Comparative Effectiveness of Infant Massage and Foot Reflexology on Infant Sleep Quality: An Explanatory Mixed-Methods Study

Ivanie Dwi Gadilaj (Midwifery Study Program, Faculty of Health Sciences, Universitas Aisyah Pringsewu)
Fitriana Fitriana (Midwifery Study Program, Faculty of Health Sciences, Universitas Aisyah Pringsewu)
Iis Tri Utami (Midwifery Study Program, Faculty of Health Sciences, Universitas Aisyah Pringsewu)

Academic Hospital Journal
Vol 8, No 1 (2026)

Background: Adequate sleep is essential for optimal infant growth and neurodevelopment, as approximately 75% of growth hormone secretion occurs during sleep. Sleep disturbances in infancy remain prevalent and may adversely affect physical, emotional, and neurological development. Infant massage and foot reflexology are widely used non-pharmacological interventions to improve infant sleep quality; however, comparative evidence supported by both quantitative outcomes and caregiver experiences remains limited.Objective: This study aimed to compare the effectiveness of infant massage and foot reflexology on infant sleep quality and to explore maternal perceptions of sleep changes following these interventions.Method: An explanatory mixed-methods study was conducted using a quantitative quasi-experimental two-group pretest–posttest design, followed by a qualitative descriptive approach. The quantitative phase involved 32 infants aged 1-12 months with sleep disturbances, who were allocated to an infant massage group (n = 16) or a foot reflexology group (n = 16). Infant sleep quality was assessed before and after intervention using a structured sleep quality questionnaire. Data were analysed using the Wilcoxon Signed-Rank Test and Mann–Whitney U Test (α = 0.05). The qualitative phase included in-depth interviews with seven mothers, purposively selected from both groups, and the data were analysed using thematic analysis to explain and enrich quantitative findings.Result:   Both infant massage and foot reflexology significantly improved infant sleep quality (p < 0.001). However, post-intervention sleep quality was significantly higher in the infant massage group compared to the foot reflexology group (p < 0.001). Qualitative findings revealed improvements in sleep duration and continuity, reduced fussiness before sleep, and increased maternal confidence in managing infant sleep routines, particularly among mothers whose infants received massage therapy.Conclusion: Infant massage and foot reflexology are effective non-pharmacological interventions for improving infant sleep quality, with infant massage demonstrating superior effectiveness. The integration of quantitative and qualitative findings highlights infant massage as a practical and family-centred intervention to support healthy sleep in infancy.