Research on the practice of massaging the head of a baby with hot water and ointments in Ghana. By Dzamesi Yael (Ph.D. in Science Education)
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The following Figure 3, describes the changes of the body heat measured in degrees Celsius over two different spots on the head during the bath. Brown line represents the changes of body heat measured over the neck, and yellow line represents the changes of body heat measured over the anterior fontanelle.
Three parameters are described along the horizontal (x) axis:
1. The numbers in an increase order represent the time that passed during the bath in minutes.
2. Under the minutes are the stages of the bath.
3. Under the stages of the bath is the behavior of the baby, which is written in red color.
Figures 3, A and B, describes the bath of Kwesi which was long and it lasted 27 minutes. As a result of that, Figure 3 had to be divided into 2. A describes the first 13 minutes of the bath, and B describes the last 14 minutes of the bath.
No hot water was added to the initial amount of water in the bucket during the bath. ​
Figure 3, A and B: Massaging and bathing the baby with hot water - Kwesi.
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A bath to Kwesi
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Abstract.
During the bath, the hot towel was placed directly on the anterior fontanelle. As a result of that, the anterior fontanelle was continually under a high temperature of at least 40 to 41.5 degrees Celsius. The temperature over the neck mainly indicated the temperature of the blood flowing back from the brain to the body. Three minutes after the neck temperature rose to 39 degrees Celsius, there was a drastic change in the behavior of the baby. The baby who was quiet at first, began to cry. After two minutes of crying, he started screaming in such a force that it was almost unbearable to hear or see him suffering. His screaming subsidized when his mother started to massage his body. However, he started screaming again when she massaged his chest even though the water was cooler. After that Kwesi continue to cry until the end of the bath.
Watch "Video 3" of the hot water bath and read the conversation of the women following the video.
Kwesi is an example of a bath with hot water. His behavior was completely different from Vincentia (Figure 1), and also different from Kofi (Figure 2). ​The temperature over his anterior fontanelle rose above 40 degrees Celsius immediately at the beginning of the bath and remained so for the next 11 minutes (Figure 3A). The hot towel was placed directly on the anterior fontanelle, and it was continually under a high temperature of at least 40 to 41 degrees Celsius. Subsequently, the temperature over the neck was elevated, and it reached its maximum of 39 degrees Celsius after 6 minutes (marked with red circle in Figure 3A). At this temperature there is an alternation of the function of the Blood Brain Barrier. Then, it took additional 3 minutes to see a drastic change in the behavior of Kwesi even though the neck temperature dropped (marked with blue circle in Figures 3A). After 9 minutes of the bath, Kwesi, who had been quiet from the beginning of the bath, started crying and after two minutes his cries became screams. He was struggling with his hands that moved in the air, unable to remove the hot towel from his head. His screams reached such a pick that those two minutes of watching him screaming were almost unbearable (from 11 to 13 minutes of the bath, Figure 3A). However, his mother who was bathing him showed no alarm and continued with the routine of the bath. Once the mother started massaging the body, Kwesi stopped screaming but continued crying (from 13 minutes to the bath, Figure 3B). The mother massaged his body (excluding the chest) for the next 7 minutes and along all that time the temperature measured over the neck and the anterior fontanelle were low and around 36 to 37 degrees Celsius. Then, the mother started massaging the chest (from 20 to 23 minutes of the bath, Figure 3B). Kwesi started screaming again even though all temperatures were low. The mother did not apply more strength on the chest than she applied on the rest of the body. It was obvious he felt more pain in the chest. Once the mother finished massaging the chest and started bathing him, the screams of Kwesi were reduced to crying until the end of the bath (Figure 3B).
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Video 3: Pressing too hard on the head of the baby.
The baby in this video is older. During the massage, the mother (M) of the baby who massages the head of the baby requests additional hot water. The woman who takes the video (W) helped to pass the a bucket with additional hot water into the room, therefore at those moments the camera was not focus on the baby.
The following conversation was between the women (W) who took the video and the mother (M) who massaged the head of her baby.
(M) Put more hot water, is not hot enough.
(W) But the water is already too hot.
(M) This is how we bath when the baby is older.
The sister of the mother who pours the water says: It is too hot, it is burning me.
(W) You are pressing too hard on the head of your baby.
The mother is laughing.
This baby is older than Kofi and Kwesi, and therefore was able to stand higher temperature. But it does not mean that the hot water does not damage his brain.
At the moments of the massage no external damage can be seen on the baby. The effect of the hot water massage can clearly be seen when the children start learning in the school. To understand the difficulty in learning Ghanaian children face in the school (possible as a result of the massage with the hot water on their head) see "Learning impairments", or "Summary of difficulties in learning" pages.