Why Has Infant Massage Survived Across Cultures?

By Aadvik Agastya · About 12 min read

In this investigation

Long before infant massage became a parenting class or wellness service, families across Asia and elsewhere were rubbing, stroking and oiling babies as part of ordinary care. In parts of India the practice remains remarkably common. Its survival raises two different questions: what does loving touch do for an infant, and what—if anything—does the oil add?

A tradition transmitted through hands

Infant massage in India is not a marginal survival. A survey of 1,497 caregivers in Maharashtra and Madhya Pradesh found that 93.8 percent reported massaging their infants. Most began during the first week of life, massage was usually daily, and oil was used in 97 percent of cases. Grandmothers and other older women commonly transmitted the practice.

The details, however, were far from uniform. Preferred oils differed between states, as did technique. A 2026 Kerala survey likewise found widespread oil massage but substantial variation in practice and limited formal knowledge of Ayurvedic recommendations. That diversity matters: a gentle parent-led massage with coconut oil is not scientifically interchangeable with forceful stretching, mustard oil, herbal preparations or massage performed by a traditional attendant.

Why would so many families keep doing it?

Infancy is a period in which touch already performs several jobs. A caregiver holds, feeds, cleans, comforts and carries the baby. Massage formalizes some of that tactile interaction into a repeated routine. It creates focused contact between caregiver and infant and, when gentle, can be soothing.

Traditional explanations add further purposes: growth, strength, sleep, skin care and protection. Indian caregivers commonly report beliefs that massage improves growth, bone strength and sleep. These beliefs document why families value the practice; they do not by themselves prove each physiological effect.

Massage and oil are two interventions

A central evidence problem is that infant oil massage combines tactile stimulation with a topical substance. Massage may affect relaxation, interaction or activity. Oil may alter friction, hydration and the skin barrier. Different oils can behave differently on infant skin. When studies combine both, assigning the outcome to one component becomes difficult.

This distinction is particularly important for newborns because their skin barrier is still developing. Preterm and low-birth-weight infants are not simply smaller versions of healthy full-term babies; evidence from neonatal units cannot automatically be generalized to routine massage of every infant at home.

Where the evidence is most promising

Research on massage and emollient therapy has produced encouraging findings in some neonatal populations, particularly preterm or low-birth-weight infants. Studies and evidence reviews have investigated weight gain, thermoregulation, skin-barrier function, infection and developmental outcomes. Some benefits appear plausible and clinically relevant, but effects depend on population, technique and topical agent.

For healthy full-term infants, the evidence is less definitive. Contemporary clinical guidance therefore tends to support gentle, responsive massage while acknowledging that stronger claims about growth, sleep or development require better standardized research.

THE EVIDENCE

Infant massage has plausible benefits and stronger evidence in some preterm and low-birth-weight settings. For healthy term babies, gentle massage may support interaction and wellbeing, but the size and durability of many claimed effects remain uncertain.

The choice of oil is not trivial

Traditional practice uses many oils. Indian surveys report sesame-based preparations, coconut, mustard, olive and commercial baby oils among others. Cultural familiarity is not enough to establish equal dermatological safety. Oils differ in fatty-acid composition, occlusion and potential effects on the skin barrier.

That is why consensus guidance developed by paediatric and traditional-medicine experts emphasizes standardizing technique and choosing appropriate substances rather than treating every inherited method as harmless. Heat, vigorous pressure, forceful manipulation and skin reactions are preventable risks.

Touch may be the oldest part of the technology

One reason massage appears in many societies may be that its essential equipment is already present: a caregiver’s hands. The practice can combine observation of the baby’s responses, skin care, comforting and dedicated interaction. Communities then embed that simple act in local oils, beliefs, songs, bathing routines and family roles.

Cross-cultural recurrence therefore does not prove that every culture discovered the same hidden mechanism. It may show that humans repeatedly elaborated a basic caregiving behaviour—touch—into culturally meaningful infant care.

When tradition becomes too forceful

A baby does not need to endure pain for massage to work. Stretching joints forcefully, pressing hard, using excessively hot oil or continuing when an infant is distressed should not gain authority merely because a technique is traditional. A 2020 Indian survey found that although caregivers overwhelmingly perceived massage as harmless, practices included joint stretching and pressing, underscoring the need for practical safety guidance.

The most defensible modern version is responsive rather than rigid: gentle touch, attention to the infant’s cues, safe positioning, appropriate oil if used, and medical guidance when the baby is premature, unwell or has a skin condition.

Modern evidence separates massage from the oil placed under the hands

Infant massage combines tactile stimulation with a topical product in many cultures, but those are two interventions. Massage may influence behaviour, sleep, pain responses and parent–infant interaction, while oil affects friction and the skin barrier. A benefit from one component should not automatically be credited to the other.

This distinction becomes especially important in newborns because their skin barrier is still developing and different oils can have measurably different effects.

A 2022 systematic review found promising effects—but not a universal miracle

An updated systematic review of sixteen randomized or controlled studies involving more than 1,400 infants found signals of benefit for pain relief, jaundice and weight gain. The authors still urged caution because study quality, interventions and outcomes varied.

The result is a good example of moderate evidence: infant massage is plausible and often helpful, but the research does not support the idea that every traditional technique, pressure level or oil produces the same benefit.

Premature infants are a special evidence category

Preterm and low-birth-weight infants have thinner, more permeable skin and higher vulnerability to heat loss and infection. Older Cochrane evidence found massage associated with modestly greater daily weight gain in some premature infants, while more recent trials have explored topical emollient oils as skin-barrier interventions.

These neonatal-unit findings should not be generalized casually to vigorous home massage of healthy term babies. Fragile infants need protocols matched to medical status.

The skin-barrier evidence makes oil choice a safety issue

Indian pediatric skin-care guidance and contemporary reviews distinguish oils by fatty-acid composition and barrier effects. Sunflower and coconut oils have more favourable evidence in some neonatal settings, while mustard and olive oils have raised concerns about barrier disruption or irritation.

This directly challenges the idea that any edible or traditional oil is automatically suitable for infant skin. Historical familiarity is useful evidence of cultural persistence, not proof of dermatological equivalence.

Mustard oil is common precisely where caution is most needed

Surveys in South Asia show mustard oil remains widely used because families associate it with warmth, strength and tradition. Laboratory and human skin-barrier research, however, has raised concern that its high allyl isothiocyanate and fatty-acid profile can irritate or delay barrier recovery.

A respectful evidence-based approach does not ridicule the tradition. It preserves the massage while substituting a better-tolerated oil when necessary.

A 2024 meta-analysis asked whether oil massage can reduce infection in preterm infants

Recent systematic work has examined whether topical emollient oil application reduces infection among preterm infants, reflecting a plausible mechanism: a stronger skin barrier may reduce microbial entry. The research is important because neonatal infection can be life-threatening.

But infection outcomes depend on gestational age, hospital care, oil quality, application technique and hygiene. The result should not be simplified into “baby massage prevents infection” for all infants.

Touch may influence regulation because infants are built for close contact

Newborns depend on caregivers for warmth, feeding and regulation. Gentle touch is part of ordinary caregiving and can influence arousal and behavioural state. Massage formalizes and extends that tactile interaction.

Skin-to-skin care has its own strong evidence base, especially around temperature regulation and breastfeeding. It should not be conflated with oil massage, but together these practices show that close physical contact can be biologically meaningful.

Parent–infant interaction may be one of the most durable benefits

A massage routine requires the caregiver to watch the infant’s face, breathing and body cues closely. Over time, this can increase confidence in reading when the baby is relaxed, overstimulated, hungry or uncomfortable.

This relational benefit is difficult to capture in a weight-gain trial but may help explain why the practice persists strongly across generations.

“Strong massage makes strong bones” is not supported

Families sometimes believe forceful stretching or pressing will straighten limbs or strengthen bones. Infant bones and joints do not need manual moulding, and excessive force can injure soft tissue or joints.

Modern pediatric guidance favours gentle, responsive massage. Crying, stiffening, colour change or distress should be treated as signals to stop rather than evidence that the baby needs to “get used to it.”

Timing after feeding matters for comfort

Massage immediately after a large feed can provoke regurgitation or discomfort. Indian pediatric guidance commonly recommends choosing a period when the baby is quiet and alert rather than hungry, deeply asleep or just fed.

This practical timing principle is more defensible than rigid clock-based rules because infant state changes from day to day.

Temperature and environment matter

Newborns lose heat more readily than adults. Undressing a baby for prolonged massage in a cold room can create thermal stress. A warm, draft-free environment and short sessions are therefore basic safety measures.

Traditional use of warmed hands or oil may partly reflect this comfort problem, although oil should never be heated enough to burn.

Purity of the oil matters because infant skin is not a kitchen surface

Cooking oils can be oxidized, fragranced, contaminated or stored in ways not designed for repeated application to newborn skin. Herbal mixtures add ingredients that may be poorly standardized.

Evidence-based neonatal care therefore favours products of known composition and good manufacturing quality rather than assuming that anything edible is automatically safe topically.

Massage should never delay urgent assessment

Poor feeding, lethargy, breathing difficulty, fever, jaundice that is worsening, persistent vomiting or abnormal movements require clinical evaluation. Traditional massage cannot diagnose or treat neonatal sepsis, severe jaundice or dehydration.

The safest role for massage is supportive care around a healthy or medically supervised infant, not an alternative to neonatal medicine.

The practice survives because it combines several rewards at once

It can moisturize skin, create warmth, calm some infants, give caregivers a repeatable interaction and satisfy family expectations about good care. Few household routines provide so many visible and emotional signals at once.

This layered utility explains cross-cultural persistence better than any single modern claim about growth hormones or bone strength.

Massage should follow the infant’s cues, not the adult’s schedule

A quiet, alert infant who relaxes with touch is a different candidate from a baby who is crying, ill, cold or overstimulated. Responsive caregiving means shortening or stopping a session when the infant turns away, stiffens, changes colour or becomes distressed.

This cue-based approach preserves the tradition while moving it away from forceful techniques performed simply because an elder believes the massage must be completed.

Bathing after oil massage should preserve skin warmth and safety

Many families bathe the baby after massage. Warm water and a short wash can remove excess oil, but very hot water, prolonged bathing or harsh cleansers can undermine the skin barrier that the oil was meant to support.

The evidence-based sequence is therefore gentle throughout: suitable oil, light pressure, warm environment and mild cleansing rather than a stronger version of every step.

The caregiver’s hands should be clean before the oil is

Infant massage creates prolonged direct contact with a newborn’s skin. Handwashing, clean nails and a clean container are therefore basic infection-control measures, especially for premature infants or babies with damaged skin.

Repeatedly dipping contaminated fingers into a shared oil jar can turn a benign product into a reservoir for microorganisms. Small single-use amounts or clean dispensing methods are preferable when infection risk is high.

Tradition can improve when families are shown the mechanism

Replacing mustard oil with a better-tolerated alternative may be easier when caregivers understand that the goal—warm, affectionate massage—remains intact. Evidence-based change works best when it preserves the valued act and alters only the risky material or technique.

The baby’s comfort, skin integrity and clinical condition should always outrank the expectation that a traditional massage must be completed exactly as an elder learned it.

Gentle massage can remain a meaningful family practice precisely because its useful core does not require force, medicinal claims or one compulsory oil. Responsive touch is compatible with modern neonatal safety.

What survives scrutiny?

Infant oil massage is an authentic and highly prevalent traditional practice in India and other parts of Asia.
The practice varies substantially in oil, technique, caregiver and intensity.
Massage and topical oil should be evaluated as separate components.
Evidence is most encouraging in selected preterm and low-birth-weight populations, but should not automatically be generalized to all infants.
Gentle tactile interaction is plausible as a soothing and caregiver-infant interaction practice.
Claims about stronger bones, superior intelligence or guaranteed sleep and growth exceed what routine community evidence can establish.
Oil choice and technique matter because newborn skin and joints are vulnerable.

The Tradivior Evidence Profile

Historical Authenticity — Strong. Infant massage has longstanding cultural continuity in India and multiple other societies.

Original-Purpose Evidence — Moderate. Caregivers consistently associate massage with growth, strength, sleep, skin care and wellbeing, though historical purposes vary across communities.

Scientific Mechanism — Moderate. Tactile stimulation, caregiver interaction and topical emollience provide plausible mechanisms, but oil-specific and broad developmental claims vary in support.

Experimental Evidence — Moderate. Evidence includes clinical studies and neonatal research, with stronger signals in particular vulnerable infant populations than for universal routine use.

Cross-Cultural Evidence — Strong. Infant massage and oiling occur in many societies, although techniques and meanings differ.

Modern Relevance — Strong. Gentle, safe, responsive massage can remain part of infant care when technique and topical products are chosen appropriately.

The Tradivior Conclusion

Partially Supported. Infant massage has survived because it turns one of humanity’s most basic caregiving behaviours—touch—into a repeated ritual of attention, soothing and skin care. Modern research gives the practice plausible and sometimes clinically meaningful support, particularly in selected neonatal populations. But not every oil, technique or inherited claim is equally safe or proven. The tradition survives scrutiny best when gentle touch is preserved and unsafe technique or exaggerated promises are left behind.

Continue investigating

Sources & further reading

Chaturvedi S et al. Prevalence and perceptions of infant massage in India: study from Maharashtra and Madhya Pradesh states. BMC Pediatrics, 2020.
Chaturvedi S et al. Protocol for Infant Massage in Home Settings: An e-Delphi Approach for Consensus Guidance Integrating Traditional Wisdom with Modern Medicine. Journal of Tropical Pediatrics, 2021.
Panicker KR et al. Traditional infant oil massage in early life: knowledge and practices among young mothers in Malappuram district, Kerala. Frontiers in Medicine, 2026.
National Academy of Medical Sciences task-force review of evidence-based traditional medicine, section on infant oil massage and emollient therapy.