Document Type : original article
Authors
1
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad¸Iran
2
School of Nursing and Midwifery,Mashhad University of Medical Sciences, Mashhad, Iran
3
Department of Complementary and Chinese Medicine, School of Persian and Complementary Medicine, Imam Reza Hospital Mashhad University of Medical Sciences, Mashhad¸Iran
4
Department of Pediatrics, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences¸ Mashhad¸Iran
5
5. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
6
Department of Urology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
7
faculty of medicine, TMS.C., Islamic Azad University, Tehran, Iran.
10.22038/jpp.2026.95086.5636
Abstract
Background: Mother milk is the ideal nutrition preterm infants. However, owing to the poor development of swallowing reflexes and sucking in preterm infants, milk production decreases.
Methods: In this clinical trial, 70 mothers of preterm infants (30–34 weeks gestation) at Ghaem Hospital, Mashhad, were randomly assigned to Jacobson’s progressive muscle relaxation (n=35) or foot reflexology intervention (n=35). Milk volume was quantitatively measured on days 1, 3, and 9, one and two hours after each intervention session, using an electric breast pump and graduated cup. Breastfeeding adequacy was assessed using a validated 14-item Persian questionnaire administered before the intervention and 21 days afterward during infant follow-up visits. The questionnaire’s content validity was confirmed by experts, and its reliability demonstrated through test-retest (r=0.81r=0.81r=0.81) and Cronbach’s alpha (0.89). Statistical analysis included independent t-tests and repeated measures ANOVA to compare group differences over time.
Results: The mean maternal age was 26.5 ± 0.99 years in the Jacobson’s relaxation group and 27.1 ± 0.94 years in the reflexology group (P = 0.488). No significant differences were observed between groups regarding type of delivery or neonatal gender (P > 0.05). Breastfeeding adequacy improved significantly within both groups after the intervention (P < 0.001), although the between group difference was not statistically significant (P = 0.306). Milk volume increased significantly after the intervention on the first, third, and ninth days (P < 0.001).
Conclusion: Both Jacobson's progressive muscle relaxation and foot reflexology had equal effectiveness on milk volume. Jacobson's progressive muscle relaxation and foot reflexology as non-pharmacologic methods for increasing breastfeeding adequacy and milk volume increased milk volume of mothers with preterm infants.
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