Breastfeeding, Lactation, Postpartum Period
Conditions
Keywords
Acupressure, Postpartum, Exclusive breastfeeding, Breastfeeding continuation, Breastfeeding self-efficacy
Brief summary
This randomized controlled trial evaluates whether acupressure education provided to mothers within the first 48 hours postpartum improves exclusive breastfeeding rates at 6 months compared with standard postpartum care alone. Mothers in the intervention group will receive structured education on self-administered acupressure at selected points and will be encouraged to continue home-based practice, while the control group will receive standard breastfeeding support. Participants will be followed for 12 months to assess breastfeeding continuation, breastfeeding self-efficacy, breastfeeding quality, and breastfeeding-related outcomes.
Detailed description
Exclusive breastfeeding for the first 6 months and continued breastfeeding up to 12 months are strongly associated with improved maternal and infant health outcomes. Despite widespread implementation of Baby-Friendly Hospital Initiative practices, early postpartum challenges often compromise breastfeeding continuation. Scalable, low-cost, self-care-based interventions that enhance maternal confidence and perceived control may support sustained breastfeeding. This study is a two-arm, parallel-group, randomized controlled trial designed to assess the effectiveness of postpartum acupressure education as an adjunct to standard breastfeeding care. Eligible mothers will be randomized in a 1:1 ratio to either an acupressure education plus standard care group or a standard care-only group. Acupressure education will include face-to-face instruction, printed visual materials, and a short instructional video, focusing on the acupoints CV17 (Shanzhong), ST18 (Rugen), SI1 (Shaoze), ST36 (Zusanli), and SP6 (Sanyinjiao). The primary outcome is the rate of exclusive breastfeeding at 6 months postpartum, defined according to World Health Organization criteria. Secondary outcomes include any breastfeeding at 12 months, breastfeeding self-efficacy, breastfeeding quality, timing of complementary feeding introduction, breastfeeding-related adverse events, and maternal satisfaction. Analyses will be conducted using an intention-to-treat approach.
Interventions
OTHERPostpartum Acupressure Education Program
Structured education on self-administered acupressure provided within 48 hours postpartum, including face-to-face instruction, printed visual materials, and a short instructional video. Participants are instructed to apply acupressure at specified points twice daily at home according to the study protocol.
Sponsors
Nigde Omer Halisdemir University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors and the statistician will be blinded to group allocation.
Intervention model description
This is a two-arm, parallel-group randomized controlled trial with individual allocation in a 1:1 ratio. Participants are randomized within 48 hours postpartum to receive either postpartum acupressure education in addition to standard breastfeeding care or standard breastfeeding care alone. There is no crossover between study arms, and all participants are followed prospectively for 12 months after delivery. Outcome assessors and the statistician are blinded to group allocation.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18 to 45 years * Term singleton birth (≥37 weeks of gestation) * ≤48 hours postpartum at the time of enrollment * Intention to breastfeed * Ability to communicate in Turkish * Access to a smartphone for educational materials and follow-up reminders * Willingness to provide written informed consent
Exclusion criteria
* Contraindications to breastfeeding (e.g., infant galactosemia) * Severe neonatal condition preventing breastfeeding * Severe maternal medical or psychiatric condition interfering with breastfeeding * Current opioid, alcohol, or substance dependence * Multiple gestation pregnancy * Severe breast injury or condition within the first 72 hours postpartum preventing breastfeeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Exclusive breastfeeding rate at 6 months postpartum | At 6 months postpartum | Proportion of participants exclusively breastfeeding at 6 months postpartum, assessed by maternal self-report using 24-hour recall with additional validation questions, consistent with World Health Organization definitions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Any breastfeeding rate at 12 months postpartum | At 12 months postpartum | Proportion of participants providing any breast milk at 12 months postpartum. |
| Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) score | Baseline (≤48 hours postpartum), 1, 3, 6, and 12 months postpartum | Total score on the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The scale consists of 14 items rated on a 5-point Likert scale (1-5), yielding a total score ranging from 14 to 70, with higher scores indicating greater breastfeeding self-efficacy. |
| Breastfeeding quality score (LATCH) | Baseline (≤48 hours postpartum) and 1 month postpartum | Breastfeeding quality assessed using the LATCH breastfeeding assessment tool. The LATCH score consists of 5 components (Latch, Audible swallowing, Type of nipple, Comfort, Hold), each rated from 0 to 2, yielding a total score ranging from 0 to 10. Higher scores indicate better breastfeeding performance. |
| Maternal breastfeeding satisfaction score | 1 month, 3 months, 6 months, and 12 months postpartum | Maternal self-reported satisfaction with the breastfeeding experience, assessed using a single-item numeric rating scale ranging from 0 to 10, where higher scores indicate greater breastfeeding satisfaction. |
| Time to introduction of complementary feeding | From birth up to 12 months postpartum | Time from birth to first introduction of any food or liquid other than breast milk, as reported by the mother. |
| Bottle or pacifier use | 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months postpartum | Maternal report of any bottle feeding and/or pacifier use by the infant. |
| Breastfeeding-related adverse events | From baseline through 12 months postpartum | Incidence of mastitis, plugged ducts, and breastfeeding-related healthcare visits. |
Countries
Turkey (Türkiye)
Contacts
CONTACTPınar Erdoğan, Assoc. Prof.
Outcome results
None listed