The physiological effects of massage before breast pumping on blood flow, temperature, and tension – A pilot study

Abstract Aim: To test the feasibility of our ultrasound protocol in evaluating the physiological changes during breast milk expression, and the impact of breast massage on temperature, blood flow and tension.Method: Breast massage was used for the right breast, and the left breast had no massage. Temperature was measured at baseline, post massage (for right breast), and post pump. The ultrasound scans were performed using a Toshiba Aplio 500 system (Toshiba Medical Systems, Otawara, Japan). B-mode, doppler ultrasound and shear wave elastography (SWE) were used. Blood flow of the IMA and LTA were measured at baseline, post massage (for right breast), 10 minutes into pump (relaxation and tension phase), and post pump. SWE was used to measure breast tension during the tension and relaxation phase of breast pump, after the breast milk was completely drained.Results: There was a slight decrease in breast temperature post massage, and further decreased post pump. With breast massage, the SWE values were higher at relaxation phase compared to no massage (left breast). However, with massage, the tension phase also showed less increase of SWE values compared to no massage, and appeared to be lower than no massage. Blood flow of IMA did not appear to follow a particular trend, with and without massage. Conclusion: Breast massage prior to pumping breast milk helped to reduce the temperature of the breast, showing that it has an effect in relieving breast engorgement. Massage also reduced the tension of the breast during the pump tension (suction) phase. There was no observable trend of massage on blood flow in both the IMQ and LTA.