Tactile kinaesthetic stimulation to promote gastrointestinal passage in preterm infants with very low birth weight - a qualitative study

Early enteral feeding in very low birth weight (VLBW) infants (<1500 g) remains challenging in neonatal intensive care. Tactile kinaesthetic stimulation (TKS) may support gastrointestinal passage; however, abdominal massage has been associated with potential adverse effects. To explore neonatal intensive care nurses’ experiences with non-abdominal TKS to promote gastrointestinal function in VLBW infants. Semi-structured interviews were conducted with twelve neonatal intensive care nurses holding TKS qualifications. Data were analysed using qualitative content analysis with deductive and inductive category development. Five categories emerged: concept and rationale, applied techniques, effects, implementation, and ethical considerations. Nurses described partial tactile interventions (e.g., foot reflexology, sacral massage), kinaesthetic movements, and positioning strategies. Reported effects included improved stool excretion, reduced flatulence, and enhanced feeding tolerance. Effective implementation required individualized adaptation, parental involvement, and respect for infant cues. Across TKS approaches, shared core principles included gentle, partial stimulation, parasympathetic activation, active movement promotion, and individualized, family-centred care. Core principles should be considered in future research and clinical practice.