessment work is completed within the 3 days of the course.

- Our PMC students have prior, related training and/or experience in health, allied health, natural therapies or early childhood education and care.

- After the 3 days in class, there is one additional assignment completed. The additional PMC task takes approximately 2 days to complete and does not need to be done in the 2 days directly following the course. PMC students can complete their additional assessment when convenient and follow the instructions provided to upload their submission for marking when they're ready. 

- Our PMC students receive both qualifications – the CIMI qualification and the PMC qualification. The CIMI level qualification is provided immediately after the 3-day face-to-face course and the PMC qualification is issued after the additional PMC assessment has been completed. 

- PMCs can work with parents, teaching infant massage in the same way that CIMIs can. What PMCs are also able to do is provide theory presentations to professional groups on infant massage. The presentations are fairly straightforward and usually follow the same format e.g. – Self-introduction, benefits of infant massage, research reviews, dispelling common myths relating to infant massage and information on services available to parents in this field. 

Various industry bodies request these types of presentations and PMCs are paid a presentation fee for this work directly by the organisation or body who has requested them. PMC presentations offer a unique opportunity to network with other professionals and potentially receive additional referrals for your infant massage work with parents.  
 

What if I'm completing the course via correspondence study?

Each correspondence intake period has a mix of both Certified Infant Massage Instructor (CIMI) and Paediatric Massage Consultant (PMC) students.

All students cover the same content/units of study.

The differences are:

- Our CIMI students are usually going into the industry as something new i.e. with no prior related background. There are no pre-requisite requirements they need to meet.

- CIMI students successfully complete 3 competency tasks at their own pace and are then able to work with parents, teaching infant massage. 

- Our PMC students have prior, related training and/or experience in health, allied health, natural therapies or early childhood education and care.

- There is one additional assignment completed for the PMC qualification.

- Our PMC students receive both qualifications – the CIMI qualification and the PMC qualification.

- PMCs can work with parents, teaching infant massage in the same way that CIMIs can. What PMCs are also able to do is provide theory presentations to professional groups on infant massage. The presentations are fairly straightforward and usually follow the same format e.g. – Self-introduction, benefits of infant massage, research reviews, dispelling common myths relating to infant massage and information on services available to parents in this field. 

Various industry bodies request these types of presentations and PMCs are paid a presentation fee for this work directly by the organisation or body who has requested them. PMC presentations offer a unique opportunity to network with other professionals and potentially receive additional referrals for your infant massage work with parents. 

Online Study

The correspondence program is thorough, easy to work through and offers a convenient way to study. 100% of the course requirements are completed from home, including all practical work meaning no travel or onsite attendance is needed.

Once your enrollment is complete and the course fees are paid, you will receive a welcome email providing you with full access to the course content. Your welcome email includes your pdf training manual with all of the course theory work and assessment instructions as well as links to the practical video files you need to watch. A training pack containing your demonstration doll and any other resources in your enrolment pack is sent via post.

There's no need to wait for your training pack to arrive via post before you begin studying. As soon as you receive your welcome email you can get started with the course theory work, then move on to the practical techniques once your demonstration doll arrives. 

You're welcome to study at your own pace to complete the course. Most students complete everything within the space of a few weeks. If students have a lot of other commitments and limited time, they might finish the course over a few months instead. Whatever study period you need is ok, there are no enforced deadlines you need to meet. 

There are 3 or 4 assessment tasks to complete depending on the qualification level you enrol in. The tasks are easy to complete and personalised assistance is available throughout the course if you need help with questions or clarifications. 

Your theory assessment is an open book, multiple-choice exam which ensures you've worked through the training manual. You're provided with an answer sheet to complete which can be emailed as an attachment or uploaded for marking. Practical tasks are recorded using any device (most students use their phone). The recordings are uploaded for the trainers to view and report on. Practical reports are extremely detailed to ensure you're confident in practical techniques prior to certification. 

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