Am J Perinatol
DOI: 10.1055/a-1787-7576
Original Article

A Randomized Control Trial of Meditation for Mothers Pumping Breastmilk for Preterm Infants

1   Department of Obstetrics and Gynecology, Washington University, Saint Louis, Missouri
Soumya Ramireddy
2   Saint Louis University School of Medicine, Saint Louis, Missouri
Sara Ficenec
3   Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
Carolyn Mank
4   Department of Obstetrics and Gynecology, Saint Louis University School of Medicine, Saint Louis, Missouri
5   Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, Missouri
6   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri-Kansas City, Children's Mercy Kansas City, Kansas City, Missouri
› Author Affiliations
Funding Financial support for this study was obtained through a Departmental Seed Grant through Saint Louis University School of Medicine Department of Obstetrics and Gynecology. Access to the Expectful meditation app, both for study procedure purposes, and as a 3-month subscription as a study incentive awarded to participants following completion of the study was provided by Expectful. The Expectful company had no role in the study design or analysis of data, or in decisions to submit our findings for publication. Expectful did provide data collection by electronic monitoring of the frequency of use of the app during the study period. The authors of this study have no financial involvement that could pose a potential conflict of interest in this study.


Objective Mothers of preterm infants face unique challenges in establishing milk supply. We hypothesized that daily meditation practice while pumping would increase milk volume.

Study Design This was a randomized control trial examining the effect of meditation on the breastmilk supply of women delivering preterm infants. The meditation group engaged in daily use of a mindfulness-focused meditation app in addition to routine lactation support. The primary outcome was mean breastmilk volume on the infant's nineth day of life. Secondary outcomes included use of lactation-promoting behaviors, continuation of breastfeeding, and measures of mental health and breastfeeding self-efficacy by validated questionnaires. In addition to the intention to treat analysis, a per protocol analysis examined the association of frequent meditation with these breastfeeding and mental health outcomes.

Results A total of 60 women were analyzed. Mean milk volume was 647.1 ± 467.8 mL in the meditation group and 514.9 ± 393.5 mL in the routine care group (p = 0.27). Median number of pumping sessions was 7 (interquartile range [IQR] 5–8) in the meditation group, compared to 6 (IQR 4–7) in the routine care group (p = 0.11). Other lactation-promoting behaviors, breastfeeding continuation, and questionnaire scores were similar.

Adjusting for confounders, we found an increase in breastmilk production of 223.2 mL (95% CI 98.8–347.5, p = 0.001) and in pumping episodes by 0.93 (95% CI 0.16–1.70, p = 0.020) associated with frequent meditation. Skin-to-skin contact was increased to 100% (p = 0.006) among women who meditated seven or more times. Adjusted odds of a clinically significant Edinburgh Postnatal Depression Scale score of >9 was 0.057 (95% CI 0.0014–0.711, p = 0.023) with frequent meditation.

Conclusion Breastmilk production was similar in mothers practicing meditation compared to those receiving routine lactation support. For women engaging in frequent mediation, there may be an effect in establishing breastmilk supply and reduction of depression symptoms.

Key Points

  • Breastmilk is not increased for neonatal intensive care unit (NICU) moms asked to engage in meditation.

  • Maternal mental health is not improved among NICU moms asked to meditate.

  • However, higher-frequency meditation is associated with increased milk volume and lower odds of high scores on depression screening.

Publication History

Received: 25 March 2021

Accepted: 18 February 2022

Accepted Manuscript online:
03 March 2022

Article published online:
24 May 2022

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