Reflexology can be a valuable aid to the treatment and care of babies and children, both those who are healthy and those who are unwell. Reflexology builds on the concept of touch and massage, which has become extremely popular and is well researched in the field of paediatrics (Field 2000). However, the opportunities for qualified practitioners to provide regular reflexology treatments for children may be limited by a variety of factors; for example if the baby is asleep or the parent is attending to other siblings. Significantly, teaching parents to give reflexology treatments to their child will be far more beneficial, helping to strengthen the bond between them and helping the parents to overcome any negative emotions associated with the baby’s or child’s condition. Additionally, reflexology can give them some manual skills to treat different conditions which may affect their baby or child, such as colic in infants or pain in those who are ill.

When working with babies, it is particularly important that a parent gives the treatment rather than the therapist; the parent will know the baby best and will have more understanding of, and the ability to interpret non-verbal language cues, which will enable him or her to work effectively and safely with the baby. Older children too can benefit from reflexology, but the frequency, style and manner of the treatment needs to incorporate their changing lifestyle. Parents may need to be encouraged to provide reflexology for general relaxation at times which suit the child’s lifestyle, such as fitting around homework, extracurricular activities and home life. Reflexology with children and babies should be fun, using nursery rhymes with babies, which they will quickly come to associate with specific movements. Examples include ‘Incey Wincey Spider’ when working the spine reflex zone, and ‘This Little Piggy’ when working over the toes. For older children, individualised stories can be used, which can be adapted as the child grows or the reason for the treatment alters. For boys, reflexology may provide relief of fatigue and muscle stiffness after playing sports; for teenage girls it could be incorporated as part of a beauty treatment and include a manicure or hairstyling. Whatever the treatment is called, it could become a very special time between parent and child, offering an opportunity for a child to open up about any worries or concerns.

If the child is ill and the parents have been given a diagnosis of a life-threatening illness, they may have feelings of hopelessness, despair and guilt. They may feel that they could have done more to prevent the situation and this may lead to an element of rejection of the child, a ‘pulling back’ in an attempt to protect themselves from grief. In this case, the baby may then be denied the positive touch which is fundamental for survival, and teaching reflexology techniques at this time offers the parents a positive role in the care of their baby/child. Within the confines of a hospital, giving touch to fragile babies and children requires sensitivity and mindfulness (see Ch. 5) and the practitioner needs to be sensitive to the emotional well-being of the parents (Tipping 2005). Parents, concerned about the stability of their child’s condition, may be fearful and lack confidence to touch and handle them, so need encouragement to touch in a gentle, sympathetic and positive way (Tipping 2002) (see Case Study 10.1).

Negative emotions associated with learning can inhibit the parents’ ability to retain information or may compromise their manual dexterity (Antonacopoulou & Gabriel 2001). If the baby or child is extremely ill, the parents may have a fear of touching them, which can inhibit their interaction and be devastating for the parents and the child. Rather than seeing himself as a primary caregiver in this situation, the father may view his role as one of support for the mother and other children (Deeney et al. 2009), which may be due to a feeling of lack of control (Arockiasamy et al. 2008). Teaching a father how to use reflexology techniques can be empowering, helping him to regain a sense of purpose in the care of his infant. In the event of life-threatening or terminal illness, parents are totally unprepared on all levels to deal with the situation (Milstein & Raingruber 2007) and it is on these occasions that healing measures such as reflexology become of paramount importance.

There are many benefits which come from teaching parents to use reflexology techniques with their baby or small child. It can help the parents to regain an element of control at a time when they are feeling uncertain and insecure, especially if the baby has been admitted to a potentially intimidating environment, such as a neonatal unit or ward (Figs 10.1, 10.2). Importantly, reflexology can induce a relaxation response in the giver as well as the recipient. To aid relaxation of the parent it may be appropriate to offer them a treatment, so any anxiety that they have is diminished and not passed to the baby. This will also facilitate the release of prolactin in mothers to aid lactation, and may reduce the impact of postnatal depression and anxiety, through the release of oxytocin (Tipping & Mackereth 2000). If this treatment is carried out with the parent holding the baby, both should benefit from the treatment.

Reflexology techniques can also be taught to parents to enable them to treat their baby or child when it is suffering from symptoms such as colic. This condition, whilst being very common, can be upsetting for the parents because they see the baby in distress, crying for long periods of time, leaving them stressed, helpless and deprived of sleep. Benedbaek et al. (2001) showed a significant improvement in symptoms of colic in a group of babies (n = 63) who received reflexology when compared to the control group. The author suggests that a treatment should be given about 1 hour before the usual onset of symptoms as suggested for massage by Carpenter & Epple (2009), thus helping to calm the baby and the parents, and limiting the severity of the impending colic, or possibly even preventing it from occurring. Other symptoms common in children have also been shown to respond to reflexology, including constipation (Bishop et al. 2003) and reduction of pain (Stephenson et al., 2000, Stephenson, 2003 and Lacey, 2002), and offering a positive intervention for parents to use when their baby is troubled by problems such as teething, earache or tonsillitis.

Field et al. (2001) argue that touch deprivation can lead to suppression of the immune system, leading to a higher incidence of infections, and it has been suggested that reflexology may strengthen the immune system, although much of this work has been done with adults (see Ch. 2). Providing regular touch therapies, such as reflexology helps to promote positive and health-enhancing contact between parent and child.

Teaching parents to become involved in the child’s care also has the potential to minimise the ‘medicalisation’ of the child’s condition (Illich 1979), which occurs in hospital when the child is treated by an ‘expert’. This is especially significant in long-term conditions, which can take many months to resolve, or where a life-limiting illness is present. Where appropriate, teaching parents reflexology techniques enables them to use the intervention at home; this helps to support the overall management and care of the child with ongoing medical conditions. A family-centred approach where the parents are actively involved in their child’s treatment may help families to feel that they are integral to the treatment. Parents often feel helpless and disempowered during their child’s treatment, and involving them in a proactive way may contribute to improving treatment outcomes and the child’s well-being. Field and colleagues have completed a number of research studies teaching parents to massage their children, with evidence of improvement in a variety of outcomes (Field et al., 1997, Field, 2000 and Field et al., 2001).

The baby must be assessed on an individual basis prior to each treatment/teaching session, observing non-verbal cues and taking into account the current condition. Newborn babies can easily become overstimulated by reflexology, as their experience of sights and sounds is intense during the first few weeks of life (Carpenter & Epple 2009). The Meissner corpuscles (the main touch receptors in the skin) are very tightly packed together at birth, so babies may experience a reflexology treatment more intensely than adults, which could be very stimulating or deeply relaxing. Observing cues is essential to determine the optimum duration and frequency of treatment. The skin of a neonate is often fragile, depending on maturity and age, and it may be appropriate to wait until the skin has matured before reflexology is attempted; the skin should be carefully inspected prior to each reflexology treatment. If the baby has an unstable temperature care should be taken to avoid the baby becoming either too hot or too cold during the treatment.

If there is any cerebral irritation, infection, unstable blood pressure, respiratory difficulty, blood glucose fluctuations, congenital heart conditions, abnormal platelets or haematological disorders, the baby should not be treated without the permission of the paediatrician. If the practitioner is in any doubt about the safety and appropriateness of treating a baby on a particular occasion, she or he should discuss this with the relevant health professional, especially if the child is receiving any medications, or their condition has deteriorated.

When a child’s condition is very unstable, excessive handling can be overstimulating and reflexology may not be appropriate. However, with skills and sensitivity, a reflexology treatment can be adapted to the needs of a fragile infant, and become a positive and memorable experience for both parent and baby (Case Study 10.2).

If the reflexologist is employed in an environment in which working with children is part of the job description, professional indemnity insurance cover will be provided by the employer. It is mandatory that anyone working with children (and other vulnerable groups) has had a Criminal Records Bureau (CRB) disclosure search performed, a procedure which is normally undertaken by the employer before appointment. It is worth noting that a CRB check undertaken by an employer is not transferable and repeat searches may need to be done if the reflexologist changes place of practice.