Effectiveness of different massage techniques for breastfeeding mothers to increase milk production: A systematic review

Insufficient milk production is cited as the important reason for early termination of breastfeeding. Massage is an effective and low-risk treatment choice for promoting milk secretion. However, previous systematic reviews of the literature have not addressed the methods of massage therapies in terms of effects on milk production among postpartum mothers. This systematic review identified and synthesized massage techniques to increase milk production among Asian mothers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statements was applied as a guideline for this review. PubMed, CINAHL, Science Direct, Scopus, SAGE Journal, BMJ Journals, and other breastfeeding sources were searched covering English publications from 2009-2020. Experimental research studies were included according to inclusion and exclusion criteria. Screening and data extraction were performed systematically. The methodological quality was assessed using standardized critical appraisal instruments for quantitative studies from the Joanna Briggs Institute. Twenty-two studies from Asian countries were selected to review. Two groups of massage treatments consisted of partial body massage and breast massage. Combined massage techniques appeared to result in more milk volume, however, the existing studies were mostly of low and moderate quality due to unclear risks of bias and having heterogeneous data. The limitation of control group details, diversity of participants characteristics, and small sample size of the included studies prevented the combination of data across studies for meta-analysis. Further research is needed to improve the methodological rigor and standard measurements of milk volume for combining the overall effects of the interventions. Massage techniques can be an interesting choice for sustainable breastfeeding duration, however, massage skills need to be standardized for nurses and included in nurse education programs.