Efetividade da laser acupuntura e laserterapia em lactantes com dor mamária: ensaio clínico randomizado

Abstract

Introduction Breastfeeding is fundamental for women and their children, and exclusive breastfeeding (EBF) is recommended by the Ministry of Health for up to 6 months. Breast pain is a common problem in the first days of the postpartum period and can contribute to early weaning. Laser Therapy and Laser Acupuncture, the latter promoted by the national policy of integrative and complementary practices, are among the new non-pharmacological options for breast pain care. However, there is still little evidence and experience in the use of these individual and associated practices. Goals To evaluate the effectiveness of laser therapy and laser acupuncture associated with breastfeeding counseling for breastfeeding women with breast pain, to reduce pain and support the maintenance of EBF. Methodology The research was divided into two stages. The first step consisted of carrying out a systematic review of the literature looking for evidence without time limits to identify clinical studies that involve Laser Therapy and Acupuncture in the outcome of reducing breast pain. The search was carried out in Pubmed, LILACS, IBECS and BDENF through the Virtual Health Library, and Scielo using descriptors guided by the Prisma methodology. The second stage was a randomized clinical trial carried out on 165 postpartum women in a reference maternity hospital for humanized care in Paraíba. The women were allocated to the Control Group (CG), 82, and the Intervention Group (IG), 83. The postpartum women in the CG received breastfeeding counseling in a service provided during their stay in the maternity ward. The women in the IG received the same guidelines as the CG associated with local laser therapy on the breasts and laser acupuncture. Results The research brought to light the evidence associated with Laser Therapy and Laser Acupuncture, being systematized in two articles. The first article is the systematic review that found three studies on laser therapy and five studies on acupuncture. The results of this systematic review found little evidence that acupuncture and the use of laser therapy can bring benefits to reducing breast pain and improving adherence to breastfeeding. The second article is about the clinical trial that identified that Laser Therapy and Laser Acupuncture is related to an improvement in average pain, with a greater effect in the intervention group. The number of women who improved from breast pain was 66.27% in the IG and 40.96% in the CG with a relative risk of 1.618 and a number needed to treat of 4. There were no differences between the groups in secondary outcomes. Final considerations Laser therapy and acupuncture have had good evidence in clinical trials in improving breastfeeding pain. The clinical trial found no differences in the improvement of breastfeeding, a result that disagrees with one of the studies in the systematic review, but with different methodology. It is recommended that these therapies can be incorporated into health services, due to the benefits already found, but new studies are needed to expand the evidence on the maintenance of breastfeeding and exclusive breastfeeding.