Acupoint stimulation for postpartum breastfeeding insufficiency: a systematic review and meta-analysis

Table 3 GRADE profile for postpartum breastfeeding insufficiency

Certainty assessment						Summary of findings
Outcome	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	No. of participants (no. of studies)	Effect		Certainty
Outcome	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	Intervention: comparison	Relative (95% CI)	Absolute (95% CI)	Certainty
Volume of milk production	Very serious^a	Serious^c	Not serious	Not serious^d	Not detected^g	749:750 (20 studies	-	MD 81.30 ml (58.94–103.67)	⨁⨁◯◯ Low
Prolactin level	Serious^b	Serious^c	Not serious	Not serious^d	Suspected^h	549:526 (12 studies)	-	MD 1.33 ng/ml (0.81–1.85)	⨁⨁◯◯ Low
Colostrum time	Serious^b	Serious^c	Not serious	Serious^e	Not clearⁱ	304:272 (4 studies)		MD 7.26 h (10.69–3.83)	⨁◯◯◯ Very low
Colostrum time (in group)	Serious^b	Serious^c	Not serious	Serious^f	Not clearⁱ	348:367 (4 studies)	RR 1.70 (1.38–2.08)	338 per 1000 (from 183 to 521)	⨁◯◯◯ Very low

CI, confidence interval; SMD, standardized mean difference; MD, mean difference; RR, risk ratios
Explanations:
^aAllocation bias, performance bias, and measurement bias were found in the studies
^bAllocation bias and performance bias were found in the studies
^cHeterogeneity was noticed in most studies
^dSample sizes more than 400 in each arm
^eRating down due to sample sizes less than 400 in each arm
^fConfidence interval did not include appreciable benefit (RR = 1.25). Rating down due to sample sizes less than 400 in each arm
^gEgger’s test showed p-value > 0.05
^hEgger’s test showed p-value < 0.05
ⁱThe number of included studies was relatively small to identify publication bias (< 10 studies)

ISSN: 2046-4053