The goal of this clinical trial is to learn whether infant abdominal massage can help reduce bilirubin levels and improve bilirubin elimination in healthy full-term newborns. The study will include 84 newborns born at 37 weeks of gestation or later, with a birth weight of at least 2,500 grams, stable vital signs, and no major health problems.
The main questions it aims to answer are:
Does abdominal massage reduce transcutaneous bilirubin levels during the first 120 hours after birth? Does abdominal massage increase bowel movements or promote earlier passage of meconium? Does abdominal massage reduce the need for phototherapy, the duration of phototherapy, or the length of hospital stay? Is abdominal massage safe and feasible for full-term newborns? Researchers will compare newborns who receive routine newborn care plus abdominal massage with newborns who receive routine newborn care alone to determine whether abdominal massage improves bilirubin-related and clinical outcomes.
Participants will:
Be randomly assigned in a 1:1 ratio to either the abdominal massage group or the routine-care group.
Receive routine newborn care, including feeding support, jaundice observation, bilirubin measurement, and phototherapy when clinically indicated.
In the intervention group, receive gentle abdominal massage for 10 to 15 minutes twice daily during hospitalization for 2 to 5 days. Massage will begin at least 1 hour after feeding while the newborn is awake, calm, and medically stable.
Have transcutaneous bilirubin measured at 0-6, 24, 48, 72, 96, and 120 hours after birth. A blood bilirubin test may be performed if the transcutaneous bilirubin level approaches the treatment threshold.
Have information recorded about bowel movements, time of first bowel movement, feeding, diaper use, body weight, phototherapy, length of hospital stay, and any adverse events.
Be followed through medical records for 7 days after discharge to determine whether the newborn returns for evaluation or is readmitted because of jaundice.
Inclusion Criteria:
Full-term newborns with a gestational age of 37 weeks or greater. Birth weight of 2,500 grams or greater. Apgar score of 7 or greater at 5 minutes after birth. Stable vital signs. No significant abnormal findings following examination by a physician after birth.
Eligible to begin the study procedures at least 1 hour after the first feeding. Written informed consent provided by a parent or legal guardian.
Exclusion Criteria:
Preterm newborns or newborns with very low birth weight. Congenital gastrointestinal abnormalities, abdominal wall defects, or conditions requiring surgery.
Major congenital diseases or chromosomal abnormalities. Admission to a neonatal intensive care unit. Sepsis, respiratory distress, or other acute or critical medical conditions. Pathologic jaundice, including hemolytic jaundice or biliary atresia. Bilirubin levels meeting criteria for immediate phototherapy or exchange transfusion.
Abdominal skin infection, skin damage, or any condition making abdominal massage unsuitable.
Considered unsuitable for participation by the attending physician.
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The data analyst will be masked to group assignment. Group labels will be coded as Group 1 and Group 2, and the allocation code will not be revealed until the primary statistical analyses are completed.
Newborns assigned to this arm will receive routine newborn care plus standardized abdominal massage. The massage will be performed by trained nurses for 10 to 15 minutes per session, twice daily, during hospitalization for 2 to 5 days. Massage will be provided at least 1 hour after feeding while the newborn is awake, calm, and clinically stable. The procedure includes gentle clockwise abdominal massage, gentle flexion of the knees toward the abdomen, and light circular massage of the lower abdomen and groin area.
Newborns assigned to this arm will receive routine newborn care, including feeding support, jaundice observation, transcutaneous or serum bilirubin measurement, phototherapy when clinically indicated, and discharge education. No abdominal massage will be provided during the study period.
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