Do Phuc Nhu Nguyen, Nguyen Lam Vuong, Kenji Hirayama, Gehad Mohamed Tawfik, Muhammed Khaled, Nguyen Tien Huy, Kaipeng Liu, Le Van Thanh, Yifan Liang, Pham Diep Thuy Duong, Marwa Ibrahim Mohammed Mansour, and Mohammed Abdelrahman
Background Neonatal jaundice is a common health problem which is expected to be seen in 60–80% of healthy newborns, with 10% occurrence of hyperbilirubinemia in neonates during first week of life. Massage therapy has been practiced for centuries to gain health benefits in infants. We aimed to evaluate effectiveness of various types of infant massage in reduction of neonatal jaundice and the need for phototherapy (PT). Methods On 26 March 2016, we conducted electronic search term in nine databases, with inclusion of randomized controlled trials (RCTs) that investigated newborn babies receiving massage therapy with documented total bilirubin before and after the treatment. Study protocol was registered on PROSPERO, CRD42016049025. Quality assessment was performed using Cochrane risk of bias tool. Frequentist network meta-analysis (NMA) and meta-analysis (MA) were used to compare all outcomes by each day of follow-up. Results With 363 studies initially identified, 32 were eligible for qualitative analysis and 29 for quantitative analysis. For neonates requiring PT, our NMA results showed that in 3rd day of life, massage and phototherapy (MP) was significantly the most effective in reduction of serum bilirubin level, while acupressure massage and phototherapy (AMP) was the least compared to by phototherapy only (P), with MD, 95%CI (-1.16 [-1.61; -0.72], 1.28 [0.79; 1.77] respectively). In 14th day of life, bilirubin level decreased the most in massage with enema and phototherapy (MEP), while MP has no significant difference compared to P. Our MA results in 4th day of life, indicated that MP had a significant decrease in bilirubin level compared with P, with MD 95%CI (-2.23 [-3.43; -1.03]). In summary comparison with P, MP was the most in decreasing bilirubin level in most of days, with the biggest decrease being in 4th day, while MEP was significantly the most in 14th day. For neonates not requiring PT, our NMA showed a significant decrease in bilirubin level with massage and bathing, acupressure massage, and massage 3–4 times/days (M2) groups in 3rd day of life, and with massage 1–2 times/days (M1) and M2 groups in 4th day. MEP group had a significantly longer duration of PT compared with P, with MD 95%CI (29.09 [9.76; 48.41]). M1 and M2 did not have a significant effect on the requirement for PT. Conclusion Massage therapy could be an effective adjuvant to PT in order to reduce the PT duration. However, it did not reduce the requirement for PT.