Article information
Abstract
Objective
To perform a literature review aimed to analyze if acupoint stimulation increases lactation quantity.
MethodStudies were collected from five electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Eligibility criteria were full-text articles in English or Spanish with clinical trial design and observational studies, with no restriction on time of publication, in which the effect of acupoint stimulation on improving the quantity of lactation by conventional acupuncture, electroacupuncture, laser, fire needling, manual stimulation, tuina or catgut had been evaluated. Two authors independently extracted data for the characteristics and main outcomes of the studies selected for inclusion. The risk of bias (RoB 2 and Robins-I) and the quality assessments (GRADE) were performed. For the quantitative synthesis, the standardized mean difference was calculated for each individual study selected and then the data were combined using a random-effects meta-analysis.
ResultsA total of 14 studies were included in the present review. Most of the included studies exhibited some concerns in the risk of bias assessment. The quality of the studies was moderate. The meta-analysis showed that manual acupoint stimulation improves the lactation quantity (SMD 95% CI = 1.63 [1.13–2.13]; p < 0.0001).
ConclusionThe literature suggests that manual stimulation of acupuncture points improves the amount of milk produced during lactation.
Keywords:
Breastfeeding
Lactation disorder
Hypogalactia
Acupuncture therapy
Acupuncture points
Resumen
Objetivo
Realizar una revisión de la literatura para analizar si la estimulación de puntos de acupuntura aumenta la cantidad de leche producida durante la lactancia.
MétodoSe recopilaron estudios de cinco bases de datos electrónicas siguiendo las recomendaciones internacionales para la elaboración de revisiones sistemáticas y metaanálisis. Los criterios de elegibilidad fueron artículos de texto completo en inglés o español con diseño de ensayos clínicos y estudios observacionales, sin restricción en el tiempo de publicación, en los cuales se hubiera evaluado el efecto de la estimulación de puntos de acupuntura en la mejora de la cantidad de lactancia mediante acupuntura convencional, electroacupuntura, láser, agujas de fuego, estimulación manual, Tui Na o catgut. Dos autores extrajeron de forma independiente los datos de las características y los resultados principales de los estudios seleccionados para su inclusión. Se realizaron las evaluaciones de riesgo de sesgo y de calidad (GRADE). Para la síntesis cuantitativa, se calculó la diferencia de medias estandarizada para cada estudio individual seleccionado y luego se combinaron los datos mediante un metaanálisis de efectos aleatorios.
ResultadosEn la presente revisión, se incluyeron un total de 14 estudios, la mayoría de estos mostraron riesgo de sesgo y una calidad moderada. El metaanálisis mostró que la estimulación manual del punto de acupuntura aumenta la cantidad de leche materna (DME 95% IC = 1,63 [1,13−2,13]; p < 0,0001).
ConclusiónLa literatura sugiere que la estimulación manual de puntos de acupuntura mejora la cantidad de leche producida durante de lactancia.
Palabras clave:
Lactancia materna
Trastorno de la lactancia
Hipogalactia
Terapia de acupuntura
Puntos de acupuntura
Article
These are the options to access the full texts of the publication Enfermería Clínica (English Edition)
Subscriber
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
References
[1]
P. Brahm, V. Valdés.
Beneficios de la lactancia materna y riesgos de no amamantar.
Rev Chil Pediatr, 88 (2017), pp. 07-14
[2]
C.G. Victora, R. Bahl, A.J. Barros, G.V. França, S. Horton, J. Krasevec, et al.
Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.
Lancet, 387 (2016), pp. 475-490
[3]
S.M. Radke.
Common Complications of Breastfeeding and Lactation: An Overview for Clinicians.
Clin Obstet Gynecol, 65 (2022), pp. 524-537
[4]
S. Liu, Z. Wang, Y. Su, L. Qi, W. Yang, M. Fu, et al.
A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis.
Nature, 598 (2021), pp. 641-645
[5]
F. Kagitani, S. Uchida, H. Hotta.
Afferent nerve fibers and acupuncture.
Auton Neurosci, 157 (2010), pp. 2-8
[6]
M. Richardson, J. Freedman.
A Model for Acupuncture Training in Primary Care.
Acupunct Med, 23 (2005), pp. 135-136
[7]
M. Anne Cochrane.
Establishment of a nurse-run acupuncture treatment for hayfever. By Mary Anne Cochrane [corrected].
Complement Ther Nurs Midwifery, 8 (2002), pp. 17-20
[8]
L. Ulloa, S. Quiroz-Gonzalez, R. Torres-Rosas.
Nerve Stimulation: Immunomodulation and Control of Inflammation.
Trends Mol Med, 23 (2017), pp. 1103-1120
[9]
Z.H. Cho, S.C. Hwang, E.K. Wong, Y.D. Son, C.K. Kang, T.S. Park, et al.
Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms.
Acta Neurol Scand, 113 (2006), pp. 370-377
[10]
N.N. Yang, L.L. Lin, Y.J. Li, H.P. Li, Y. Cao, C.X. Tan, et al.
Potential Mechanisms and Clinical Effectiveness of Acupuncture in Depression.
Curr Neuropharmacol, 20 (2022), pp. 738-750
[11]
J.S. Yu, B.Y. Zeng, C.L. Hsieh.
Acupuncture stimulation and neuroendocrine regulation.
Int Rev Neurobiol, 111 (2013), pp. 125-140
[12]
X. Zhou, X. Li, H. Ding, Y. Lu.
Acupuncture effects on in-vitro fertilization pregnancy outcomes: A meta-analysis.
Complement Ther Clin Pract, 46 (2022),
[13]
W. Djaali, K. Abdurrohim, D.R. Helianthi.
Management of Acupuncture as Adjuvant Therapy for In Vitro Fertilization.
Med Acupunct, 31 (2019), pp. 361-365
[14]
C.A. Cruz Salas, E. López Espinosa, S. Quiroz-González.
Disminución del índice de pulsación de las arterias uterinas utilizando acupuntura geométrica para la preparación de transferencia de un embrión congelado en una paciente de 51 años: reporte de caso.
Rev Int Acupunt, 17 (2023),
[15]
Y. Xu, W. Zhao, T. Li, Y. Zhao, H. Bu, S. Song.
Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis.
PLoS One, 12 (2017),
[16]
K.H. Kim, J.W. Kang, M.S. Lee, J.-D. Lee.
Assessment of the quality of reporting for treatment components in Cochrane reviews of acupuncture.
BMJ Open, 4 (2014),
[17]
M. Cumpston, T. Li, M.J. Page, J. Chandler, V.A. Welch, J.P. Higgins, et al.
Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions.
Cochrane Database Syst Rev, 10 (2019),
[18]
R. Torres-Rosas.
Generalidades de la elaboración de la revisión sistemática en acupuntura.
Rev Int Acupuntura, 16 (2022),
[19]
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
[20]
J.A.C. Sterne, J. Savovic, M.J. Page, R.G. Elbers, N.S. Blencowe, I. Boutron, et al.
RoB 2: a revised tool for assessing risk of bias in randomised trials.
BMJ, 366 (2019), pp. l4898
[21]
G. Guyatt, A.D. Oxman, E.A. Akl, R. Kunz, G. Vist, J. Brozek, et al.
GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables.
J Clin Epidemiol, 64 (2011), pp. 383-394
[22]
R.K. Owen, N. Bradbury, Y. Xin, N. Cooper, A. Sutton.
MetaInsight: An interactive web-based tool for analyzing, interrogating, and visualizing network meta-analyses using R-shiny and netmeta.
Res Synth Methods, 10 (2019), pp. 569-581
[23]
W. Viechtbauer.
Conducting Meta-Analyses in R with the metafor Package.
Journal of Statistical Software, 36 (2010), pp. 1-48
[24]
K.M. Coburn, J.L. Vevea, M.K.M. Coburn.
Package ‘weightr’.
Estimating Weight-Function Models for Publication Bias, (2019),
[25]
D. Lüdecke.
esc: Effect size computation for meta analysis (Version 0.5. 1).
The Comprehensive R Archive Network, (2019),
[26]
S. Zapart, J. Knight, L. Kemp.
‘It Was Easier Because I Had Help’: Mothers’ Reflections on the Long-Term Impact of Sustained Nurse Home Visiting.
Matern Child Health J, 20 (2016), pp. 196-204
[27]
D. Koniak-Griffin, I.L. Verzemnieks, N.L.R. Anderson, M.-L. Brecht, J. Lesser, S. Kim, et al.
Nurse Visitation for Adolescent Mothers: Two-Year Infant Health and Maternal Outcomes.
Nurs Res, 52 (2003), pp. 127-136
[28]
D.L. Olds.
The nurse–family partnership: An evidence-based preventive intervention.
Infant Ment Health J, 27 (2006), pp. 5-25
[29]
D.T. Geddes, Z. Gridneva, S.L. Perrella, L.R. Mitoulas, J.C. Kent, L.F. Stinson, et al.
25 Years of Research in Human Lactation: From Discovery to Translation.
Nutrients, 13 (2021), pp. 3071
[30]
J. Verzura, D. Cortez, M. Fernandez, A. Díaz, A. Barrios, A. Rodriguez, et al.
Lepeptin in breast milk and maternal blood serum and its relation to the anthropometric measurements of infants.
Invest Clín, 60 (2019), pp. 141-152
[31]
M.E. Hernández-Aguilar, Y. Pérez-Cervera.
Investigación en acupuntura de México y el mundo: un análisis bibliométrico de la base de datos Web of Science.
Revista Internacional de Acupuntura, 17 (2023),
[32]
Y. Gong, N. Li, Z. Lv, K. Zhang, Y. Zhang, T. Yang, et al.
The neuro-immune microenvironment of acupoints—initiation of acupuncture effectiveness.
J Leukoc Biol, 108 (2020), pp. 189-198
[33]
S. Han.
The role of mechanoreceptors in acupuncture.
Medicine in Novel Technology and Devices, 17 (2023),
[34]
Y. Hu, H. Lu, J. Huang, Y. Zang.
Efficacy and safety of non-pharmacological interventions for labour pain management: A systematic review and Bayesian network meta-analysis.
J Clin Nurs, 30 (2021), pp. 3398-3414
[35]
P. Yin, N. Gao, J. Wu, G. Litscher, S. Xu.
Adverse events of massage therapy in pain-related conditions: a systematic review.
Evid Based Complement Alternat Med, 2014 (2014),
[36]
M.A. Rosetti, D.L. Spatz.
Effects of Acupressure on Lactation: An Integrated Review.
MCN Am J Matern Child Nurs, 47 (2022), pp. 345-352
[37]
M.L.-S. Chen, J.-Y. Tan, L.K.-P. Suen.
Auricular therapy for lactation: A systematic review.
Complement Ther Clin Pract, 29 (2017), pp. 169-184
[38]
J. Li, X. Hui, L. Yao, A. Shi, P. Yan, Y. Yao, et al.
The relationship of publication language, study population, risk of bias, and treatment effects in acupuncture related systematic reviews: a meta-epidemiologic study.
BMC Med Res Methodol, 23 (2023), pp. 96
[39]
D. Adams, T. Wu, Y. Yasui, S. Aung, S. Vohra.
Systematic reviews of TCM trials: how does inclusion of Chinese trials affect outcome?.
J Evid Based Med, 5 (2012), pp. 89-97
[40]
L. Wei, H. Wang, Y. Han, C. Li.
Clinical observation on the effects of electroacupuncture at Shaoze (SI 1) in 46 cases of postpartum insufficient lactation.
J Tradit Chin Med, 28 (2008), pp. 168-172
[41]
T. Huang, B.-Y. Chen, J.-Q. He, J. Bai, M. Gu, H.-T. Cao, et al.
Study on clinical efficacy of needling Danzhong(CV 17) in treating postpartum hypogalactia.
J Acupunct Tuina Sci, 6 (2008), pp. 27-31
[42]
H.Y. Zhou, L. Li, D. Li, X. Li, H.J. Meng, X.M. Gao, et al.
Clinical observation on the treatment of post-cesarean hypogalactia by auricular points sticking-pressing.
Chin J Integr Med, 15 (2009), pp. 117-120
[43]
J.-J. Zheng, Z. Yi, L. Ping, X.-Y. Wang.
Effect of Tuina at the breasts on postpartum lactation.
World J Acupunct-Moxibustion, 22 (2012), pp. 5-8
[44]
M.S. Esfahani, S. Berenji-Sooghe, M. Valiani, S. Ehsanpour.
Effect of acupressure on milk volume of breastfeeding mothers referring to selected health care centers in Tehran.
Iran J Nurs Midwifery Res, 20 (2015), pp. 7-11
[45]
D.M.W. Parwati, L.E. Hartati, T. Suheri.
The Effect of Breast Acupressure and Oxylosins Massage to Improve the Breast Milk Production in Postpartum Mother.
JMSCR, 5 (2017), pp. 28756-28760
[46]
D.R. Arumsari, I.W.A. Indrawan, E.S. Wahyuni.
The combination of acupressure and affirmation relaxation as an alternative method to increase breast milk production and breastfeeding self-efficacy.
Res J Life Sci, 5 (2018), pp. 66-76
[47]
P. Lu, Z.Q. Ye, J. Qiu, X.Y. Wang, J.J. Zheng.
Acupoint-tuina therapy promotes lactation in postpartum women with insufficient milk production who underwent caesarean sections.
Medicine (Baltimore), 98 (2019),
[48]
N. Sulymbona, S. As’ad, A. Khuzaimah, U.A. Miskad, M. Ahmad, B. Bahar.
The effect of acupressure therapy on the improvement of breast milk production in postpartum mothers.
Enferm Clín, 30 (2020), pp. 615-618
[49]
A.M. Maged, M.E. Hassanin, W.M. Kamal, A.H. Abbassy, M. Alalfy, A.N. Askalani, et al.
Effect of Low-Level Laser Therapy versus Electroacupuncture on Postnatal Scanty Milk Secretion: A Randomized Controlled Trial.
Am J Perinatol, 37 (2020), pp. 1243-1249
[50]
M. Ahmad, A.N. Usman, A.W. Sinrang, E. Alasiry, B. Bahar.
Potential of acupressure to be complementary care by midwives in postpartum women’s breast milk production.
Enferm Clín, 30 (2020), pp. 589-592
[51]
S. Suwikrom, N. Jaisamuth, P. Poonsawad.
Acupuncture to Boost Breast Milk in Postpartum Hypogalactia: Randomized Controlled Trial.
J Med Assoc Thail, 104 (2021), pp. 1930-1936
[52]
J. Sheng, Y. Ding, J. Wang, J. Zhang, X. Qi, H. Xia.
The Acceptability, Feasibility, and Effectiveness of Breast Massage Combined with Acupoint Stimulation to Promote the Volume of Human Milk in Mothers with Preterm Infants: A Pilot Study.
Evid Based Complementary Altern Med, 2021 (2021),
[53]
Wigati A, Astuti D, Nasriyah N, Hartinah D. The Effect of Back Acupressure on the Breast Milk Secretion and Infants Weight at the Martenity Ward, Fastabiq General Hospital, Pati, Central Java. 8th International Conference on Public Health, 2021: Sebelas Maret University.
[54]
J. Ya-pei.
Treatment of 62 Patients with Postpartum Lactation Disorder by Acupuncture.
J Acupunct Tuina Sci, 4 (2006), pp. 242-243
[55]
Q. Wen-dong, L. Wen-jun, G. Shu-zhong.
Effects of precondition of acupoint embedding thread on-enterokinesia and lactation in the postcesarean parturient.
Zhongguo Zhen Jiu, 27 (2007), pp. 417-420
[56]
H.C. Wang, J.M. An, Y. Han, L.N. Huang, J.W. Zhao, L.X. Wei, et al.
Multicentral randomized controlled studies on acupuncture at Shaoze (SI 1) for treatment of postpartum hypolactation.
Zhongguo Zhen Jiu, 27 (2007), pp. 85-88
[57]
J.Q. He, B.Y. Chen, T. Huang, N. Li, J. Bai, M. Gu, et al.
Randomized controlled multi-central study on acupuncture at Tanzhong (CV 17) for treatment of postpartum hypolactation.
Zhongguo Zhen Jiu, 28 (2008), pp. 317-320
[58]
I. Neri, G. Allais, V. Vaccaro, S. Minniti, G. Airola, P. Schiapparelli, et al.
Acupuncture treatment as breastfeeding support: preliminary data.
J Altern Complement Med, 17 (2011), pp. 133-137
[59]
J.J. Zheng, Y. Zhao, P. Lu, X.Y. Wang.
Effect of Tuina at breast on postpartum lactation.
Zhongguo Zhen Jiu, 32 (2012), pp. 159-161
[60]
L.P. Li, Y.H. Bao, J.M. Chu.
[Effects of postpartum lactation of puerperal women with qi and blood deficiency treated by catgut embedding therapy].
Zhongguo Zhen Jiu., 34 (2014), pp. 189-190
[61]
Y. Zhu, Y. Liu, X. Quan.
Application of acupoint massage in postpartum hypogalactia in puerpera.
Zhongguo Zhen Jiu, 38 (2018), pp. 33-37
[62]
Q. Fang, Y.L. Li, M.Y. Cai, W. Huang, C. Yuan, X.N. Chen.
Efficacy of Ropivacaine injection at acupoints for labor analgesia and its effect on breastfeeding and serum prolactin.
Zhen Ci Yan Jiu, 44 (2019), pp. 434-438
[63]
W. Asmalinda, D. Lestari.
Efek Kombinasi Back Massage dan Acupoint Massage terhadap Peningkatan Kadar Prolaktin.
Jurnal Kesehatan, 11 (2020),
[64]
N. Anita, M. Ahmad, A.N. Usman, A.W. Sinrang, E. Alasiry, B. Bahar.
Potency of back message and acupressure on increasing of prolactin hormone levels in primipara postpartum; consideration for midwifery care.
Enfermería Clínica., 30 (2020), pp. 577-580
[65]
W.W. Su, X.A. Gao, J.S. Tian.
Effect of electroacupuncture at Shaoze (SI 1) on breast milk volume and composition in postpartum hypogalactia.
Zhongguo Zhen Jiu, 40 (2020), pp. 13-16
[66]
G. Pierdant, K. Westphal, A. Lange, T.I. Usichenko.
Stimulation of Lactation Using Acupuncture: A Case Study.
J Hum Lact, 38 (2022), pp. 559-563
