Effectiveness of Breast Massage on Enhancing Breast Milk Production in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Objectives:

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.