Effectiveness of Breast Massage on Enhancing Breast Milk Production in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Restricted accessReview articleFirst published online 2026
Effectiveness of Breast Massage on Enhancing Breast Milk Production in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
To evaluate the efficacy of breast massage (BM) in enhancing breast milk production in postpartum women, as compared to control interventions.
Methods:
A systematic review was conducted using PubMed, Scopus, ScienceDirect, TCI, and ThaiLis. Relevant articles were identified from inception to July 2025. Only randomized controlled trials (RCTs) reporting the effect of BM on breast milk production and breastfeeding discomfort were included. The risk of bias in the included studies was assessed using the Cochrane Collaboration’s tool. Data analysis was performed using RevMan 5.4.1.
Results:
A total of 18 RCTs with 1,099 participants were included. Compared with the control group, BM demonstrated a significantly greater effect on increasing breast milk volume (standardized mean difference = 0.76; 95% CI = 0.47, 1.05; p < 0.00001, I2 = 87%). Additionally, BM significantly reduced scores for breast engorgement, pain, and temperature, while increasing the number of infant urinations compared to the control group. However, the number of infant defecations did not significantly differ. Participants receiving BM also experienced greater resolution of breast engorgement, although there was no significant difference in complete breastfeeding rates. BM was also associated with a significantly lower anxiety level and a significant increase in serum prolactin levels compared to the control group.
Conclusion:
BM appears to be an effective intervention for enhancing breast milk production and decreasing breast engorgement, breast pain, and anxiety levels in postpartum women.
VictoraCG, BahlR, BarrosAJD, et al.Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong impact. Lancet2016;387(10017):475–490; doi: 10.1016/S0140-6736(15)01024-7
2.
MeekJY, NobleL. Section on Breastfeeding. Policy statement: Breastfeeding and the use of human milk. Pediatrics2022;150(1):e2022057988; doi: 10.1542/peds.2022-057988
3.
HortaBL, VictoraCG. Long-term effects of breastfeeding: A systematic review. World Health Organization: Geneva; 2013.
4.
ArayiciS, DizdarEA, SimsekGK, et al.Relationship between birthweight for gestational age and colostrum macronutrient composition: A comparative analysis in small, appropriate, and large for gestational age infants. J Hum Lact2025;41(3):371–378; doi: 10.1177/08903344251342561
5.
StuebeAM, SchwarzEB. The risks and benefits of infant feeding practices for women and their children. J Perinatol2010;30(3):155–162; doi: 10.1038/jp.2009.107
6.
Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet2002;360(9328):187–195; doi: 10.1016/S0140-6736(02)09454-0
7.
World Health Organization. Global strategy for infant and young child feeding. World Health Organization: Geneva; 2003.
8.
McGuireTM. Drugs affecting milk supply during lactation. Aust Prescr2018;41(1):7–9; doi: 10.18773/austprescr.2018.002
9.
MunsittikulN, TantaobharseS, SiripattanapipongP, et al.Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: A randomized controlled trial. Int Breastfeed J2022;17(1):43; doi: 10.1186/s13006-022-00485-6
10.
DisakornS, SummartU, SongthamwatS, et al.Effects of the therapeutic breast massage on the milk ejection of postpartum mothers: A randomized controlled trial. KKUJPHR2024;17(2):1–10.
11.
FoxmanB, D’ArcyH, GillespieB, et al.Lactation mastitis: Occurrence and medical management among 945 breastfeeding women in the United States. Am J Epidemiol2002;155(2):103–114; doi: 10.1093/aje/155.2.103
12.
BerensP, EglashA, MalloyM, et al.ABM clinical protocol #26: Persistent pain with breastfeeding. Breastfeed Med2016;11(2):46–53; doi: 10.1089/bfm.2016.29002.pjb
13.
HoffCE, MovvaN, VollmarAKR, et al.Impact of maternal anxiety on breastfeeding outcomes: A systematic review. Adv Nutr2019;10(5):816–826; doi: 10.1093/advances/nmy132
14.
AhnS, KimJ, ChoJ. Effects of breast massage on breast pain, breast-milk sodium, and newborn suckling in early postpartum mothers. J Korean Acad Nurs2011;41(4):451–459; doi: 10.4040/jkan.2011.41.4.451
15.
WittAM, BolmanM, KreditS, et al.Therapeutic breast massage in lactation for the management of engorgement, plugged ducts, and mastitis. J Hum Lact2016;32(1):123–131; doi: 10.1177/0890334415619439
16.
ZhengJJ, ZhaoY, LuP, et al.Effect of Tuina at breast on postpartum lactation. World J Acupunct-Mox2012;22(4):5–8; doi: 10.1016/S1003-5257(13)60019-7
17.
RahayuningsihT, MudigdoA, MurtiB. Effect of breast care and oxytocin massage on breast milk production: A study in Sukoharjo Provincial Hospital. JMCH2016;1(2):101–109; doi: 10.26911/thejmch.2016.01.02.05
18.
SariLP, SalimoH, BudihastutiUR. Optimizing the combination of oxytocin massage and hypnobreastfeeding for breast milk production among postpartum mothers. JMCH2017;1(1):20–29; doi: 10.26911/thejmch.2017.02.01.03
19.
LuP, YeZ-Q, QiuJ, et al.Acupoint-tuina therapy promotes lactation in postpartum women with insufficient milk production who underwent caesarean sections. Medicine (Baltimore)2019;98(35):e16456; doi: 10.1097/MD.0000000000016456
20.
ShengJ, DingY, WangJ, et al.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 Complement Alternat Med2021;2021:1–10; doi: 10.1155/2021/5979810
21.
KhoonphetC, ChunuanS, PhumdoungS. Effects of Southern Thai Traditional Massage with warm compression on lactation and breast engorgement: A randomized controlled trial. Pacific Rim Int J Nurs Res2022;26(3):390–403.
22.
DagYS, YayanEH. The effect of circular and oscillating breast massage on the amount of breast milk produced: An innovative method. Breastfeed Med2022;17(7):593–598; doi: 10.1089/bfm.2021.0071
23.
SeptianingrumY, HatmantiNM, FitriasariA, et al.The effectiveness of hypnobreastfeeding massage on anxiety and breast milk production in postpartum mothers. Gac Méd Caracas2022;130(Supl 1):S299–S307; doi: 10.47307/GMC.2022.130.s1.48
24.
AndersonL. The feasibility of early expression and breast massage to support breastfeeding mothers of preterm infants: A mixed methods study [Doctoral dissertation, School of Nursing, Midwifery and Social Work]. The University of Queensland: Queensland; 2023. doi: 10.14264/1c504b1
25.
ChoiW-R, KimY-S, KimJ-R, et al.A randomized controlled trial of pectoralis major myofascial release massage for breastfeeding mothers: Breast pain, engorgement, and newborns’ breast milk intake and sleeping patterns. Korean J Women Health Nurs2023;29(1):66–75; doi: 10.4069/kjwhn.2023.03.15
26.
SritasS, KositamongkolS, NukawS, et al.Evaluating the safety and efficacy of manual lymphatic drainage with Thai traditional massage on breast milk volume, breast pain and engorgement in post-cesarean mothers of preterm infants: A randomized controlled trial. TOPHJ2023;16(1):e187494452309192; doi: 10.2174/0118749445267207230919070638
27.
ErciyasSK, KavlakO. The effect of back and breast massage on the amount of milk and anxiety level of mothers with preterm birth: A randomized controlled study. J Neonatal Nurs2024;30(3):251–257; doi: 10.1016/j.jnn.2023.10.003
28.
MollaahmetogluSE, GuvencG. The effect of breast massage and warm compress application on milk production and anxiety in mothers with premature newborn: A randomized controlled trial. Breastfeed Med2025;20(6):416–423; doi: 10.1089/bfm.2024.0382
29.
HigginsJPT, ThomasJ, ChandlerJ, et al.Cochrane Handbook for systematic reviews of interventions version 6.0 (updated August 2019). Cochrane; 2019. Available from: www.training.cochrane.org/handbook [Last accessed: July15, 2025].
30.
PageMJ, McKenzieJE, BossuytPM, et al.The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ2021;372(372):n71; doi: 10.1136/bmj.n71
31.
HarrisonH, GriffinSJ, KuhnI, et al.Software tools to support title and abstract screening for systematic reviews in healthcare: An evaluation. BMC Med Res Methodol2020;20(1):7; doi: 10.1186/s12874-020-0897-3
32.
JadadAR, MooreA, CarrollD, et al.Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials1996;17(1):1–12; doi: 10.1016/0197-2456(95)00134-4
33.
HigginsJP, AltmanDG, GotzschePC, et al.The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ2011;343:d5928; doi: 10.1136/bmj.d5928
34.
HigginsJP, ThompsonSG, DeeksJJ, et al.Measuring inconsistency in meta-analyses. BMJ2003;327(7414):557–560; doi: 10.1136/bmj.327.7414.557
35.
EggerM, SmithGD, SchneiderM, et al.Bias in meta-analysis detected by a simple, graphical test. BMJ1997;315(7109):629–634; doi: 10.1136/bmj.315.7109.629
36.
PetersJL, SuttonAJ, JonesDR, et al.Comparison of two methods to detect publication bias in meta-analysis. JAMA2006;295(6):676–680; doi: 10.1001/jama.295.6.676
37.
HeberleABS, MouraMAM, SouzaMA, et al.Assessment of techniques of massage and pumping in the treatment of breast engorgement by thermography. Rev Lat Am Enfermagem2014;22(2):277–285; doi: 10.1590/0104-1169.3238.2413
38.
MengS, DengQ, FengC, et al.Effects of massage treatment combined with topical cactus and aloe on puerperal milk stasis. Breast Dis2015;35(3):173–178; doi: 10.3233/BD-150401
39.
RajuL, ThomasS, RaoS. Effectiveness of breast massage on lactation among immediate postnatal mothers- A randomized controlled trial. RGUHS J Nurs Sci2018;8(1):12–17; doi: 10.26715/rjns.8_1_2
40.
Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition during lactation. National Academies Press (US): Washington; 1991. doi: 10.17226/1577
41.
WilsonE, WooddSL, BenovaL. Incidence of and risk factors for lactational mastitis: A systematic review. J Hum Lact2020;36(4):673–686; doi: 10.1177/0890334420907898
42.
Ke-SapanK, LapolJ, KetkaewC, et al.Breast massage and breast compression to stimulate milk flow in postpartum mothers: A systematic review. J Res Innov Evid Based Healthc2022;1(2):1–14.
43.
AndersonL, KynochK, KildeaS, et al.Effectiveness of breast massage for the treatment of women with breastfeeding problems: A systematic review. JBI Database System Rev Implement Rep2019;17(8):1668–1694; doi: 10.11124/JBISRIR-2017-003932
44.
NuampaS, PayakkaraungS. Effectiveness of different massage techniques for breastfeeding mothers to increase milk production: A systematic review. Pacific Rim Int J Nurs Res2021;25(1):114–130.
45.
KabirN, TasnimS. Oketani lactation management: A new method to augment breast milk. J Bangladesh Coll Phys2010;27(3):155–159; doi: 10.3329/jbcps.v27i3.4293
46.
NuampaS, TangsuksanP, JitimaV, et al.Breast massage for breastfeeding promotion and problem solving: Evidence-based nursing practice: Evidence-based nursing practice. Nurs Sci J Thail2020;38(3):4–21.
47.
CottermanKJ. Reverse pressure softening: A simple tool to prepare areola for easier latching during engorgement. J Hum Lact2004;20(2):227–237; doi: 10.1177/0890334404264224
48.
ZhaoC, TangR, WangJ, et al.Six-step recanalization manual therapy: A novel method for treating plugged ducts in lactating women. J Hum Lact2014;30(3):324–330; doi: 10.1177/08903344145323
49.
KernermanE, ParkE. Severe breast pain resolved with pectoral muscle massage. J Hum Lact2014;30(3):287–291; doi: 10.1177/0890334414535842
50.
DimitrakiM, TsikourasP, ManavB, et al.Evaluation of the effect of natural and emotional stress of labor on lactation and breast-feeding. Arch Gynecol Obstet2016;293(2):317–328; doi: 10.1007/s00404-015-3783-1
51.
GiuglianiERJ. Problemas comuns na lactação e seu manejo. J Pediatr2004;80(5):147–154.
52.
BrookOR, GuralnikL, KeidarZ, et al.Pitfalls of the lactating breast on computed tomography. J Comput Assist Tomogr2004;28(5):647–649; doi: 10.1097/01.rct.0000126818.57759.66
53.
DahroA. Psikologi kebidanan; ana-lisis perilaku wanita untuk kesehatan. Jakarta: Salemba medika; 2011.
54.
ChristianLM. Psychoneuroimmunology in pregnancy: Immune pathways linking stress with maternal health, adverse birth outcomes, and fetal development. Neurosci Biobehav Rev2012;36(1):350–361; doi: 10.1016/j.neubiorev.2011.07.005
55.
AdedinsewoDA, FlemingAS, SteinerM, et al.Maternal anxiety and breastfeeding: Findings from the MAVAN (Maternal Adversity, Vulnerability and Neurodevelopment) study. J Hum Lact2014;30(1):102–109; doi: 10.1177/0890334413504244
DixonL, SkinnerJ, FoureurM. The emotional and hormonal pathways of labour and birth: Integrating mind, body and behavior. nzcomjnl2013;48:15–23; doi: 10.12784/nzcomjnl48.2013.3.15-23
58.
LindgrenL. Emotional and physiological responses to touch massage. Arkitektkopia: Umeå; 2012.
59.
DouglasP. Does the Academy of Breastfeeding Medicine’s Clinical Protocol #36 ‘The Mastitis Spectrum’ promote overtreatment and risk worsened outcomes for breastfeeding families? Commentary. Int Breastfeed J2023;18(1):51; doi: 10.1186/s13006-023-00588-8
60.
EggerM, SmithGD. Meta-analysis bias in location and selection of studies. BMJ1998;316(7124):61–66; doi: 10.1136/bmj.316.7124.61
61.
RothsteinHR, SuttonAJ, BorensteinM. Publication bias in meta-analysis. In: Prevention, Assessment and Adjustments. (RothsteinHR, SuttonAJ, BorensteinM, eds.) John Wiley & Sons, Chichester: UK; 2005; pp. 1–7.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
