Effectiveness of non-pharmacological traditional Chinese medicine therapies in promoting human milk feeding outcomes: a systematic review and network meta-analysis

Suboptimal human milk feeding outcomes remain a significant public health concern worldwide. In recent years, non-pharmacological traditional Chinese medicine therapies have been increasingly explored as complementary strategies to conventional lactation support for improving human milk feeding outcomes. A systematic review and network meta-analysis of randomized controlled trials was conducted. PubMed, Embase, Cochrane Library, MEDLINE, CNKI, and Wanfang databases were searched from inception to 20 June 2025. Risk of bias was assessed using the Cochrane’ risk of bias tool 2.0. NMA was performed using STATA 18.0 to compare the effectiveness of different non-pharmacological traditional Chinese medicine therapies on exclusive breastfeeding rates, breast milk volume, time to lactogenesis II, and serum prolactin levels. A total of 33 randomized controlled trials involving 5710 participants were included. Network meta-analysis revealed that among the evaluated TCM interventions, massage + acupressure was the most effective in improving exclusive breastfeeding rates (surface under the cumulative ranking curve: 99.3%) and shortening time to lactogenesis II (surface under the cumulative ranking curve: 86.1%). For increasing breast milk volume (surface under the cumulative ranking curve: 96.3%) and elevating serum prolactin levels (surface under the cumulative ranking curve: 91%), acupuncture + auricular point sticking-pressing ranked highest. Additionally, standalone massage and acupressure demonstrated consistent beneficial effect across all outcomes, with surface under the cumulative ranking curve values ranging from 49.2% to 72.2%. Massage + acupressure and acupuncture + auricular point sticking-pressing emerged as the most effective non-pharmacological traditional Chinese medicine therapies for improving human milk feeding outcomes. Furthermore, massage and acupressure may serve as foundational therapies due to their consistent efficacy across multiple outcomes. These findings provide evidence-based guidance for clinical practice and underscore the potential role of non-pharmacological traditional Chinese medicine therapies as complementary approaches to conventional lactation support in enhancing human milk feeding outcomes.