Introduction: Breastfeeding is an important tool for reducing infant mortality in developing countries like India. The  present  study  was  an  attempt  at  identifying  the effectiveness of a simple, easily  adaptable and public health  system  friendly  methods apart from conventionally used methods to promote lactation among postpartum mothers. In India, back massage had been practised in many cultures/societies to promote/sustain breastfeeding.

Methods: A case control study was performed at postnatal ward of a tertiary level hospital, with aiming to study the effect of back massage on lactation among postnatal mothers. During the study total 100 mothers of postnatal wards were included which were randomly divided into two groups: group A (N=50)–mothers who has received back massage in first three postnatal days and group B (N=50) -mothers who had not received back massage. The study was carried out in mothers of  healthy full term appropriate for gestational age neonates which were born to primi mothers without medical illness or breast abnormalities, vaginally delivered and had normal feeding reflexes. The massage was started on mothers and its effect on various parameters like post feed weight gain, sleep duration, number of urine and stools passed per day etc were assessed.

Results: There was significantly higher mean post feed weight gain, mean number of urine and stool passed per day and mean duration of sleep in back massage group than control group.

Conclusion: The back massage is effective in improving the lactation among postnatal mother. Back massage is specifically can be used in postnatal mothers who are facing the problems in initiating and sustaining breastfeeding

Keywords: Back massage, Lactation, Breast milk, letdown reflex, lactation failure, postnatal mothers, exclusive breastfeeding.

1. KhanalTika Bhawani, Angeline et al, Effect of Back Massage on Lactation Among Postnatal Mothers in Postnatal Ward of Selected Hospital, Mangaluru. IJAR, Volume : 6 | Issue : 11 | November 2016 | ISSN - 2249-555X | IF : 3.919 | IC Value : 74.50
2. Grajeda R, Pérez-Escamilla R. Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women. J Nutr. 2002 Oct;132(10):3055-60.
3. Ueda T, Yokoyama Y, Irahara M, Aono T. Influence of psychological stress on suckling-induced pulsatile oxytocin release. Obstet Gynecol. 1994 Aug; 84 (2):259-62.
4. Ruvalcaba RH. Stress-induced cessation of lactation. West J Med. 1987 Feb;146 (2):228-30. 5. Mathur GP, Chitranshi S, Mathur S, Singh SB, Bhalla M. Lactation failure. Indian Pediatr. 1992 Dec;29(12):1541-4.
5. Dewey KG. Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr. 2001 Nov;131(11):3012S-5S.
6. Sakha, A.G.G. Behbahan. The onset Time of Lactation after Delivery. Medical Journal of The Islamic Republic of Iran. 2005; 19(2):135-39.
7. Wang HC, An JM, Han Y, Huang LN, Zhao JW, Wei LX, Dong L, Zhai GR, Li XP, Yang AJ, Gu M. [Multicentral randomized controlled studies on acupuncture at Shaoze (SI 1) for treatment of postpartum hypolactation]. Zhongguo Zhen Jiu. 2007 Feb;27(2):85-8.
8. Lu P, Qiu J, Yao F, Zheng JJ. [Effect of acupoint Tuina on lactation amount for parturient]. Zhongguo Zhen Jiu. 2010 Sep;30(9):731-3
9. Nommsen-Rivers LA1, Heinig MJ, Cohen RJ, Dewey KG. Newborn wet and soiled diaper counts and timing of onset of lactation as indicators of breastfeeding inadequacy. J Hum Lact. 2008 Feb;24 (1): 27-33. doi: 10.1177/0890334407311538.
10. Patel U, Gedam DS, Verma M, effect of back massage on lactation among postnatal mothers. Int J Med Res Rev 2013;1(1):05-11
11. National Family Health. Survey (NFHS-4). 2015-16. Ministry of Health and family walfare. Available online at: www.nhm.gov.in>schemes>maa. Accessed on 27/09/2020
12. Jogdeo B, BhoreN,et al, The Effect of Back Massage on Breast Feeding among Neonates who’s Mothers Had Undergone Cesarean Section, International Journal of Science and Research (IJSR) ISSN (Online): Volume 5 Issue 4, April 2016 ,2319-7064 Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
13. Widiastuti NMR et al, 2019, Improved breastfeeding with back massage among postnatal mothers ,* International Journal of Research in Medical Sciences. Int J Res Med Sci. 2020 Feb;8(2):580-583.

Dr Aditya Kushwah

Resident doctor Department of Paediatrics