Effect of Reflexology on Pain, Fatigue, Sleep Quality, and Lactation in Postpartum Primiparous Women After Cesarean Delivery: A Randomized Controlled Trial

J Hum Lact. 2024 May;40(2):221-236. doi: 10.1177/08903344241232982. Epub 2024 Mar 1.


Background: Mothers commonly experience pain, fatigue, sleep disruption, and breastfeeding problems after cesarean delivery. To date, no follow-up study has examined all of these variables to evaluate the utility of reflexology in reducing these problems and supporting breastfeeding.

Research aim: This study aimed to determine the effect of foot reflexology performed in the postpartum period on pain, fatigue, sleep quality, and lactation in primiparous women who underwent cesarean delivery.

Methods: This is a two-arm, parallel-group randomized controlled trial. Data were collected between January 1, 2020, and January 31, 2021, with a sample of 80 women who were randomly assigned to the reflexology (n = 40) and control (n = 40) groups. The reflexology group received 40 minutes of foot reflexology once a week for 8 weeks. The primary outcomes of the study were pain, fatigue, sleep quality, and breastfeeding efficacy.

Results: Pain scores in the reflexology group decreased by 90.9% in week 1, 90.2% in week 2, and 59.8% in week 3 compared to the control group. Pain resolved at week 4 in the reflexology group and week 7 in the control group. The reflexology group showed a 36.9% decrease in fatigue level, a 48.0% increase in energy level, a 70.7% increase in sleep quality, and a 20.2% increase in breastfeeding efficacy compared to the control group (p < 0.05).

Conclusions: Foot reflexology reduces postpartum symptoms and positively affects breastfeeding and can be used safely in postnatal care practices.

Keywords: breastfeeding; cesarean section; lactation; postpartum care; reflexology.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Breast Feeding*
  • Fatigue / etiology
  • Female
  • Humans
  • Lactation
  • Massage
  • Musculoskeletal Manipulations*
  • Pain / etiology
  • Postpartum Period
  • Pregnancy
  • Sleep Quality