Is Reflexology safe while breastfeeding?

Summary of use during breastfeeding

Foot reflexology is a system of applying pressure to the feet at specific points on the feet that are supposed to reflect other areas and organs in the body. Studies have been single-blinded (only the mother), and the frequency of application has ranged from multiple times a day to once a week. The specific points that were stimulated and the endpoints of the studies also varied.

Given the above limitations, small studies have found that foot reflexology may increase the early milk volumes and possibly total protein and calcium in mothers of preterm infants. Studies in mothers with cesarean section deliveries found that it may increase infant weight gain and hasten the return to birth weight, increase breastfeeding efficacy, and improve lactation status. A meta-analysis of 3 studies found that foot reflexology had positive effects on the LATCH score, the visual analogue scale for breast tension, postpartum comfort, and breastfeeding satisfaction scores.

Effects on the breastfed infant

Relevant published information was not found as of the revision date.

Effects on milk supply

Nursing mothers who had not initiated breastfeeding and had premature infants aged 7 to 54 days and gestational age of 28 to 34 weeks, were randomly assigned into two groups (n = 37 in each). In both groups, foot massage was done once daily for seven days, 10 minutes for each foot including general massage of foot soles for the first 5 minutes. For the second 5 minutes, massage was for breast, pituitary and solar plexus related areas in the intervention group and for unrelated areas in the control group. A trained person did the massage on the first day, then taught the mothers to perform the massage. Outcomes were assessed in all mothers on days 1, 4 and 7 following intervention. The findings showed significantly greater increase in the amount of milk supply and lower formula intake by the infants in the reflexology group who received pressure on the breast-related points on the feet for 7 days compared with the control group who received pressure on unrelated points. Also, there was a lower increase in the formula volume intake in the first, fourth and seventh days in the intervention group compared with the control group. Scores of depression, stress and anxiety were not statistically different between the groups.[1]

Mothers undergoing cesarean section and having an infant with a gestational age of 29 to 36 weeks admitted to the NICU had reflexology performed on each foot for 20 minutes in the intervention group (n = 25). The control mothers had normal lactation training (n = 25). Milk volume extracted with an electric breast pump at 11 am each day was compared between the groups on a per-protocol basis. Mothers who received reflexology had greater milk volumes on day 1 through 5, but not on day 6 of the study.[2]

Eighty lactating mothers during the first to fifth days after delivery who had breast engorgement were divided into two groups of foot reflexology once a day for 3 days and routine care. The mean severity of pain after the intervention decreased in both reflexology and control groups, but significantly decreased to a greater extent in the reflexology group than in the control group.[3]

Sixty mothers who received a caesarean section were divided into two groups, 30 who received reflexology and 30 who received routine care. On the 4th day, more of the mothers in the reflexology group had adequate milk secretion compared to initial values.[4]

A randomized study was performed on mothers having a cesarean section. The participants were selected using convenience sampling, and then randomly allocated to three groups of foot reflexology, Benson relaxation, or control (n = 45 per group). For reflexology, the reflex points (pituitary gland, solar plexus, and uterine) were massaged for 10 minutes by applying constant or rotational pressure (20 minutes for both feet). The interventions were performed two hours post-operatively and six hours after the first intervention. The mean pain scores significantly decreased after the intervention in the reflexology and Benson relaxation groups in both the first and second interventions. The difference between the infants’ 10-day weight and birth weight was positive in the two intervention groups and negative in the control group. Also, the rate of return to the birth weight ten days postpartum was significantly greater in the two intervention groups than in the control group.[5]

A randomized trial compared postpartum women who received foot reflexology (n = 45) to routine care only (n = 45). The reflexology group received routine care application of pressure with the thumb and index finger using acupressure thumb on the big toe of each foot for 10 minutes each with a rest interval of 5 minutes in between each session. This was done twice a day for 3 consecutive days. There was statistically significant difference found on all the parameters of the infant breastfeeding assessment tool developed for the study among experimental group.[6]

A single-blind, randomized clinical trial was conducted on primiparous mothers whose premature infants up to 34 weeks were hospitalized in the neonatal intensive care unit. Mothers were randomized to reflexology (n = 37) or control (n = 37). Mothers in the intervention group received foot reflexology for 20 minutes (ten minutes per foot) for seven consecutive days every morning. It is unclear what, if any, intervention the control group received. On the first and seventh days of the study, groups were compared with respect to of milk volume, triglycerides, cholesterol, albumin, total protein, and calcium. Foot reflexology massage showed a trend towards increasing the volume of breastmilk, total protein and calcium, although it was not statistically significant.[7]

A single-blind study of primiparous women who gave birth by cesarean section compared those who received foot reflexology 40 minutes once a week (n = 40) to the control group (n = 40) assigned to rest for 40 minutes a week for 8 weeks. Pain scores in the reflexology group decreased by 91% in week 1, 90% in week 2, and 60% in week 3 compared to the control group. Pain resolved at week 4 in the reflexology group and week 7 in the control group. The reflexology group showed a 37% decrease in fatigue level, a 48% increase in energy level, a 71% increase in sleep quality, and a 20% increase in breastfeeding efficacy compared to the control group. These effects persisted to week 8 postpartum.[8]

A single-blind study in primiparous women giving birth by cesarean section randomly assigned women to receive foot reflexology (n = 40) or routine postnatal care (n = 40). Reflexology consisted of massage of the entire foot using thumb and finger techniques, giving hard but gentle pressure to specific reflex areas for 10 minutes twice daily for the first 3 days postpartum. On the 3rd day postpartum following six sessions of foot reflexology among the experimental group, the LATCH and VAS scales were administered to both groups. The experimental group showed a significant improvement in lactation status, with mean scores increasing from 4.73 to 8.68, compared to 4.28 to 6.75 in the control group. Post-intervention mean pain scores were lower in the experimental group (4.75) compared to the control group (7.65), that also achieved statistical significance.[9]

A meta-analysis was performed on 3 studies that examined the impact of foot reflexology on postpartum comfort and breastfeeding outcomes in postpartum women. Foot reflexology had positive effects on the LATCH score, the visual analogue scale for breast tension, postpartum comfort, and breastfeeding satisfaction scores.[10]

A single-blind, randomized study assigned primiparous mothers who underwent a cesarean section delivery to receive either foot reflexology (n = 40) or routine care only (n = 40). Reflexology was performed once a week for 8 weeks. The first session was performed in the hospital, and the other seven sessions at home. Each session lasted 40 minutes, 20 minutes for each foot. Pain, fatigue, sleep quality, and breastfeeding were assessed weekly for 8 weeks. Pain scores in the reflexology group decreased by 90.9% in week 1, 90.2% in week 2, and 59.8% in week 3 compared to the control group. Pain resolved at week 4 in the reflexology group and week 7 in the control group. The reflexology group showed a 36.9% decrease in fatigue level, a 48.0% increase in energy level, a 70.7% increase in sleep quality, and a 20.2% increase in breastfeeding efficacy compared to the control group.[11]

Levels in milk

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.