The Effect of Foot Reflexology on Breast Milk Volume of Mothers with Premature Hospitalized Infants: A Randomized Control Trial

Abstract

Abstract: Introduction: Due to the complications of milk deficiency in mothers of premature infants, some disadvantages of pharmaceutical and mechanical methods for increasing milk production in mothers and limited evidence regarding effect of reflexology on breastfeeding, this study was conducted to determine the effectt of foot reflexology on milk volume immediately after reflexology and daily breast-milk volume production (primary outcomes); daily formula milk volume consumption, and depression, anxiety and stress score (secondary outcomes) of mothers with premature hospitalized infants. Method: 74 nursing mothers with premature infants who did not start breast-feeding (born in the 28-34 weeks' gestation & aged 7-54 days postnatal), were randomly assigned into two groups. In both groups for seven days, once daily reflexology for each two feet were done for 10 minutes, the first 5 minutes was general massage for soles of feet and the second 5 minutes was massage and pressing of breast, Pituitary & solar plexus related areas in the intervention group and massage of unrelated areas (shoulder, eye and sciatica waist) in the control group. Results: One mother of each group did not receive the intervention more than one day. Outcomes in all mothers were assessed in days 2, 4 and 7. In the intervention group compared with the control group, there was a further increase post intervention milk volume in the 7th day [median (interquartile range) 7 mL (4.5 to 10) vs. 1 (-1 to 2), P<0.001], daily milk volume in 4th day [14 (3.5 to 55) vs. 3.0 (-3 to 25), P=0.020] and in 7th day [38 (9 to 107.5) vs. 5 (-3 to 16), P<0.001]. There were not statistically significant difference between two group in the other times (p>0.05). Overall (considering all three time-points values following the intervention) the amount of increase in the daily intake of formula milk by the infant in the intervention group was significantly less than the control group (P=0.023). There were no statistically significant differences between the groups in terms of mean scores of depression, anxiety and stress of mothers at the 7th follow-up day (p>0.05). Conclusion: The results showed the effect of reflexology on increasing breast milk of premature infant's mothers. So this method is suggested to be utilized for premature infant's mothers due to its simplicity, high acceptance & no reported side effects.