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Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis

Importance: Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and exclusivity. There are connections between lactation and mental health. Objective: To appraise all available evidence on whet...

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Main Authors:	Levene, Ilana, Mohd Shukri, Nurul Husna, O'Brien, Frances, Quigley, Maria A., Fewtrell, Mary
Format:	Article
Language:	English
Published:	American Medical Association 2024
Online Access:	http://psasir.upm.edu.my/id/eprint/113421/1/113421.pdf http://psasir.upm.edu.my/id/eprint/113421/ https://jamanetwork.com/journals/jamapediatrics/fullarticle/2818395
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spelling	my.upm.eprints.1134212024-11-25T02:12:06Z http://psasir.upm.edu.my/id/eprint/113421/ Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis Levene, Ilana Mohd Shukri, Nurul Husna O'Brien, Frances Quigley, Maria A. Fewtrell, Mary Importance: Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and exclusivity. There are connections between lactation and mental health. Objective: To appraise all available evidence on whether the provision of relaxation interventions to lactating individuals improves lactation and well-being. Data Sources: Embase, MEDLINE, CINAHL, Allied and Complementary Medicine Database, Web of Science, and the Cochrane Library were searched on September 30, 2023, and topic experts were consulted. Study Selection: Two independent reviewers screened for eligibility. Inclusion criteria were full-text, peer-reviewed publications with a randomized clinical trial design. Techniques that were entirely physical (eg, massage) were excluded. A total of 7% of initially identified studies met selection criteria. Data Extraction and Synthesis: Two independent reviewers extracted data and assessed risk of bias with the Cochrane Risk of Bias 2 tool. Fixed-effects meta-analysis and Grading of Recommendations, Assessment, Development, and Evaluations guidelines were used to synthesize and present evidence. Main Outcomes and Measures: Prespecified primary outcomes were human milk quantity, length and exclusivity of human milk feeding, milk macronutrients/cortisol, and infant growth and behavior. Results: A total of 16 studies were included with 1871 participants (pooled mean [SD] age for 1656 participants, 29.6 [6.1] years). Interventions were music, guided relaxation, mindfulness, and breathing exercises/muscle relaxation. Provision of relaxation was not associated with a change in human milk protein (mean difference [MD], 0 g/100 mL; 95% CI, 0; 205 participants). Provision of relaxation was associated with an increase in human milk quantity (standardized mean difference [SMD], 0.73; 95% CI, 0.57-0.89; 464 participants), increased infant weight gain in breastfeeding infants (MD, z score change = 0.51; 95% CI, 0.30-0.72; 226 participants), and a slight reduction in stress and anxiety (SMD stress score, -0.49; 95% CI, -0.70 to -0.27; 355 participants; SMD anxiety score, -0.45; 95% CI, -0.67 to -0.22; 410 participants). Conclusions and Relevance: Results of this systematic review and meta-analysis suggest that provision of relaxation was associated with an increase in human milk quantity and infant weight gain and a slight reduction in stress and anxiety. Relaxation interventions can be offered to lactating parents who would like to increase well-being and improve milk supply or, where directly breastfeeding, increase infant weight gain. American Medical Association 2024 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/113421/1/113421.pdf Levene, Ilana and Mohd Shukri, Nurul Husna and O'Brien, Frances and Quigley, Maria A. and Fewtrell, Mary (2024) Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis. JAMA Pediatrics, 178 (6). pp. 567-576. ISSN 2168-6203; eISSN: 2168-6211 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2818395 10.1001/jamapediatrics.2024.0814
institution	Universiti Putra Malaysia
building	UPM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Putra Malaysia
content_source	UPM Institutional Repository
url_provider	http://psasir.upm.edu.my/
language	English
description	Importance: Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and exclusivity. There are connections between lactation and mental health. Objective: To appraise all available evidence on whether the provision of relaxation interventions to lactating individuals improves lactation and well-being. Data Sources: Embase, MEDLINE, CINAHL, Allied and Complementary Medicine Database, Web of Science, and the Cochrane Library were searched on September 30, 2023, and topic experts were consulted. Study Selection: Two independent reviewers screened for eligibility. Inclusion criteria were full-text, peer-reviewed publications with a randomized clinical trial design. Techniques that were entirely physical (eg, massage) were excluded. A total of 7% of initially identified studies met selection criteria. Data Extraction and Synthesis: Two independent reviewers extracted data and assessed risk of bias with the Cochrane Risk of Bias 2 tool. Fixed-effects meta-analysis and Grading of Recommendations, Assessment, Development, and Evaluations guidelines were used to synthesize and present evidence. Main Outcomes and Measures: Prespecified primary outcomes were human milk quantity, length and exclusivity of human milk feeding, milk macronutrients/cortisol, and infant growth and behavior. Results: A total of 16 studies were included with 1871 participants (pooled mean [SD] age for 1656 participants, 29.6 [6.1] years). Interventions were music, guided relaxation, mindfulness, and breathing exercises/muscle relaxation. Provision of relaxation was not associated with a change in human milk protein (mean difference [MD], 0 g/100 mL; 95% CI, 0; 205 participants). Provision of relaxation was associated with an increase in human milk quantity (standardized mean difference [SMD], 0.73; 95% CI, 0.57-0.89; 464 participants), increased infant weight gain in breastfeeding infants (MD, z score change = 0.51; 95% CI, 0.30-0.72; 226 participants), and a slight reduction in stress and anxiety (SMD stress score, -0.49; 95% CI, -0.70 to -0.27; 355 participants; SMD anxiety score, -0.45; 95% CI, -0.67 to -0.22; 410 participants). Conclusions and Relevance: Results of this systematic review and meta-analysis suggest that provision of relaxation was associated with an increase in human milk quantity and infant weight gain and a slight reduction in stress and anxiety. Relaxation interventions can be offered to lactating parents who would like to increase well-being and improve milk supply or, where directly breastfeeding, increase infant weight gain.
format	Article
author	Levene, Ilana Mohd Shukri, Nurul Husna O'Brien, Frances Quigley, Maria A. Fewtrell, Mary
spellingShingle	Levene, Ilana Mohd Shukri, Nurul Husna O'Brien, Frances Quigley, Maria A. Fewtrell, Mary Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
author_facet	Levene, Ilana Mohd Shukri, Nurul Husna O'Brien, Frances Quigley, Maria A. Fewtrell, Mary
author_sort	Levene, Ilana
title	Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
title_short	Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
title_full	Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
title_fullStr	Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
title_full_unstemmed	Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
title_sort	relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis
publisher	American Medical Association
publishDate	2024
url	http://psasir.upm.edu.my/id/eprint/113421/1/113421.pdf http://psasir.upm.edu.my/id/eprint/113421/ https://jamanetwork.com/journals/jamapediatrics/fullarticle/2818395
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score	13.223943

Relaxation therapy and human milk feeding outcomes: a systematic review and meta-analysis

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