Add-on Effectiveness of EA or TENS in Early Postpartum Breast Engorgement

Comparing the add-on Effectiveness of Electro-acupuncture or Transcutaneous Electrical Nerve Stimulation in Early Postpartum Breast Engorgement: A Pilot Randomized Pragmatic Trial

A total of 36 volunteers of postpartum women within 7 days with significant breast engorgement, will be recruited in China Medical University Hospital, Taichung, Taiwan. The participants will be randomly assigned into 3 groups, each of 12 people, namely, routine care group, routine care plus electrical-acupuncture experiment group, and routine care plus transcutaneous electrical nerve stimulation group.

Participants will receive once a day, three consecutive days of interventions in each group, including identical routine care. On each visit, severity index (SI) subject to the extent of erythema, tension and pain over breast will be assessed. Questionnaires of Breastfeeding Self-Efficacy Scale (BSES-SF) and of Edinburgh postnatal depression scale (EPDS) will be performed. Heart-rate variability was evaluated and recorded via a real-time handheld HRV device. Oxycontin, Cortisol, sodium and potassium levels in breastmilk will be tested . A telephone follow-up will be performed in 30 days after completion of treatment, and the data will be collected and analyzed.

Inclusion Criteria:

• Gestational age > 37 wk
• Delivery of singleton, healthy newborn baby
• Within 7 days postpartum
• Within 24 hours from initial painful breast engorgement
• Difficulty on lactation due to plugged ducts, SI index ≧ 5 (0-19)

Exclusion Criteria:

• Fever>37.5∘C
• Mastitis or breast abscess
• Signs of sepsis or other infection
• Perinatal mother and infant diseases (Gestational hypertension、Gestational Diabetes Mellitus、Pre-eclampsia 、Gestational thyroid diseases or Intrauterine growth retardation)
• Psychological diseases
• Bleeding tendency
• Artificial valves
• Pacemaker
• Epilepsy
• Consciousness disturbance
• Skin infections
• Hepatitis B carrier
• Acquired Immune Deficiency Syndrome
• Breast tumors
• Breast Surgeries