The effect of body and mind stress-releasing techniques on the breastfeeding of full-term babies; a critical analysis of published interventional studies

Fotiou, Catherine; Siahanidou, Tania; Vlastarakos, Petros V.; Tavoulari, Evangelia; Chrousos, George P.

doi:10.1080/14767058.2016.1275547

Cited by 16 publications

(18 citation statements)

References 38 publications

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“…Such an approach could potentially stimulate the let‐down reflex resulting in more efficient milk ejection, especially when a mother intends or expects to breastfeed. Over a long period, this could help mothers to prolong breastfeeding duration, hence improving overall breastfeeding rates in a population (Fotiou et al, ). This is especially important given that breastfeeding rates worldwide are still below target levels (Victora et al, ),…”

Section: Introductionmentioning

confidence: 99%

“…Because the let-down-reflex is affected by maternal psychological state, it has been hypothesised that milk ejection and/or synthesis could be improved by reducing maternal psychological distress (Newton & Newton, 1948;Ueda et al, 1994), potentially through the use of relaxation therapy (Fotiou, Siahanidou, Vlastarakos, Tavoulari, & Chrousos, 2017;Shukri, Wells, Mukhtar, Lee, & Fewtrell, 2017). Such an approach could potentially stimulate the let-down reflex resulting in more efficient milk ejection, especially when a mother intends or expects to breastfeed.…”

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confidence: 99%

“…Such an approach could potentially stimulate the let-down reflex resulting in more efficient milk ejection, especially when a mother intends or expects to breastfeed. Over a long period, this could help mothers to prolong breastfeeding duration, hence improving overall breastfeeding rates in a population (Fotiou et al, 2017). This is especially important given that breastfeeding rates worldwide are still below target levels (Victora et al, 2016), To further our understanding of the physiological aspects of breastfeeding, specifically milk synthesis and ejection, in this review, we investigate the effects of attempts to induce a more positive maternal psychological state on breastfeeding outcomes, focussing in particular on the direct effects of relaxation intervention therapy on milk volume and milk composition (including bioactive factors such as cortisol) that could be influenced by psychological state.…”

mentioning

confidence: 99%

“…These mothers are often reliant on milk expression for long periods of time and are less likely to establish breastfeeding than mothers who deliver a healthy term infant (Bonet et al, 2011;Lee & Gould, 2009;Merewood, Brooks, Bauchner, MacAuley, & Mehta, 2006). Previous reviews on the effects of the relaxation therapy mainly involved patients in hospital (Kwekkeboom & Gretarsdottir, 2006;Pelekasis, Matsouka, & Koumarianou, 2016;van Dixhoorn & White, 2005), and to our knowledge, only one recent review has reported the effects of relaxation interventions in breastfeeding women (Fotiou et al, 2017). This review only included mothers of full-term infants, and their main focus was the influence on breastfeeding success including breastfeeding initiation and duration rates (Fotiou et al, 2017).…”

mentioning

confidence: 99%

“…Previous reviews on the effects of the relaxation therapy mainly involved patients in hospital (Kwekkeboom & Gretarsdottir, 2006;Pelekasis, Matsouka, & Koumarianou, 2016;van Dixhoorn & White, 2005), and to our knowledge, only one recent review has reported the effects of relaxation interventions in breastfeeding women (Fotiou et al, 2017). This review only included mothers of full-term infants, and their main focus was the influence on breastfeeding success including breastfeeding initiation and duration rates (Fotiou et al, 2017).…”

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The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: A systematic review

Shukri

Wells

Fewtrell

2017

Maternal & Child Nutrition

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Maternal psychological state is recognised to influence lactation success, largely by affecting milk ejection. Thus, increased psychological distress can disrupt milk flow and in the long‐term, affect milk synthesis. Conversely, it is possible that milk ejection could be improved by using relaxation therapy during breastfeeding. We performed a systematic review to evaluate the effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes and to assess the consequent impact(s) on infant growth and behaviour. A literature search was performed using the PRISMA guidelines where we included intervention studies (including nonrandomised controlled studies) using relaxation therapy in breastfeeding mothers during the post‐natal period. Out of 147 identified records at the initial search, 5 studies were eligible, of which 3 were randomised controlled trials and 2 were nonrandomised or quasi‐experimental studies. These studies were conducted in Europe, America, and India and included 311 mother–infant pairs, of which 64 infants were full‐term and 247 were premature infants. Relaxation therapy was shown to increase milk yield in mothers of preterm infants in 2 randomised trials, however, the milk sampling protocol for these studies could be questioned. None of the studies investigated the consequent effects on infant outcomes. Overall, limited evidence was found on the effectiveness of relaxation therapy on breast milk composition and infant outcomes. Experimental studies with better standardisation of protocol and robust methodological design are needed to investigate the effectiveness of relaxation therapy on both breastfeeding and infant growth and behavioural outcomes.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: A systematic review

Shukri

Wells

Fewtrell

2017

Maternal & Child Nutrition

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Lactation-focused audio relaxation versus standard care for mothers of very preterm infants (the EXPRESS randomised clinical trial)

Levene,

Hardy,

Bell

et al. 2024

Pediatr Res

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Background Mothers of very premature newborns often have low milk supply. Systematic review has shown increased milk quantity with relaxation interventions. We hypothesised that a self-directed audio relaxation and lactation-specific visualisation would increase milk quantity after a very premature birth. Methods Unmasked, randomised, controlled trial, recruiting 132 participants in four United Kingdom neonatal units. Eligible women had given birth to one or two infants between 23+0 and 31+6 weeks of gestation. The intervention was a 12-min voice recording including breathing exercises, muscle relaxation and lactation-specific visualisation. Primary outcome was the highest 24-h breastmilk weight expressed on any of day 4, day 14 or day 21 after birth. Results Mean birth gestation was 27.8 weeks (SD 2.4), with 26% of participants giving birth under 26 weeks (34/132). Adjusted mean difference in primary outcome was 73.9 g (95% CI −61.7 to 209.5, p = 0.28). Spielberger State-Trait Anxiety Index adjusted mean difference was −1.9 (−8.2 to 4.3, p = 0.54). The majority of relaxation group participants felt the intervention was relaxing (32/42, 76%). Conclusions There was no beneficial effect of this relaxation intervention on milk quantity. Mothers of very premature infants may value relaxation interventions but they are unlikely to have a large effect on milk quantity. Impact This randomised trial did not show a beneficial effect of a self-directed audio relaxation and visualisation on mothers’ own milk quantity expressed after very preterm birth. Mothers of very and extremely preterm infants may value relaxation interventions, but they are unlikely to have a large effect on milk quantity. Prior systematic review of mixed populations has shown an increase in mothers’ own milk quantity with relaxation interventions. Combining this study with existing meta-analysis could result in a new hypothesis that the lower the gestation at birth, the smaller the impact of relaxation on milk quantity.

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A Randomized Control Trial of Meditation for Mothers Pumping Breastmilk for Preterm Infants

et al. 2022

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Objective: Mothers of preterm infants face unique challenges in establishing milk supply. We hypothesized that daily meditation practice while pumping would increase milk volume. Study Design: This was a randomized control trial examining the effect of meditation on the breastmilk supply of women delivering preterm infants. The meditation group engaged in daily use of a mindfulness-focused meditation app in addition to routine lactation support. The primary outcome was mean breastmilk volume on the infant’s 9th day of life. Secondary outcomes included use of lactation-promoting behaviors, continuation of breastfeeding and measures of mental health and breastfeeding self-efficacy by validated questionnaires. A per protocol analysis examined the association of frequent meditation with these breastfeeding and mental health outcomes. Results: Sixty women were analyzed. Mean milk volume was 647.1 ± 467.8 mL in the meditation group and 514.9 ± 393.5 mL in the routine care group (P = 0.27). Median number of pumping sessions was 7 (IQR 5-8) in the meditation group, compared to 6 (IQR 4-7) in the routine care group (P = 0.11). Other lactation-promoting behaviors, breastfeeding continuation and questionnaire scores were similar. Adjusting for confounders, we found an increase in breastmilk production of 223.2 mL (95% CI 98.8 - 347.5, P = 0.001) and in pumping episodes by 0.93 (95% CI 0.16 - 1.70, P = 0.020) associated with frequent meditation. Skin-to-skin contact was increased to 100% (P = 0.006) among women who meditated seven or more times. Adjusted odds of a clinically significant Edinburgh Postnatal Depression Scale score of > 9 was 0.057 (95% CI 0.0014- 0.711, P = 0.023) with frequent meditation. Conclusion: Breastmilk production was similar in mothers practicing meditation compared to those receiving routine lactation support. For women engaging in frequent mediation, there may be an effect in establishing breastmilk supply and reduction of depression symptoms.

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The effect of body and mind stress-releasing techniques on the breastfeeding of full-term babies; a critical analysis of published interventional studies

Cited by 16 publications

References 38 publications

The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: A systematic review

The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: A systematic review

Lactation-focused audio relaxation versus standard care for mothers of very preterm infants (the EXPRESS randomised clinical trial)

A Randomized Control Trial of Meditation for Mothers Pumping Breastmilk for Preterm Infants

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