Abstract
Background
Postpartum hypogalactia (PH) is prominent during lactation and may negatively impact the mother’s or infant’s health. Acupuncture is widely used to increase maternal breast milk production. However, the effects of acupuncture on PH remain unclear. Therefore, this review aimed to evaluate the efficacy and safety of acupuncture in individuals with PH.
Materials and methods
Articles on potentially eligible randomized controlled trials (RCTs) on acupuncture for PH published from database inception to October 2023 were retrieved from the PubMed, Web of Science, Cochrane Library, EMBASE, EBSCO, Scopus, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, WanFang, and VIP databases. Two reviewers independently screened the records, extracted essential information, and evaluated the methodological quality of the RCTs using the revised Cochrane risk-of-bias (RoB) tool. The primary outcome was a change in serum prolactin (PRL) levels before and after treatment. Secondary outcomes included milk secretion volume (MSV), total effective rate (TER), mammary fullness degree (MFD), and exclusive breastfeeding rate (EBR). Meta-analyses were performed using RevMan v5.4. Finally, the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation tool.
Results
This study included 19 RCTs involving 2,400 participants. The included studies were classified as having an unclear to high RoB. Our findings indicated that, overall, acupuncture showed a significant effect in increasing serum PRL levels (standardized mean differences [SMDs] = 1.09, 95% confidence interval [CI]: 0.50, 1.68), MSV (SMD = 1.69, 95% CI: 0.53, 2.86), TER (relative risk [RR] = 1.25, 95% CI: 1.10, 1.42), and EBR (RR = 2.01, 95% CI: 1.07, 3.78) compared to that in the control group; however, no difference in MFD (SMD = 1.17, 95% CI: –0.09, 2.42) was observed. In the subgroup analysis, acupuncture combined with Chinese herbs or conventional treatment was significantly more effective in increasing serum PRL levels, MSV, and TER than did Chinese herbs or conventional treatment alone. Moreover, acupuncture alone resulted in significantly higher serum PRL levels compared to Chinese herbs; however, this benefit was not observed for TER and MFD. The quality of evidence was critically low.
Conclusion
Acupuncture may effectively increase milk secretion in women with PH. However, owing to the low quality of evidence, further rigorously designed studies are warranted to confirm our findings.
Funder
Central Financial Transfer Payment to Local Projects in 2022 of National Administration of Traditional Chinese Medicine
Publisher
Public Library of Science (PLoS)
Reference66 articles.
1. The efficacy of diet supplemented with Lepidium sativum (Chandrashoor) on expressed breast milk volume in hypogalactic mothers—An open-label noncross-over randomized trial;M Ranade;Ayu,2021
2. Guideline: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services. Geneva: World Health Organization; 2017.
3. WHO. Global breastfeeding scorecard, 2018: Enabling women to breastfeed through better policies and programmes. 2018;July: 8. https://www.who.int/publications/m/item/global-breastfeeding-scorecard-2018-enabling-women-to-breastfeed-through-better-policies-and-programmes..
4. Promoting the practice of exclusive breastfeeding: a philosophic scoping review;TB Amoo;BMC Pregnancy Childbirth,2022
5. Breastfeeding-oriented education for parturients separated from their hospitalized infants: a qualitative study of nurses’ perspectives in Shanghai, China;H Feng;BMC Pregnancy Childbirth,2022