Postpartum Acupressure Education and Breastfeeding Outcomes

Effect of Postpartum Acupressure Education on Breastfeeding Outcomes: A 12-Month Randomized Controlled Trial

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.

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.

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