The effect of music on breast milk volume in mothers of neonates admitted to the neonatal intensive care unit: a systematic review and meta-analysis

Abstract Background Mothers of neonates admitted to the neonatal intensive care unit typically experience higher levels of anxiety and stress due to early separation from their infant, the critical condition of the neonate, psychological stressors, and dependence on mechanical breast pumping. Music therapy, as a safe, low-cost, and non-invasive intervention, has considerable potential to reduce stress and improve lactation-related physiological responses. Methods This systematic review and meta-analysis was registered with PROSPERO under registration code https://www.crd.york.ac.uk/PROSPERO/view/CRD420261327864 and followed the PRISMA 2020 guideline. The search covered studies published between January 2006 and February 2026. Databases including Medline (PubMed), Web of Science, Scopus, Cochrane CENTRAL, Embase, CINAHL and Google Scholar were searched using MeSH keywords to identify clinical trials examining the effect of music on breast milk volume in neonates admitted to the neonatal intensive care unit. Risk of bias was assessed using the Cochrane RoB 2 tool (and its crossover extension for non-parallel designs). Standard mean difference (SMD) was extracted in milk volume (mL) in end point of intervention per trial. Certainty of evidence was assessed using GRADE. Results In this study, 87 articles entered the screening and selection phase, following the main steps of a systematic review process; 15 articles were assessed based on inclusion and exclusion criteria. Nine articles did not meet the required criteria, and 6 articles were analyzed using CMA2 software. Based on the combination of six studies ( N = 459 Participants), the pooled standard mean difference in breast milk volume was [SMD = 1.02 (0.42–1.6, p < 0.001) (95% CI), indicating that the intervention had a statistically significant effect compared to the control group. Discussion The findings of the present study showed that a music-based intervention for mothers of neonates admitted to the NICU led to a significant increase in breast milk volume. One finding of this study was the potential role of intervention dose, type of music, and Co-intervention. Therefore, using studies that standardize the type of music and duration of intervention can help reduce study heterogeneity and increase effectiveness. Given the intervention’s high safety and low cost, policymakers and clinical administrators should explore integrating it into lactation support programs.