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The postpartum period is a critical time marked by significant physiological and psychosocial changes that can affect sleep, emotional well-being, and breastfeeding behaviors. Previous studies indicate that mode of delivery and sleep quality are closely associated with breastfeeding outcomes, with cesarean birth often linked to poorer sleep and lower breastfeeding success. Evidence also suggests that postpartum sleep disturbances are related to reduced breastfeeding self-efficacy, lower motivation, fatigue, depressive symptoms, and shorter breastfeeding duration.
However, the literature lacks studies that evaluate insomnia severity, breastfeeding motivation, and breastfeeding success simultaneously-particularly during the first 48 hours after birth. This analytical study aims to assess insomnia severity, breastfeeding motivation, and breastfeeding success (LATCH) within the first 48 postpartum hours and to examine the relationships among these variables. Findings are expected to support early postpartum clinical interventions to improve maternal and infant health outcomes.
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| Measure | Description | Time Frame |
|---|---|---|
| Breastfeeding Success (LATCH Score) | Breastfeeding success will be assessed using the LATCH Breastfeeding Assessment Tool, which evaluates five domains: latch, audible swallowing, type of nipple, maternal comfort (breast/nipple), and holding/positioning. Each item is scored from 0 to 2, with a total score ranging from 0 to 10. Higher scores indicate greater breastfeeding success. | Within the first 48 hours postpartum (one-time assessment at enrollment) |
| Insomnia Severity (Insomnia Severity Index, ISI) | Insomnia severity will be measured using the Insomnia Severity Index (ISI), a 7-item self-report questionnaire assessing difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, satisfaction with sleep, interference with daytime functioning, noticeability of impairment, and distress caused by sleep problems. Each item is scored from 0 to 4, yielding a total score of 0-28. Higher scores indicate more severe insomnia. | Within the first 48 hours postpartum (one-time assessment at enrollment) |
| Breastfeeding Motivation (Breastfeeding Motivation Scale Subscale Scores) | Breastfeeding motivation will be evaluated using the Breastfeeding Motivation Scale based on Self-Determination Theory. The scale includes 24 items rated on a 4-point Likert scale and provides scores for five subdomains: integrated regulation, intrinsic motivation/identified regulation, introjected regulation (social approval), introjected regulation (social pressure), and external regulation (secondary benefits). Subscale scores are calculated as the mean of items within each subdomain; higher scores indicate stronger motivation of that type. | Within the first 48 hours postpartum (one-time assessment at enrollment) |
| Maternal and Neonatal Characteristics (Descriptive Data Form) | Participant demographic, obstetric, delivery-related, neonatal, breastfeeding history, breastfeeding-related characteristics, and sleep habit information will be collected using a structured descriptive information form developed by the researchers based on the literature. |
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Inclusion Criteria:
Exclusion Criteria:
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The study population will consist of primiparous and multiparous women aged ≥18 years who have delivered a healthy term infant, whose newborn is not admitted to the NICU, and who initiated breastfeeding within the first 48 hours postpartum.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Güzin Ünlü Suvari, M.Sc. | Contact | +902165004429 | guzin.unlu@acibadem.edu.tr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Acibadem Health Group | Recruiting | Istanbul | Altunizade | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Altıparmak, S., & Yılmaz, A. N. (2021). The effect of birth type on breastfeeding success and insomnia severity in puerperant women. Samsun Sağlık Bilimleri Dergisi, 6(1), 119-127. | ||
| 38455339 | Background | Witkowska-Zimny M, Zhyvotovska A, Isakov R, Boiko DI, Nieradko-Iwanicka B. Maternal Sleeping Problems Before and After Childbirth - A Systematic Review. Int J Womens Health. 2024 Mar 2;16:345-371. doi: 10.2147/IJWH.S446490. eCollection 2024. | |
| 31294785 |
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Individual participant data (IPD) will not be publicly shared due to privacy concerns and the sensitive nature of maternal and infant health information. However, anonymized data may be made available upon reasonable request to the corresponding author after publication of the study results.
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| Within the first 48 hours postpartum (one-time assessment at enrollment) |
| Background |
| Khadka R, Hong SA, Chang YS. Prevalence and determinants of poor sleep quality and depression among postpartum women: a community-based study in Ramechhap district, Nepal. Int Health. 2020 Feb 12;12(2):125-131. doi: 10.1093/inthealth/ihz032. |
| 8176525 | Background | Jensen D, Wallace S, Kelsay P. LATCH: a breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs. 1994 Jan;23(1):27-32. doi: 10.1111/j.1552-6909.1994.tb01847.x. |
| Background | Boysan, M., Güleç, M., Besiroglu, L., & Kalafat, T. (2010). Uykusuzluk Siddeti Indeksi'nin Türk örneklemindeki psikometrik özellikleri. Anadolu Psikiyatri Dergisi, 11(3), 248. |
| 26372935 | Background | Kestler-Peleg M, Shamir-Dardikman M, Hermoni D, Ginzburg K. Breastfeeding motivation and Self-Determination Theory. Soc Sci Med. 2015 Nov;144:19-27. doi: 10.1016/j.socscimed.2015.09.006. Epub 2015 Sep 8. |
| 36110402 | Background | Ruan H, Zhang Y, Tang Q, Zhao X, Zhao X, Xiang Y, Geng W, Feng Y, Cai W. Sleep duration of lactating mothers and its relationship with feeding pattern, milk macronutrients and related serum factors: A combined longitudinal cohort and cross-sectional study. Front Nutr. 2022 Aug 30;9:973291. doi: 10.3389/fnut.2022.973291. eCollection 2022. |
| 40986135 | Background | Kayahan C, Ozturk CS. Antenatal and postnatal breastfeeding motivation and self-efficacy in primiparous women: a prospective observational study. Eur J Pediatr. 2025 Sep 23;184(10):631. doi: 10.1007/s00431-025-06481-2. |
| ID | Term |
|---|---|
| D001942 | Breast Feeding |
| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D001519 | Behavior |
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