Photobiomodulation as a promising approach in the management of nipple lesions during breastfeeding: a systematic review and meta-analysis of randomized clinical trials.

Nipple injuries are common and can cause intense pain, leading to early weaning in breastfeeding. This study investigates the efficacy of photobiomodulation therapy (PBM) in reducing pain and promoting the healing of nipple lesions in lactating women. The protocol of this study was registered in PROSPERO and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020). Electronic searches were conducted (PubMed/MEDLINE, Web of Science, Scopus, Embase, Cochrane Library and grey literature) until March-2024. The eligibility criteria were randomized clinical trials (RCTs). Meta-analysis was conducted using R software with the "META" package. The Odds Ratio (OR) effect measurement was calculated, and a fixed-effect model was applied with a confidence interval of 95%. The Cochrane collaboration tool was used to assess the risk of bias, and the GRADE approach was used to assess the quality of evidence. A total of 924 records were screened, and 7 studies meeting the criteria were included in this review. The findings indicated a notable decrease in breastfeeding-related pain, along with expedited healing of nipple injuries and improvement in quality of life among participants receiving PBM compared with control group. In addition, a meta-analysis confirmed less sucking pain for the PBM group OR 0.43 ([95% CI - 0.23 to 0.79]; p = 0.001). Most studies had a low risk of bias, and the certainty of evidence was classified as low. The results suggest that PBM may be a promising therapeutic approach to reduce pain and improve the healing of nipple lesions. However, more robust, and methodologically standardized randomized clinical trials are needed to confirm and elucidate these results.