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)
The practice.
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Abstract.
The women saw the fontanelles and the sutures in the head of the newborn baby as wounds or holes that came as a result of the pressure on the head of the baby during the delivery. They believed that air could pass through them into the head of the baby. Therefore, they treated these wounds with hot water. The baby is bathed twice a day, morning and evening with hot water, from day one of his or her life until the baby is two months old and sometimes until the baby is six months old. This period is the most critical developmental stage of the brain of the newborn baby as it is not yet fully developed at birth. The bath is in four stages: 1. Massaging the head. 2. Massaging the body. 3. Bathing the body. 4. Putting Robb ointment on the head of the baby. In a lukewarm water baths the babies were awake and calm. However, in the hot water baths, they were asleep, or they cried and wailed. These behaviors are abnormal. The baby who was asleep was suspected to be in a temporal stage of losing his consciousness which can be the result of the effect of the heat on the chemical balance in the brain. The baby who cried and wailed miserably was not only in pain but also in a potential damage. The potential damage in both babies was a combination of chemical changes and the structural changes of the nerves and synapses in the brain. The structural damage is a long-term damage, and it would affect the cognition of these babies, which later will be displayed in their learning impairments.
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The views of Ghanaian women on the nature of the anterior fontanelle, the soft spot, and the massage of the head of a baby with hot water.
The research involved understanding the way the women saw the anterior fontanelle and the sutures in the skull of their babies. They saw the fontanelles and the sutures as wounds or holes that came as a result of the pressure on the head of their baby during the delivery. They believed that the vibration of the skin on the anterior fontanelle is a breathing process. In their opinion, an air passes through the skin of the anterior fontanelle into the head. This can cause different illness to the baby and in order to avoid such misshapen, they massage the head of the baby with hot water. Even though many of them have been advised in the hospital after the delivery of their baby not to use the hot water to massage the head of the baby, they saw the advice as irrelevant to their life. For more information see "Why the practice is done" page.
The views of the traditional herbalist on the nature of the anterior fontanelle, the soft spot, and the massage of the head of a baby with hot water.
In order to examine the traditional roots of this practice, a herbalist was interviewed. The herbalist saw the existence of the fontanelles in the head of a baby as natural phenomenon that needs no medical interference. However, he saw the sutures as cracks that indicates a broken skull because of the delivery pressure and therefore, there is the need to massage the head of the baby with hot water in order to heal the sutures or cracks. For more details see "Traditional herbalist view" page.
​The traditional bath of babies in Ghana.
The research involved understanding the followings:
1. The details of the bath: How the baby was bathed, in particular the part of massaging the head of the baby. The temperature of the head of the baby and the temperature of the water, see "Bath on a doll test" page.
2. The effect of the heat on the behavior of the baby during the bath. The baby is bathed daily, twice a day, morning, and evening from day one of his or her life during the next two and sometimes up to six months. This period is the most critical developmental stage of the brain of a newborn baby as it is not yet fully developed at birth. For details on the development of the brain of a newborn baby see "Developmental processes in the brain" page.
1. The four stages of the bath:
A. Head: Massaging the head with hot water took from few minutes up to 15 minutes and the temperature of head of the baby was between 36.6 and 39.5 degrees Celsius (See section 2 in this page). The temperature of the water varied between 39.2 and 65.3 degrees Celsius. The ideal temperature for bathing a baby is between 37 and 38 degrees Celsius which is around the natural and healthy body temperature [131]. The temperatures of the water in the bucket measured in this research were far above not only the ideal temperature for bathing babies, but also far above the ideal temperature for bath for adults which is 39 degrees Celsius. Any temperature above 39 degrees Celsius can cause physiological changes in the body [9], because the body temperature is elevated, and the body can suffer from over heated condition which is called hyperthermia.
B. Body: Massaging the body took up to 20 minutes. The heat of the water at that time was reduced. The hands, legs and joints of the baby were massaged with the towel the same as the head was massaged.
C. Bath: Washing the body with soap and water took a few minutes. By that time the water was not hot, and the body of the baby was cool.
D. Medication: After the bath, an ointment such as Robb is applied on the head of the baby. Robb ointment contains chemicals which are harmful to the brain, and they are easily absorbed by the hot skin of the head. Especially it is easy for the harmful chemicals to reach the brain through the anterior fontanelle because there is not a bone underneath but a skin and a membrane.
For a full description of the bath of the baby see "How the baby is bathed" page.
2. The effect of the heat on the behavior of the babies during the bath.
Observations were made in lukewarm water and hot water baths. In the lukewarm water bath, the babies were awake and calm, and the temperature of their head was between 36.5 and 37.5 degrees Celsius. In the hot water bath, the babies seemed as if they were asleep, or they cried and wailed, and the temperature of their head fluctuated between 37 and 39.5 degrees Celsius. A temperature of a body of 39.5 degrees Celsius is defined as a state of a fever. Even in this critical situation the brain tries to regulate the heat of the body and the brain, that they should not be affected by the heat of the fever. However, in the massage of the head with hot water, the brain is heated directly and therefore the consequence damage to the brain should be more sever than in the situation that the baby has a fever or his or her temperature is 39.5 degree Celsius. Sleeping during a bath is abnormal behavior and we suspected that the sleeping baby was in a temporal stage of losing his consciousness which can be the result of the effect of the heat on the balance of chemical in the brain.
Crying to the extend of wailing is also an abnormal behavior of a baby during a bath and it indicated not only on a pain but also on a potential brain damage.
Both babies suffered from potential changes and therefore, damage in the structural of the nerves in the brain. The brain of a baby can not compensate fully on the damage. The structural damage is long a term damage, and it affects the cognition of the baby which later would be displayed in his or her Learning Impairments.
For more details on the behavior of the babies during the bath see "Observation of the daily bath" page. For the understanding of the meanings of the different behaviors observed in the baths and their possible causes see "Discussion of results" page.
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