Is Phototherapy safe while breastfeeding?

Summary of use during breastfeeding

Laser therapy and phototherapy are considered acceptable during breastfeeding.[1,2] Phototherapy for psoriasis is also generally acceptable; however, nursing should be withheld for 24 hours after ingestion of an oral psoralen, such as methoxsalen.[2-4] Laser therapy was used in some Russian and Austrian studies to prevent and treat lactation mastitis and nipple fissures.[5-9] However, these studies are rather old and not well controlled. A more recent, well-controlled trial found that laser treatment of the nipples resulted in greater nipple pain relief than sham therapy.[10] Meta-analysis of 7 more recent studies found that diode laser light at various frequencies was effective in reducing pain in nipple trauma, defined as fissures, excoriations, cracks, abrasions, or erosions.[11] Some small studies have found that application of laser light to the breasts increases serum prolactin and milk production. Laser application to cesarean section wounds did not adversely affect serum prolactin.[12] A study from China indicated that high-intensity red light (630 nM) plus antibiotics were more effective than antibiotics alone in healing mastitis and preventing recurrence.[13] Laser light has also been used as part of a 5-step procedure to treat mastitis.[14]

Effects on the breastfed infant

Relevant published information was not found as of the revision date.

Effects on milk supply

Use of low-level laser therapy to enhance healing of the surgical incision following cesarean section was evaluated in a small, poorly controlled study. Laser light was applied for 15 minutes on 3 consecutive days postoperatively. On the third day, serum prolactin levels were not significantly different in the two groups. The treatment appeared to help wound healing.[12]

A small, randomized study compared primiparous mothers who were supplementing their infants with formula during the first month postpartum and who received either 12 sessions of low-level laser light to the breasts over 3 weeks (n = 20) or no treatment (n = 20). All mothers received similar counseling by a blinded physician certified in lactation counseling. The treated group had greater increases in serum prolactin, and breastmilk lactose, protein and fat at 3 weeks and 3 months after the start of therapy.[15]

A randomized study of women (n = 20 in each group) who were mixed feeding their infants in the first month postpartum compared 12 sessions of electroacupuncture or low-level laser therapy to the breast over 1 month and control women. All women also received oral domperidone 10 mg three times daily. Laser therapy increased serum prolactin, infant weight and maternal perception of milk production more than domperidone alone, but less than electroacupuncture.[16]

A controlled study in Egypt in breastfeeding women with nipple pain and fissures at 1 to2 weeks after delivery compared photobiomodulation to a topical cream. Photobiomodulation consisted of 12 sessions of low-level laser treatment, and the topical cream contained tocopherol, panthenol, almond oil, paraffin oil, petrolatum, and olive oil applied after each feed. The group that received the photobiomodulation had lower values on the visual analogue pain scale and greater infant weight gain at the second, third and fourth week of therapy.[17]