Comparing the Effectiveness of Jacobson's Progressive Muscle Relaxation and Foot Reflexology on Adequacy of Breastfeeding and Milk Volume of Mothers with Preterm Infants

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 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.

Abstract

Background: Mother’s milk is the ideal nutrition for preterm infants. However, due to the underdevelopment of swallowing reflexes and sucking in preterm infants, milk intake often decreases.
Methods: In this clinical trial, 70 mothers of preterm infants (30–34 weeks of gestation) at Ghaem Hospital, Mashhad, were randomly assigned to either Jacobson’s progressive muscle relaxation (n=35) or foot reflexology intervention (n=35). Milk volume was quantitatively measured on days 1, 3, and 9, at one and two hours after each intervention session, using an electric breast pump and a 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 was demonstrated through test-retest (r=0.81) and Cronbach’s alpha (0.89). Group differences over time were evaluated using independent samples t-tests along with repeated measures analysis of variance (ANOVA).
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 the groups regarding the type of delivery or neonatal gender (P > 0.05). Breastfeeding adequacy improved significantly within both groups after the intervention (P < 0.001), although the difference between groups 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 were equally effective in increasing milk volume. These relaxation and foot reflexology as non-pharmacologic methods enhanced breastfeeding adequacy and milk production in mothers of preterm infants.

Keywords

References

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Journal of Pediatric Perspectives
Volume 14, Issue 4
April 2026
Pages 20040-20050

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